Inferior Alveolar Nerve Damage Lawsuit

Kerr v. Hlousek

Alveolar Nerve CanalThis dental malpractice claim was filed in Anne Arundel County after a woman suffered permanent paresthesia following a tooth extraction procedure. It was filed in Health Claims Arbitration on February 21, 2018, and it is the 91st medical malpractice case filed in Maryland this year.

Summary of Plaintiff's Allegations

A dentist extracted two of a woman's lower third molars. Before the procedure, the dentist never obtained the necessary x-rays, and as a result, he never determined the exact location of the woman's Inferior Alveolar Nerve (IAN). The IAN canal is visible on x-rays and cone beam CT scans, so with the proper precautions, it can be easily avoided. Because the dentist failed to visualize the IAN, he traumatized the nerve during the process of extracting the woman's molars.

The woman reported her injury - paresthesia, a tingling sensation - immediately, but the dentist failed to administer the appropriate steroids or vitamins. Instead, the dentist misled her, saying "this happens" and the unpleasant sensation would fade within six months. When the woman continued to complain of tingling more than six months after the tooth extraction, the dentist told her it would go away after another six months. The paresthesia never went away. So she brought this lawsuit in Annapolis against the oral surgeon.

Additional Comments
  • Because the precise location of the inferior alveolar nerve (also called the mandibular canal) differs slightly within each individual's lower jaw, it is extremely important for dentists to take x-rays before attempting a procedure.

  • When a dentist sets out to surgically invade the patient's lower jaw with instrumentation, great care is required to avoid entering the alveolar canal which is filled with the inferior alveolar nerve and blood vessels

  • Even if the dentist's cavalier response to the claimant's reported injury, "this happens," was correct, he still had a responsibility to properly treat the injury. Regardless of whether or not the dentist was at fault for traumatizing the claimant's IAN, as soon as he was made aware of the claimant's injury, he should have prescribed steroids and referred the claimant to an oral surgeon specializing in nerve repair. Steroids are a well-known treatment for nerve injuries, and nearly every nerve injury dental malpractice claim involves a failure to prescribe steroids.

  • This injury is often caused by dentists who take inferior x-rays or do not take the right x-rays. A panorex or CT scan showing the approximate current conditions is often required before any drilling or implant placement. In surgery malpractice cases, we say you have to see what you are going to cut. Dentists and oral surgeons need know where they are before they drill.

Jurisdiction
  • Anne Arundel County
Defendants
  • An oral surgeon in Annapolis
Negligence
  • Failing to take appropriate diagnostic radiographs.
  • Failing to refer the claimant to appropriate specialists in a timely manner.
Specific Counts Pled
  • As a direct result of the defendant's negligence, the claimant suffered a permanent nerve injury and expended a significant sum of money for additional dental and medical treatment.

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