This overview of high-severity dental liability cases was originally printed in our First Quarter 2023 issue of The Scope: Dental Edition. Read more articles from the publication here.
Lawsuits brought alleging dental malpractice are often looking for recovery of costs in what MLMIC Insurance Company categorizes as “low-severity injuries” and generally follow dissatisfaction with prosthetic implants, crown applications and retained foreign bodies, which are often root canal files. In fact, these relatively low-value cases make up more than 75% of the lawsuits brought against our insured dentists.
Many of these low-severity cases are brought by the patient, without an attorney, in Small Claims Court, and are quickly resolved without discovery by negotiation, mediation or, ultimately, a non-jury trial. These Small Claims Courts cannot award compensation for pain and suffering. Awards are limited to a maximum of $5,000 in city courts, $3,000 in town and village courts and $10,000 in New York City courts. Most of these are adjudicated in favor of the dentist with no award to the patient.
A much smaller portion of the dental cases brought reach the threshold of “high severity,” which, according to the National Association of Insurance Commissioners’ (NAIC) definition, involve serious permanent disability or death. These cases are driven by the value or potential value of the injury alleged.
Generally speaking, the patient is represented by counsel, who brings the action to the New York State Supreme Court, which can award damages for pain and suffering and is not limited by any damage cap. Examples include a jaw fracture or nerve injury with allegations of malpractice often related to poor technique or failure to appreciate an existing condition and that can escalate through failure to diagnose and treat infection or cancer, resulting in extensive, expensive and disfiguring treatment, significant pain and suffering and, rarely, death.
It is the infrequent dental case that is resolved with an indemnity payment of $1 million or more. MLMIC Claims Specialists work to identify these injury allegations early, retain experts to assess compliance with or deviation from the standard of care, mitigate damages and create a strategy for resolution.
From a risk management perspective, MLMIC believes that there are lessons to learn from the most common small claim to the rarest and most severe losses. The difference between a good outcome and a poor one, between a healthy, satisfied patient and an expensive, time-consuming, anxiety-inducing lawsuit, is often the result of thorough documentation and effective patient communication, as well as timely and appropriate referral.
Over the next few months, we’ll share three high-severity dental case studies that involve some of these actionable points, with helpful legal analyses of the vulnerabilities that led to patient dissatisfaction, litigation and settlements. Keep an eye on our blog, sign up for our monthly newsletter and follow us on Twitter and LinkedIn so you don’t miss these publications!