Will I get sued?

[dentdent]

So basically on my first patient out in the real world for the first time - I'm starting a RCT and i perf the tooth. I wrote in the chart notes what happened but now I'm worried.. is there something specific that needs to be written in the chart notes to prevent a lawsuit? Can a lawsuit even be prevented in this type of situation?

Here's to a long road of sleepless nights 😕

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[bigbadaboom]

So basically on my first patient out in the real world for the first time - I'm starting a RCT and i perf the tooth. I wrote in the chart notes what happened but now I'm worried.. is there something specific that needs to be written in the chart notes to prevent a lawsuit? Can a lawsuit even be prevented in this type of situation?

Here's to a long road of sleepless nights 😕

It happens. "If you haven't perf'ed or broken a file, you haven't done enough endo." Not my words, but I believe it.

Document exactly what happened in the chart. Inform the patient what happened, and document in the chart that you did. Make the proper treatment plan, or referral to endo. Hopefully the tooth is still restorable. In the case the tooth is lost, I'd be OK to reimburse the patient the cost of implant personally. Patients also need to understand that despite our best effort to help them, poop happens.
Lawyers will want to get you for any reason. Whether it's a case or not is another issue. Contact your malpractice carrier if patient threatens to sue. Depending on the state, many will require a complaint to the state board first.

Better prepared you are the less likely you will see perforation again. Skills come with experience. Understanding the anatomy and familiarity with instruments are also very important in endodontics.

Don't look guilty in front of the patient, even if you are. Of course don't tell patient it's your first day on the job.


Good luck and don't lose sleep. Learn from your mistake and never make the same again.

 

[caffeinehigh]

So basically on my first patient out in the real world for the first time - I'm starting a RCT and i perf the tooth. I wrote in the chart notes what happened but now I'm worried.. is there something specific that needs to be written in the chart notes to prevent a lawsuit? Can a lawsuit even be prevented in this type of situation?

Here's to a long road of sleepless nights 😕

Quick referral is ideal.... The best time to repair a perf, is right when it happens.

 

[Dr. Dai Phan]

So basically on my first patient out in the real world for the first time - I'm starting a RCT and i perf the tooth. I wrote in the chart notes what happened but now I'm worried.. is there something specific that needs to be written in the chart notes to prevent a lawsuit? Can a lawsuit even be prevented in this type of situation?

Here's to a long road of sleepless nights 😕

Hey there,

Things like this happens and as long as you offer to replace the tooth that can't be saved, patients will not have any issue with it. Don't beat around the bush, make excuses, being defensive because if patient is mad, he/she will be prone to complain you to the state boards or sue you. Lawyers don't jump on this type of thing unless the error is gross (ie RCT without rubber dam and you drop a file in patient's throat, permanent nerve damage, endo on a wrong tooth, severely ruin the entire dentition with faulty restorations, etc...) because if there is little return financially, they are not going to take the case. Perforation on a tooth is common and there is not much for monetary gain. The lesson from this is ALWAYS inform patient of potential risks and complications through properly signed consent form. Take this from me: "patients don't sue you unless they don't like you". DP

 

[Dr. Dai Phan]

is there something specific that needs to be written in the chart notes to prevent a lawsuit?

Hi there,

There is nothing you can write in the chart to prevent a lawsuit because patients can sue you anytime for anything they want. However, there are things you can write in the chart that will aquitt you should the case goes to court. Like this " patient is advised the risk of perforation on the tooth due to limited access (or whatever) and wishes to proceed. Patient was offered to be referred to an endodontist but refused due to financial constraints and driving distance. Patient fully understands the risk associated with this procedure and elects to proceed". This will clear you of any wrong doing unless the perforation is out of ordinary. Of course this is just an example that may not be what happened in your case. DP

 

[jheidenr]

Did you have have them sign a written consent prior to treatment? Not a bad idea to do this routinely with your endo patients and discuss verbally potential complications, questions, etc. before starting the procedure.

 

[beannaithe]

Make sure you ALWAYS get a consent form signed, especially one where they have to initial next to every possible complication. Takes longer for them to sign, but it will cover your butt. Then ask them if they have any questions.

Perfs happen. We've all perf'd teeth and the saying is true, that you haven't done enough endo until you've perf'd a couple of teeth.

When discussing with the patient, just say "I'm having trouble finding the canals due to calcification, funky anatomy, etc so I really NEED to refer you to a specialist." Do not touch the handpiece anymore. If you've found a few canals, insturment them with a 10 file. Place CaOH, cotton pellet, and temp material. Take the tooth out of occlusion. Take radiograph. Give them referral and pain meds. I wouldn't charge them for anything at this visit. Call endodontist and tell them about perf and let them finish the endo.

Document everything. If the tooth is restorable, proceed with crown/build-up. If it's not restorable, offer to pay for implant directly to a surgeon or perio, then restore in the office at no cost. Patients are generally understanding that stuff happens, they just want you to make it right. Plus, if a patient tries to sue you after they've taken your services for free AND you paid for the implant, they're likely to get laughed out a courtroom. Just don't give your patient MONEY.