Broken drill in tooth - who's liable?

Dental_Trauma

Hello, i'm new on this site - i came accross it while searching for info about said incident where my dentist's drill broke while performing root canal treatment. There was a useful thread that came up which almost put my mind at rest health wise since this seems quite common and can end up not causing any problems. However, what the thread doesn't cover is who pays for all the extra treatment that can result from the broken drill? Because it is much more likely that the root with the drill in will flare up, resulting in possible extraction and then the need for a bridge. I will also certainly need to go to the endodontist and also have the tooth more regularly monitored and x-rayed.
Soooo, i am hoping and praying that all this or at least the treatment which is a direct result of the broken drill, will be covered by the dentist's professional indemnity insurance.
Does anyone know please?

I don't blame the dentist particularly (i don't think!) but it sure as heck 'aint my fault! I don't have dental insurance so all this root work is being payed for in full and there's no way i can take the extra hit that could result from the broken drill. All advice gratefully received!

stationaryace

The same thing happened to my dad. He is in the middle of treatment to sort it, which has all been arranged through the same NHS dentist who made the mistake, and my dad has not had to pay for this work. However, it took nearly a year for him to get his first correction appointment after it happened and if he had wanted an earlier appointment he would have had to pay to go private. Not sure how it works if its a private dentist in the first place.

bank_of_slate

This would be better on the health section of this board, then Toothsmith and donteatthat can comment
...Linda xx

donteatthat

Hi

It is true to say broken instruments can happen during this procedure. Roots can be very fiddly and curved, and you can't always see the degree of this from the x-ray. It's a complication rather than negligence, and the outcome will really depend on whether the instrument can be removed, and if not how well the root can be cleaned and filled around it. It can even happen to the best of specialists, I work with one and he had the same thing just recently.

It is something that should be discussed as part of the consent process, but it does sound like the dentist is taking appropriate action. I wouldn't think he/she will be claiming on his indemnity, however if this happend to me I would foot the bill of the remedial work for the goodwill - as you say its not the patient's fault.

It doesn't mean the tooth has had it, but a visit to the endodontist would be a good idea. They will have a microscope and are trained and experienced in getting such things out!!

Sounds like you have a good relationship with your guy, and I am sure they will want to sort it out for a favourable outcome on both sides which will reduce their stress - none of us like it when complications happen to us - so I would let them get on with the necessary steps, and in the instance that a bill comes your way present it diplomatically back at the practice and I am sure they will take care of it.

We get loads of patients in on this basis - the dentist has called and said there is a problem, and we invoice directly to the practice.

HTH
det

Savvy_Sue

MOVING THREADS FOR BETTER RESPONSES

Hi, Martin’s asked me to post this in these circumstances: I’ve asked Board Guides to move threads if they’ll receive a better response elsewhere (please see this rule) so this post/thread has been moved to the Health board, where it should get more replies. If you have any questions about this policy please email [EMAIL="abuse@moneysavingexpert.com"]abuse@moneysavingexpert.com[/EMAIL].

Toothsmith

donteatthat wrote: »

Hi

however if this happend to me I would foot the bill of the remedial work for the goodwill - as you say its not the patient's fault.

det

I think we're going to have a little disagreement here D.E.T.!

As you said, an instrument breaking is a known risk of trying to do a root filling. And an important part of preparing a patient for treatment is - as you said, making sure they are aware of the risks of treatment.

If you've made patients aware of the risk, and work in a careful way, then if an instrument breaks, then it's not the operators fault, and I don't personally see why the operator should pay for a specialist referral.

If that happened routinely, then every dentist (Or at least every dentist who had control over the prices they charged) would have to factor a little bit extra into each and every root filling price, to cover the cost of the specialist referral if something goes pear shaped.

This is probably fine from a practice management point of view - and as you said, it would maintain the goodwill of that patient - but at the hidden expense of the other patients.

I can see why a dentist who didn't explain all the risks might do it - as there may be possible action if risks aren't explained.

If a dentist breaks a file and DOESN'T tell the patient, then that is classed as negligent, and when and if it's discovered, that dentist should really worry!

Personally though, the way I look at it is that it wasn't me that got the tooth into a state where it needed a root filling. I will try my very best to fix the problem for the patient, but if one of the instruments (which I have no control over the manufacture of) breaks, then that's one of the risks the patient must accept.

If they don't accept the risk - then I would refer them to the specialist as a first resort, and they can pay someone else. As my fees are less than the specialist - and as most of my patients are on Denplan - so it would be inclusive rather than extra - the vast majority are happy to let me have a crack at it first!

donteatthat

lol puts on the gloves......

I hear what you are saying. However, I do stand by what I said, but a fractured instrument should be a rarity, and in our practice we would consider the goodwill of the patient more important than taking the moral high ground over who should pay to sort out the complication. Even when the patient has been prior warned about the possibilities. I wonder how many dentists do actually get a full signed informed consent form for RCT, which includes "the files may fracture and I can't get them out, you will have to pay for the specialist". Not many I bet, but I'm sure you do.

I don't do endo (as I'm sure you know!) so fortunatley this isn't something I worry about. But I wouldn't charge a patient the full amount for an RCT, which I was unable to complete because something went wrong. This guy has paid for this treatment. I'm not saying he should pay no-one, but he doesn't mention that he was informed previously this could be a problem and he sounds like he is being pretty decent about it.

Maybe we are daft in our practice, but we've got a big case going on with a failed implant case. No-ones fault, the patient was informed implants may fail, but we are pulling out all the stops to correct this to save the goodwill of the practice for the benefit everyone (the treating dentist has retired) including him, the patient, the referring dentist.

I am sure you agree with me when I say - goodwill can be hard to generate, and quick to lose, and would you, if the chips were down and this happened to you, honestly tell the patient "tough luck, your problem, pay up"? Even with the right consent, do you think that would be good advertising when the patient talks to their family and mates?

Toothsmith

Not signed - I must admit.

Actually, the last time I had a reamer break, and it cause trouble (Not that I've had many break and not cause trouble!), it was sorted out very well by hospital oral surgery department (On the NHS) who did a nice apicectomy on the easy-to-get-to buccal root of the molar in which it had snapped.

I can think of about 3 other patients who I know (and they know!) have a bit of file in a tooth, and fortunately all are symptomless at the moment!!

Again, being mainly Denplan, if extraction and bridges were needed - patients would only pay lab fees with me anyway - and true enough - I might go halves there!!

donteatthat

lol, so the deciding factor thing here.....was the patient fully informed before? I reckon not, and it was a bit of a surprise hence his question.

In anycase, the reason I gave up RCT - too many blinkin snapped files ha ha!!

Toothsmith

True enough - so a guilty conscience might just cough up!

donteatthat

I was only joking - it's never happened to me