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DALTON v DR DAMYANOV (2015)

View profile for Melanie Reynolds
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A 65-year-old woman, received £10,000 for the negligent removal of her tooth without a pre-existing hole in her sinus having been checked, in January 2012. She suffered a year of severe headaches and bad taste and smell in her mouth before a foreign body was removed from her sinus approximately 12 months later.

Clinical Negligence: On 11 January 2012, the claimant (C), had her UL7 tooth extracted on the advice of the defendant dentist (D). Before the extraction, C informed D that when she was 18 years old she had had a tooth extraction that caused a hole in her upper right sinus. However, no X-rays were obtained post extraction. The UL7 tooth was removed and the socket was filled with dental packing. C was given antibiotics.

Over the next week or so, C did not feel well. The site of the extraction was very painful and she had severe headaches. She went back to D on 18 January and he packed the socket with more dental packing. She went back again on 25 January and was told by D that part of the root from the extracted tooth was still in situ. He had that removed and the socket packed again.

During 2012 C continued to feel unwell and suffered with a range of symptoms including severe debilitating headaches and a bad taste and smell in her mouth. She underwent a range of investigations with a neurologist, ENT surgeon, oral and maxillofacial surgeon, and haematologist, but no cause for her symptoms could be found. C also had another tooth (UL6) removed unnecessarily due to a suspicion that it was the cause of her ongoing symptoms.

On 19 December 2012 C had an exploratory operation of her left maxillary sinus under general anaesthetic. The surgeon found and extracted foreign material from her left sinus which, histologically, was confirmed as residual dental packing. However, radiographic examination indicated the presence of a hard foreign body. It was likely that it was a fragment of tooth root.

C sustained injury and brought an action against D alleging that he was negligent in: (i) failing to take into account C's past history of sinus perforation; (ii)causing or permitting a fragment of tooth root to remain in UL7 post extraction;(iii) failing to remove the entire tooth root; (iv) failing to take a radiograph immediately post extraction to ascertain whether any tooth fragments remained; (v) failing to conduct the routine procedure of reassembling the tooth post extraction to ensure all pieces had been removed; (vi) failing to have regard to X-rays which showed a calcified body in the UL7 and a calcified body within the antral floor respectively; (vii) failing to determine by way of radiographic examination pre and post extraction whether there was sufficient bone; (viii) failing to have been prepared for a procedure known as closure of oroantral fistula; alternatively (ix) failing to refer C for a specialist extraction.

Liability admitted.