Jury: Pulled teeth worth $2 million

Aug 25, 2009

A South Carolina woman was awarded $2 million in damages last week after a jury found that a dental clinic in Florence County had mistakenly removed all of her upper teeth.

Following a trial earlier this month, the defendants -- Robert Scott, D.D.S., and Sexton Dental Clinic -- were ordered to pay Elizabeth Smith $500,000 in actual damages and $1.5 million in punitive damages.

But lawyers for the clinic this week filed a motion for a new trial, according to Ruan Westraad, president and CEO of Sexton Dental Clinic, which was founded in 1923 and has six full-time dentists and 75 support staff at its Florence location. The judge's decision on the motion is expected September 8, Westraad told DrBicuspid.com.

Changes in treatment plan

“The issue was whether the recommended treatment plan was appropriate for the client.”
— Robert Ransom, attorney

Smith went to the Sexton Dental Clinic in May 2006 seeking treatment for a cracked upper front tooth, according to a complaint filed in August 2007 by her lawyer, Robert Ransom. The defendants allegedly recommended extracting three of her upper teeth, plus the fabrication of a partial upper denture. Smith authorized the extractions and the denture, but Dr. Scott ended up pulling all 16 of her upper teeth, according to the complaint.

"My client first met and spoke with and was evaluated by Dr. Robert Jamison [also named in the lawsuit but exonerated by the jury], who recommended a particular treatment plan, and she agreed," Ransom told DrBicuspid.com. "Dr. Scott then came into the treatment room and, without speaking to her, pulled all 16 teeth."

The defendants "thereafter fabricated entries in the Plaintiff's dental chart in a conscious effort to fraudulently cover up, hide, and defend their wrongful conduct in removing all 16 of the Plaintiff's upper teeth," the complaint states.

"The issue was whether the recommended treatment plan was appropriate for the client," Ransom said. "His [Jamison's] treatment plan was not to pull all 16 teeth. But when we got hold of her chart and had it reviewed by a records examiner, we were told that some of the items were suspicious. There was a variety of information recorded that was hopelessly inconsistent."

For instance, he said, one part indicated that when she first came into the clinic, she was already missing six or seven teeth. Another part of the chart, where the doctor was to record the treatment that had been done, said that 10 teeth had been removed, not 16, according to Ransom.

Implied consent

Westraad offered a different explanation of what took place. When Smith first came into the clinic, she was examined by Dr. Jamison, who recommended that she have all her upper teeth removed because of extensive decay, Westraad said. When Smith indicated that such a procedure was not affordable for her, Westraad said, Dr. Jamison came up with a "best-case scenario": to extract 10 teeth and leave six in order to secure a partial. Dr. Jamison also noted in her chart that she had periodontal disease and possible caries in the remaining teeth.

But when Dr. Scott subsequently examined Smith, he determined that the remaining teeth would not sustain the partial for very long, and he, too, recommended that all the upper teeth come out, Westraad said. Dr. Scott then told Smith, "Today, we're going to extract all your upper teeth," according to Westraad, and when she did not turn him down, he went ahead with the surgery under local anesthesia.

Smith is still without any upper teeth or dentures, according to Ransom. During the trial, expert witnesses estimated it will cost $80,000 to fit her with implants, he said.

But Westraad said that Smith had been fitted for full uppers during a return visit to the clinic the day after the initial surgery, and that she actually wore the dentures during her depositions prior to the trial. In addition, Westraad emphasized that on subsequent visits to the clinic she never complained about any of the work performed there, including the extractions. He also noted that Smith paid to have 10 teeth removed prior to any of the work being done.

"Let's apply some common sense here," Westraad said. "If you believe that they pulled 13 of your teeth by mistake, who wouldn't go back to the place of business and not file a complaint?"

Dr. Scott has not been suspended and is still practicing at the Sexton Dental Clinic, according to Westraad. Ransom said there are no plans at this time to file a formal complaint with the state dental board.