Is Wisdom Tooth Removal Surgery an Unnecessary Risk?

In recent weeks, several news sources have reported the death of a 17-year-old Maryland girl who died from hypoxia (oxygen deprivation) during a routine wisdom teeth extraction. Her parents filed a medical malpractice lawsuit this month, which brought the case to the attention of consumers, media, and dental industry professionals. The tragedy has caused many to question the necessity of wisdom teeth removal, an elective surgery that may lead to serious health consequences with no significant health benefit.

Girl's Death Gives Rise to Bigger Questions for the Dental Industry

In April, Jenny Olenick was to have her wisdom teeth removed, a surgery undergone by five million teens and adults each year. However, the procedure went fatally wrong when her heart rate slowed to a "panic level" and she began losing oxygen after being anesthetized. Her parents' malpractice lawsuit alleges that the dentist and anesthesiologist were negligent in monitoring Ms. Olenick's breathing and oxygenation and in failing to resuscitate her once her heart rate and oxygen level dropped.

Ms. Olenick's tragedy has prompted many people to wonder why dentists almost unanimously encourage wisdom teeth removal when the teeth have not actually caused any problems for the individual, but the surgery poses real risks.

The American Association of Oral and Maxillofacial Surgeons strongly recommends that young adults have their wisdom teeth removed to "prevent future problems and to ensure optimal healing." But some dentists claim the science support prophylactic extraction is thin, and that profit is the real reason so many wisdom teeth removals are performed. As reported by Huffpost Healthy Living, dental consultant Jay Friedman wrote in the American Journal of Public Health, "Third-molar surgery is a multibillion-dollar industry that generates significant income for the dental profession. It is driven by misinformation and myths that have been exposed before but that continue to be promulgated by the profession."

According to the report, American dentists and oral surgeons pull 10 million wisdom teeth every year, an effort that costs more than $3 billion and leads to 11 million days of postoperative discomfort. Mr. Friedman goes on to say "At least two thirds of these extractions, associated costs, and injuries are unnecessary, constituting a silent epidemic of [physician-induced] injury that afflicts tens of thousands of people with lifelong discomfort and disability."

The dangers associated with wisdom teeth removal will likely receive even more attention in the coming months. ABC News affiliate WSBTV has reported that 14-year-old Ben Ellis of Gilmer County, Georgia was found dead on December 8 after undergoing wisdom tooth surgery the day before. His case is still under investigation.

Experienced Medical Malpractice Lawyers

If you ever believe that your health or the health of a loved one was compromised by incompetence or negligence on the part of a dentist, doctor, nurse, hospital, or other health care professional, contact Paulsen & Armitage, LLC in Denver for a free consultation with an experienced Colorado medical malpractice attorney.

Medical Malpractice and Unnecessary Tests

Search for "medical malpractice" and "unnecessary tests" on the Internet, and most of the results will talk about how fears of being sued for medical malpractice cause doctors to order unnecessary tests, which increases costs to the overall health care system and is a reason why we should have tort reform. Well, it turns out that there is another reason why doctors may order unnecessary tests: it's profitable. Unfortunately, a test that is not helpful to the patient may actually be harmful, and ordering or administering unnecessary tests can itself be a form of medical malpractice.

This issue is a hot topic in Colorado and across the nation. The September issue of Consumer Reports, in an article titled The Business of Healing Arts, cites increasing calls from physicians themselves arguing against the overuse of testing, and even treatment, in cardiac cases where the facts do not support such an approach. We all want our doctors to have access to the latest and best high-tech diagnostic equipment, and to use it whenever necessary. But when doctors and hospitals acquire this equipment, the only way they can recoup their costs is by ordering tests that patients and their insurance companies pay for. The profit motive is there; unfortunately it does not always seem to be subordinate to the Hippocratic Oath.

The Consumer Reports article was cited in a similar report by the National Journal online (Consumers Get Unnecessary Heart Tests: Consumer Reports, August 2, 2011), citing unnecessary testing such as EKGs ($50), Stress Tests ($250), and angiograms ($5,000), not to mention the next step - unnecessary treatment such as angioplasty ($20,000 and up). Here in Colorado, the Denver edition of the Huffington Post reported on the recent fine levied against a provider of CT scans (Heart Check America Hit With Largest Malpractice Fine In Colorado's Radiation Department History, August 8, 2011). Heart Check America was fined $3.2 million by the Colorado Department of Public Health and Environment for performing CT scans that were not ordered by a state-licensed physician.

