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When a patient becomes a moving target

11 July 2014
As this case shows, it’s prudent when embarking on an extensive course of treatment to ensure the patient will still be around to see it through...

A middle-aged lady was the wife of the chief executive of a large multi-national business. They had lived for some years in South East Asia, where she had been receiving treatment from a dentist. Her mouth had been heavily restored with a significant number of fillings and root fillings.

While accompanying her husband on a brief business trip to the United States, a large restoration fractured in an upper molar tooth and she made an emergency appointment to see a local dentist.

While providing a temporary repair, the American dentist explained to her that there were a number of other heavily filled teeth in her mouth which were at risk of suffering the same problem. She asked the dentist to quote the likely cost of carrying out this treatment in the USA and she was astonished at the sums of money involved, which were much higher than the treatment costs she had come to expect in South East Asia.

Extensive reconstruction

Shortly before moving permanently to the USA, the lady decided to go ahead with an extensive reconstruction involving 21 units of crown and bridgework. Her dentist had actually suggested this work to her a few years earlier, but she had deferred this for various reasons. Time was short and this complex course of treatment was carried out under fierce constraints of time and availability.

The patient had paid a modest deposit, but eventually the time came for her to leave the country – before the treatment had been completed. The patient was still wearing a number of temporary crowns. She paid a further sum, which took into account the fact that treatment was not yet complete, but she failed to attend her final appointment on the day before she was due to fly out of the country, and a significant sum of money remained outstanding.

Lost temporaries

The patient lost several temporary crowns within weeks of arriving in the USA. She attended a prosthodontic specialist who was very critical of the work already carried out and of the tooth preparation where the temporary crowns had been lost.

At the patient’s request he produced an estimate for remedial treatment which amounted to six times the total cost originally quoted by the dentist in South East Asia.

The patient’s husband instructed a lawyer who demanded full reimbursement of all the payments made on account, the total cost of the remedial treatment in the USA and a sizeable further sum to reflect the patient’s pain, suffering and inconvenience. The total settlement exceeded the total lifetime contributions made by the practitioner involved.

Learning point:
When undertaking any lengthy or complex treatment, it is worth exploring the patient’s availability for appointments and any imminent travel plans.
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These case studies are based on real events and provided here as guidance. They do not constitute legal advice but are published to help members better understand how they might deal with certain situations. This is just one of the many benefits dental members enjoy as part of their subscription. 
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