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Good records are the best defence

14 July 2014
Tragic situations can arise where dentists are alleged to be to blame, such as in this case where only good record keeping saved the clinician a great deal of worry and stress...

A dentist was treating a medically compromised patient and needed to provide local anaesthesia to treat a carious lower molar. The patient had chronic heart failure but had successfully tolerated local anaesthetic without adrenaline on several previous occasions.

An inferior dental nerve block was administered using 2ml of Citanest plain (Prilocaine 4%). The treatment was completed uneventfully and the patient escorted home by his carer. Some eight hours later the patient collapsed and was taken by ambulance to the local Accident and Emergency Unit.

The examining physician diagnosed major coronary artery blockage, which he maintained was aggravated by the use of adrenaline normally found in local anaesthetic solution. Sadly the patient died later that evening and a few days later the dentist received a threatening letter from the patient’s son complaining that the local anaesthetic had been responsible for his father’s death.

Fortunately the dentist’s clinical records clearly indicated the type of local anaesthetic used and in response, Dental Protection was able to vigorously defend his actions. Furthermore, an expert opinion was obtained which clearly stated that the choice of local anaesthetic was appropriate in the circumstances and could not have contributed to the patient’s death.

Some weeks later, the dentist received an apologetic letter from the patient’s son, thanking him for the care and kindness shown to his late father!

Learning point:
Good records are the best defence for a clinician so it is wise to adopt the same diligent routine for every patient treatment to ensure you are protected even if a surprise outcome should arise.
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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 Protection members enjoy as part of their subscription. 
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