Trends in endodontic claims in Italy

Abstract

According to the scant data available in the literature, endodontic claims are common among dental professional liability cases and the second most common type of claim. This study aimed to describe the characteristics of endodontic claims in Italy and the most frequently disputed errors, and the discussion below includes consideration of ethical and medico-legal aspects thereof. We retrospectively analysed 120 technical reports written on cases of professional malpractice in endodontics in the last 5 years. The complainant patients were males in 22.5% of the cases, while females made up the remaining 77.5%. In the dentist sample, male operators were more often involved in litigation cases (80%) than female operators. The most frequently claimed technical errors were: lack of a complete filling of root canal/s (71.7%), the perforation of tooth structure (12.7%), extrusion of sealing materials beyond the apex of the tooth (9.6%) and the fracture of an endodontic instrument (5.9%). In 1.7% of cases it was found that the expert did not make any errors performing the endodontic therapy. In only very few cases (2.7%) no therapy was considered necessary, while the most common therapeutic solution involved in endodontic misconduct was tooth extraction (53.0%). In many cases the dentist preferred to extract the endodontically undertreated tooth and substitute it prosthetically rather than trying to re-treat it. The discrepancy between the total number of cases examined and those that eventually go to court leads us to believe that the majority of endodontic malpractice cases are resolved in out-of-court settlements.

Hemidiaphragm Paralysis after Robotic Prostatectomy: Medical Malpractice or Unforeseeable Event?

“…This case describes the extremely rare event of hemidiaphragm paralysis after surgery on sites distant from there, which has been seldom reported in literature. This article aims at both improving the knowledge of clinicians focusing attention on postsurgical symptoms of these cases and providing useful evidence for preventing unfair, expensive and stressful medico-legal litigation [24,25] .…”

Medicolegal Aspects of Vertical Root Fractures

“…A "frustrating patient visit" [ 28 ] may develop when a treatment decision regarding the "complaint tooth" has to be carried out, and in case of a crucial relationship deterioration between the practitioner and the patient, irrational treatment solutions, such as to extract the tooth, may be chosen [ 2 ]. For example, it had been reported that almost 50 % of teeth with a short root fi lling, almost 90 % of perforated teeth, and all teeth diagnosed with a separated instrument were extracted [ 4 ]. However, for the vertical root fracture, it may be the opposite way around-the tooth has typically been extracted because it is untreatable and then a medicolegal scenario may arise shortly after.…”

“…Endodontic treatment-related claims are among the top three frequent reported complaint areas [ 2 ], and among specifi c causes for these complaints, are vertical root fractures [ 4 ].…”

Medicolegal Consideration in Endodontics: General and Surgical Aspects

“…Notably, oral surgery seems to be lesser involved within recent years, whereas implant placements are a new growing area of malpractice complaints. The latest report has implant as the number one most frequent claim area [ 9 ].…”