X-rays and CT scans expose patients to high levels of radiation. Other tests can produce harmful results in other ways. For example, a cardiac stress test can itself induce a heart attack, and radioactive and known carcinogens are often used in conjunction with the test (nuclear stress test). It is true that missing a diagnosis or failing to order a test may be evidence of medical malpractice. But ordering an unnecessary test, whether motivated by profit or the practice of "defensive medicine," also falls below the expected standard of care, and doctors should be held liable for any harm that results. If you believe you have been harmed from unnecessary diagnostic testing or medical treatment, contact the medical malpractice lawyers at Paulsen & Armitage, LLC.

Medical Malpractice - It's Not Just for Doctors Anymore

A $3 million judgment was recently awarded to a family of a ten-year old girl born with multiple disabilities. The judgment was awarded against the midwife who oversaw and assisted with the birth at a Maine medical center. In California, an anesthesiologist was found liable for causing a brain injury due to lack of oxygen, resulting in a settlement with the anesthesiologist and a $2.25 million jury award against the medical center where the procedure was performed.

When we think of medical malpractice, we may think of doctors and surgeons in particular, but the concept of liability actually extends to just about any health care practitioner who violates an applicable standard of care. Besides medical doctors, we have midwives and anesthesiologists, as described above. Of course, an anesthesiologist is actually an M.D., as is a psychiatrist, who as a doctor can prescribe medicine and also be liable for medical malpractice. Who else can be held liable for medical malpractice?

Nurses, Nurse Practitioners, Physician's Assistants - All of these positions are licensed by the state, and all of these practitioners can be liable for failing to adhere to the appropriate standard of care. Lab technicians who perform tests incorrectly or report the results inaccurately may also be liable for the damage they cause.

Pharmacists - Doctors can be liable for prescribing the wrong medicine or the wrong dosage. A pharmacist could be liable for mis-filling the prescription or typing out the label incorrectly, leading to an improper dosage.

Hospitals - ambulatory, urgent care, treatment center. In general, employers are liable for the negligence of their employees. In the case of doctors and surgeons, however, it is not always clear whether the doctor was an employee of the hospital or an independent contractor with privileges to practice at the facility. In addition to the negligence of employees, another question is whether the hospital itself had adequate policies and procedures in place and adequately trained and supervised employees.

HMOs - Health Maintenance Organizations that refuse to pay for diagnostic tests or treatment out of cost concerns may be liable for injuries that result.

The hallmark of medical malpractice is professional negligence by a health care provider which deviates from the acceptable standard or level of care in the community. If your health has been compromised by anyone in the health care field, you should contact an experienced medical malpractice attorney to discuss the circumstances surrounding your case. In Colorado, contact Paulsen & Armitage, LLC.

Colorado Supreme Court Establishes Rule on Expert Testimony

On November 22, 2010, the Supreme Court of Colorado announced its decision in the matter of In Re Garrigan v. Bowen, relating to the use of expert testimony in a medical malpractice action. In the underlying case, the plaintiff patient sued the defendant anesthesiologist, claiming that the defendant negligently managed the patient's care during lumbar spine surgery, causing the plaintiff to suffer loss of vision as a result.

As part of its defense, the defendant hired an expert witness who was the lead author of a published study on post-operative visual loss. The defense expert was going to testify about the study at trial.

The Limits of Discovery

The phase before trial is known as discovery, when each party seeks to obtain facts and information about the case from the other party. A crucial component of discovery is obtaining the other party's witness list, including expert witnesses the party plans to call at trial. It is important to know what the witness will testify to in order to adequately prepare for trial.

Rule 26 (a)(2)(B)(I) of the Colorado Rules of Civil Procedure requires the party to produce a written report or summary of the testimony to be provided, along with "…the data or other information considered by the witness in forming the opinions…" to be expressed in the case. In the present case, the plaintiff objected that the defense did not list the raw data upon which the study was based, but only produced the study itself.

The trial court held that the defense witness had considered the raw study data in forming her opinions for the present case, so the defense should have provided the underlying data when requested by the plaintiff. The Supreme Court disagreed and held that the expert did not consider the underlying data in connection with the particular case, and so the defense was not required to produce such information for the plaintiff.

In making its ruling, it seems that the Supreme Court has significantly narrowed what material must be disclosed by an expert witness, regardless of the facts and circumstances of the particular case. This rule limits the trial courts' discretion to rule on what evidence should be produced in the discovery process. It also hampers the ability of one side to adequately prepare a cross-examination of the other party's witness.

This ruling cuts both ways, in that both plaintiffs and defendants typically use expert medical testimony in medical malpractice cases. With neither side being adequately prepared to examine the other party's testimony, the result of this ruling may be to make medical malpractice trials more confusing and difficult for the jury to reach an understanding of the facts.

If you believe that you or someone you love has been the victim of medical negligence or medical malpractice, contact the Colorado medical malpractice lawyers at Paulsen & Armitage, LLC, for assistance.