Sometimes, a tiny oversight in treatment planning and the consent process can lead to months of hardship, as this case illustrates...
A patient presented with a fracture of the porcelain facing of the premolar retainer of a three-unit fixed bridge replacing a missing upper first molar. The bridge had been constructed by the same dentist four-and-a-half years earlier and had apparently been successful up until that time.
The dentist agreed to replace the bridge if the patient would pay for the laboratory costs involved. Following the fitting of the new bridge, an account was sent to the patient in respect of the laboratory fees. No response was received and over a period of six months, increasingly strongly-worded demands for money were issued. Eventually, debt-collectors were instructed and with no positive result there either, a court summons was issued and served upon the patient.
As so often happens, it was at this point that the dentist heard again from the patient, this time from his lawyers, in the form of a counterclaim for negligence. This alleged that not only had the first bridge always been bulky in appearance and uncomfortable to the cheek and lips, but that the second bridge was no better.
Having paid for the original bridge, the patient argued that it was unreasonable to charge him again to remedy its deficiencies. It was at that point that the dentist contacted Dental Protection, which instructed its lawyers to defend the counterclaim.
In preparing the dentist’s witness statement, it became clear that his recollection of the patient’s agreement to pay the laboratory costs had, with the passing of time, become a little hazy. There was no written evidence of any estimate or signed agreement to pay the fees. In other words, it boiled down to the dentist’s word against the patient’s.
The clinical evidence of the first and second bridges had been destroyed. Similarly there was no written evidence to support the dentist’s claim for outstanding fees.
The dentist’s lawyers managed to negotiate an agreement with the patient’s lawyers that the claim for negligence would be discontinued if the claim for the outstanding laboratory fees were dropped. Both sides were to be responsible for their own legal costs.
A signed agreement from the patient to accept responsibility for the laboratory costs involved might have been sufficient in this case to have avoided the dispute and the subsequent substantial legal fees, not to mention the 18 months of stress and worry experienced by the dentist.