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Osteoradionecrosis Cases

Osteoradionecrosis develops after tooth extraction three years after radiation treatment. Multiple surgeries required -- $2.96 Million gross jury verdict sets record for highest dental malpractice verdict in Florida history.

The plaintiff, age forty-eight, went to the defendant general dentist in October 1985 for dental extractions and dentures. The medical history given to the defendant included squamous cell carcinoma of the left mandibular retromolar mucosa which was treated with radiation in 1982. He also listed the names, addresses and phone numbers of his physicians. The defendant did not call either of the physicians and made no investigation of the plaintiff's history. The defendant extracted twelve teeth, one of which was a root fragment in the mandibular left molar region. The tooth was directly in the path of the 1982 radiation. Two months after the extractions, the dentist inserted dentures. The plaintiff returned four times during the next three months complaining that the lower left extraction socket hadn't healed and that there was a foul odor and taste, to which the defendant advised the plaintiff that the symptoms were the result of "radiation infection" and would get better in time. The plaintiff returned eight months later with advanced osteoradionecrosis requiring resection of his mandible producing a discontinuity defect. Over the next seven years the plaintiff underwent three bone grafts, a pectoralis myocutaneous flap and other soft tissue grafts. The plaintiff claimed that the defendant was negligent for failing to consult with or refer to an oral surgeon. That the extraction was negligent and improperly monitored and that the defendant failed to obtain his informed consent. The defendant claimed that there was no need for a consultation or referral, that the extraction socket fully healed and that the plaintiff never voiced any complaints about the extraction socket. The defendant claimed that the plaintiff's failure to follow-up with his cancer doctors and continued smoking and drinking habits was comparative negligence. The defendant also claimed that the head and neck surgeon, radiation therapist and hospital were negligent for not having the tooth extracted prior to radiation and that the reconstructive surgeon who operated on the plaintiff after the oseoradionecrosis developed was also negligent.

A $2.96 million verdict was returned following a two-week jury trial which was reduced for five percent comparative negligence and twenty-five percent apportionment of fault against the hospital. Kenneth P. Liroff, D.D.S., J.D., of