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Legal Risks

Causes of Malpractice Cases

  1. Most of the malpractices are outcomes of unexpected and/ or unrealistic expectations perceived by the patients. The following sequence of events often leads to a patient filing a malpractice case:
    • A dental problem occurs that may be unexpected but not unusual.
    • The patient is unhappy with the result.
    • The patient contacts the dentist for clarifications or solutions.
    • The patient is dissatisfied with the explanations given by the dentist.
  2. Another most common reason for patients filing a case is poor communication on the part of the dentist or the staff.
  3. Failure to diagnose or inform the patient of a specific clinical finding.
  4. Failure to diagnose and treat or refer the patient to a specialist.
  5. Failure to explain treatment options and the expected realistic treatment outcomes and or consequences.

Key points to remember in malpractice cases

  • Vicarious liability

    Clear lines of communication between all members of the dental team are required to establish individual areas of responsibility.

  • Seeking Consent

    It is important for the dentist to have the written consent of the patient. Prior to obtaining written consent, it is important for the dentist to explain the details of diagnosis and treatment plan, all possible treatment options, the procedure, the possible outcomes, possible complications, post operative care, the degree of the success of the treatment, all these aspects should be informed and recorded in a formal document to avoid any future disputes.

  • Record Keeping

    Dentists who do not keep adequate records are placed in an invidious position when a patient makes a claim about some aspect of care which has been provided and of which the dentist has little recollection.

    A prime example is when a patient changes dentist and is told that he or she requires extensive treatment, usually at significant cost. Naturally any patient would be concerned and feel antipathy towards the previous dentist. If the previous dentist has not kept records of the patient's condition when last attending or notes of refusal to undergo treatment recommended, then defending allegations could prove difficult.Should the matter progress to a claim for negligence resulting in a court appearance then the patient would be likely to be given credence over a practitioner whose notes were unable to support any recall of the events.

    If there is a lack of documentation that warnings had been given to the patient, in a dispute it becomes the patient's word against the dentist's and the patient will often have greater credibility.
  • Clinician’s Responsibility

    Ethical practice is no barrier to making a profit.

    The lines of communication with the patient may need to be improved to avoid any potential areas of conflict. If the diagnosis is inappropriate, it follows that the treatment provided will be similarly inappropriate.

    Clinicians are individually responsible for the standard of care that they provide irrespective of the ownership of the premises in which it is provided.

    It is difficult for any healthcare professional to deal with a non-compliant patient. It is easy in those circumstances to make incorrect assumptions about someone's ability to pay or their motivation for treatment. Such decisions are likely to be viewed by Courts of Law as unnecessarily paternalistic, thereby failing to take into account the views of the patient. It is always best to seek patient views on all occasions and to fully document them in the patient record.

  • Treatment Failure

    When considering the quality of dental care, assessment will vary from country to country, depending on:

    • local conditions.
    • attitudes to care.
    • the balance between traditional practice and evidence-based dentistry.
  • Appropriate Referral

    Inability of a dentist to diagnose and /or treat any patient must be followed by a referral to an specialist without much delay. Detailed information like, history of the patient, medications prescribed, treatment provided, problems encountered and other vital information must be passed on by the referring dentist to the referral doctor to avoid any clinical negligence claim.

  • Seeking Redress

    Time spent seeking consent to a referral is better than the time spent sorting out any misunderstandings later on.

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Indian Dental Association
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