A recent study by Givol et.al., published in the Journal of Endodontics, points out some interesting facts about malpractice claims in endodontics.
Endodontic claims are the most frequently filed malpractice claims in dentistry. It has been reported that there are twice as many endodontic malpractice claims than other specialty areas. Endodontic claims have been reported to be 14% – 17% of the total malpractice claims in dentistry.
The study by Givol et. al. was a review of malpractice claims made in Israel between 1992 – 2008. Some interesting data comes from this review. Of the 720 complaints that were analyzed, 72% were considered “justified” and 27% were considered “unjustified” complaints.
Errors found and analyzed were categorized as pre-operative, intra-operative and post-operative.
Most of the errors occurred in the intraoperative phase of treatment. These included access preparation, detection of canals, instrumentation or obturation.
Swelling & pain as the only complaint were reported in 100 cases and none of them were considered “justified” complaints. Swelling and pain are considered a side effect of treatment and not a complication. Patients should be informed of this possible side effect during informed consent. It has been reported by Tsesis et. al. that pain and swelling can occur following endodontic treatment in 1.5% – 20% of cases. Helping patients understand this possible side effect can help prevent misunderstanding and hopefully prevent unnecessary malpractice claims.
The lack of adherence to strict treatment protocols resulting in poor quality treatment was a common cause of malpractice claims.
Endodontic treatment requires exceptional technical skill and strict adherence to accepted treatment protocols. Proper case selection and appropriate referral to a specialist can also prevent unnecessary complications.
SOURCES
The Endo Blog – www.theendoblog.com
Givol N, Rosen E, Taicher S, Tsesis I. Risk Management in Endodontics. J Endod 2010;36:982-984.
Tsesis I, Faivishevsky V, Fuss Z, Zukerman O. Flare-ups after endodontic treatment: A meta-analysis of literature. J Endod 2008;34:1177-81.