She was only 15 years old.
She had been to the orthodontist since her teeth were crooked and were crowding. The orthodontist evaluated her and determined that in order to create an orthodontic treatment plan, she would need to have some of the baby teeth in her mouth extracted.
This sounded reasonable. It made sense. By allowing some baby teeth in her mouth to be removed, it would allow her mouth and jaw to be less cluttered and permit the application of braces in a timely fashion.
The orthodontist did the correct thing. He prepared an itemized document that set forth exactly which teeth she needed to have removed. Again, he did the right thing by not handing that piece of paper directly to the patient or the patient's mom, and instead sent it directly to the dentist by mail.
This 15-year-old girl and her mom went to the general dentist and explained the need for the extractions according to the orthodontist. By the time of their arrival, the general dentist had received instructions from the orthodontist and agreed to proceed forward with the teeth removal.
The extraction process went relatively smoothly and neither the patient for her mom were aware of any issues or problems.
Many months later when this 15-year-old girl returned to the orthodontist for follow-up, the orthodontist was puzzled. There were two gaps in her lower jaw where the patient's adult teeth should have been erupted and coming in. These were empty spaces and nothing was coming in..
X-rays of the lower jaw revealed something unusual.
When comparing them to the original x-rays it was obvious that this young girl's permanent teeth in her lower jaw were missing!
That explained why there were no teeth that had erupted into the lower jaw.
The orthodontist was at first confused. Upon looking back at the original instruction sheet that he sent to the general dentist, he asked specifically to have specific teeth removed. He never asked to have any permanent teeth removed.
However, looking at the x-ray it was obvious that not just were baby teeth removed, but two adult teeth as well.
This created a significant treatment plant problem for dealing with her orthodontics as well as what to do now that the patient's permanent teeth were missing from her lower jaw.
After having a dental expert review the records and x-rays, it became readily apparent that the general dentist who extracted the teeth and the lower jaw violated the basic standard of care. He failed to know, learn and understand the dental anatomy before taking action in removing what would later turn out to be a permanent and lifelong action.
This dentist, if you had doubts or questions, should have stopped what he was doing and consulted a colleague to get the proper bearing and understand where he was within the dental anatomy before performing the extraction.
As an alternative, he could've easily sent the patient out to an oral surgeon who, most likely, would've had a clear understanding of the patient's dental anatomy and prevented this tragedy from occurring.
The purposes of having standards of care is to prevent mistakes like these from happening everyday.
Amazingly, the defense acknowledged and admitted that the doctor violated the standard of care. Despite the fact that the defense admitted readily that the dentist had violated the standard of care and pulled out the wrong teeth, it was not until just weeks before we were scheduled to begin jury selection in this case that we were able to successfully resolve this case for the benefit of my clients.