Bury Your Head in the Sand or Default Judgment

Bernie, a realtor, was Sam’s devoted patient for over 20 years She came for routine check-ups. She really trusted Sammy. She rarely required anything more than her twice yearly brief cleaning. All was well until the summer of 1993. Bernie had no complaints about her past professional dental services. Sam assured her she had no problems in her mouth. However in the summer of 1993 Bernie felt something wasn’t kosher. Bernie had great difficulty arranging routine appointments. It became almost impossible for Bernie to first schedule and then for Sam to keep an appointment. For example Bernie arrived the date of her appointment and Sue the receptionist told her it was cancelled. This happened time and again, without explanation or notice of cancellation. Bernie was frustrated and embarrassed at the apparent lack of consideration. But patient’s such as Bernie can overlook a lot. She chalked it up to someone’s missed communication.

However Bernie’s last appointment in July 1995 marked a watershed in her relationship with Sam. It came as a shock to her system when Sam told her she had tooth problems. Teeth 34 and 36 now needed crowns. So there and then Sammy installed temporary aluminum crowns on her teeth. Bernie was anxious but Sam assured that her permanent crowns would be installed at the next appointment. In good faith Bernie paid $600.00 towards the final crowns. Surprise, surprise Bernie never got those permanent crowns. She made several abortive attempts at setting up appointments with Sam. Those abortive attempts included visits to his office. Sue told her each time the appointments could not be kept.

What relief when Sam called one Sunday morning in the fall of 1995. He agreed to meet Bernie at his office to install the permanent crowns that afternoon. Strange, scheduling noted Bernie but did she have a choice? So Bernie came to the office. Unfortunately no matter what Sam did he couldn’t get those crowns to fit. He promised he would have proper-fitting crowns within the week. But of course all subsequent efforts by Bernie to meet Sam failed.

That was the limit. Even to Bernie’s patience. So she consulted a new dentist. Dr. Joey met with Bernie the next week. Joey completed his oral examination and took full mouth radiographs. He gently told Bernie she was not in great dental shape. Here is what he discovered:

• Decay was present in 11 teeth.
• One of the teeth #46 was extensively decayed.
• There were aluminum crown forms on teeth #34 and #36.
• There was a heavy accumulation of calculus on most of the teeth with 3 to 5 millimetre pockets in the posterior.
• All four wisdom teeth were impacted.

He recommended the following treatment:

1. A thorough scaling of the teeth.
2. Restoration of ten of the teeth in amalgam or composite material.
3. Because of the extensive decay in tooth 46 endodontic treatment followed by a full coverage crown.

• Referral to an endodontist for the root canal treatment.
• Followed by preparation and installation of crowns.

Joey’s treatment took approximately 7 hours. The cost for Joey’s part of the treatment was $2423.00. The root canal was extra, for the endodontist fee. Joey didn’t like to become involved in legal fights. However when Bernie told him she intended to sue Sam he agreed to provide an opinion about her prior treatment.

He wrote:
“In my opinion the amount of extensive decay in tooth #46 should have been detected by a dentist seeing a patient on regular six month check-ups.
In my opinion the placement of aluminum crown forms is a technique outdated by at least 10 years or more. It is also customary to construct a temporary bridge after the teeth have been worked on to prevent them from drifting. If they were to drift this would prevent the final bridge from fitting. Leaving them in place for more than a few weeks in my opinion could create periodontal problems. Due to leakage of the cementing medium recurrent decay could start if left for longer than a couple of months.
Because these aluminum crown forms had been left for so long I referred Bernie to a periodontist for a consultation. He recommended that #34 be removed and that periodontal surgery be done on the lower left side. Following this root canal treatment would be needed on #36 and #37. Then a fixed bridge could be done from #33 to #36 and #37. The bridge has to be extended to include the #37 to give proper support because tooth #34 has to be removed.
In my opinion if instead of aluminum crown forms a proper temporary bridge had been done and checked properly then it is unlikely that periodontal treatment or endodontic treatment or removal of #34 would have to be done. Because this treatment has to be done much more time and a much higher fee will be involved.
My fee for a three unit bridge which Bernie needed initially would be approximately $2300.00. My fee for a five unit bridge which Bernie needs now would be approximately $4300.00. These fees include the laboratory charges. I will require approximately 5 hours of chair time. These fees do not include any work done by the periodontist or by the endodontist.” So Bernie retained her lawyer. She wanted to recover damages from Sam. She was very disappointed and now had an established mistrust of dental professionals. She alleged that Sam either left incomplete or negligently carried out work he undertook to complete. Sam for reasons unknown but consistent with his recent pattern of behaviour neither notified his insurance company of the lawsuit nor retained a lawyer. He did not take any steps to defend himself against Bernie’s allegations.

So Bernie’s lawyer set the matter down for a default judgment trial. Bernie testified in open court. She filed affidavits and filed her letter from Joey and several other subsequent treating specialists.

We may never understand or know why the relationship between Bernie and Sam deteriorated. Or what triggered Sam’s fall from grace. However you can find out how Judge Harry decided the case in the next issue of JWDental Legal News. So stay tuned. Helpful hints on what to do when served with a lawsuit will also follow.