Atlanta Injury Lawyers Blog

Published on: November 15, 2024

Dental Nerves and Pre-Planning in Georgia

A female patient was injured during the installation of a dental implant procedure due to the alleged negligence of the general dentist, who failed to adequately measure the distance of the tooth to the underlying dental nerve. The plaintiff claimed that the failure to properly measure the distance to the nerve caused the inferior alveolar nerve injury and related damages.

A lot has been written about whether the course of the inferior alveolar nerve can been seen radiographically. The course of the lingual nerve and the inferior alveolar nerve and seen with high resolution Magnetic Resonance Imaging (HR-MRI). This procedure will result in a 3-D image of the course of the nerve and can be used to plot many dental procedures such as root canals, extractions and dental implant procedures. Importantly, the lingual nerve is in the jaw on the other side of the lingual plate from the teeth, while the inferior alveolar nerve runs lengthwise in the jaw under the mandibular teeth. Inside the inferior alveolar nerve is the inferior alveolar neurovascular bundle, which, once again, can be seen on HR-MRI films.

Almost all operative dental procedures in the mandible require Pre-operative assessment of the position and course of the trigeminal nerves in the mandible. While some general dentists rely on x-rays to map these nerves, a cone beam CT Scan, at a minimum, is required because x-rays are not 3 dimensional and do not have the accuracy of a cone beam CT scan. For this reason, a cone beam CT scan is the standard of care during pre-operative planning for many dental procedures and failure to utilize this results in dental malpractice. The use of plain radiographs (x-rays) such as periapical films is not routinely used in Georgia and is not within the standard of care to assess risk of a dental nerve injury prior to one of the dental procedures listed above. CBCT provides a 3 dimensional look of the anatomy including the nerves with much less radiation exposure to the patient and is far superior to x-rays due to the minimal distortion compared to traditional x-rays. CBCT can be used for pre-operative dental procedure risk assessment.

Published on: October 28, 2024

Lack of External Oversight Can Contribute to Georgia Dental Malpractice

by Robert J. Fleming

Dentistry is one of the last professions which lacks external oversight. In other words, dentistry in Georgia, for example, remains a profession where clinical exams (office visits), diagnostic testing (x-rays and cone beam CT scans), diagnosis, treatment plans and the actual treatment are all done by the dentist, as opposed to professionals outside the office. This shelters the dentist from external oversight by experts who are not affiliated with the dentist. Common sense dictates here: lack of external oversight leads to no way of knowing whether the root canals, extractions, dental implants, etc. are actually needed, let alone whether they are being performed within the standard of care. To compound this problem, when dental complications arise, the patient almost always returns to the dentist who performed the original procedure. Many times, when the procedure has caused an injury (such as a nerve injury), this leads to a failure to refer claim along with a dental malpractice lawsuit. Other times, dentists may perform procedures that are not warranted.

Example 1: Current American Dental Association guidelines require that x-rays only be taken after a dental exam is performed by the dentist and there is suspected dental issue that warrants x-rays to further explore the condition. Anyone who regularly goes to the dentist know that this guideline is almost never followed. In other words, x-rays are taken as a matter of course before the dentist even comes into the room.

Example: An oral surgeon performed a dental procedure on a patient which resulted in the patient suffering a fractured jaw and subsequent nerve injury. After experiencing pain and numbness, the patient returned to the oral surgeon (the one that broke her jaw during a botched extraction) only to be assured that “this is normal, healing takes time, and we will put you on some antibiotics and pain medications and keep on eye on it.” Never was the patient told that her jaw was broken (which was evident by the x-rays taken by the oral surgeon immediately after the extraction was completed). This is a typical example of a lack of oversight contributing to a coverup by the dentist that caused the injury in the first place. The patient wound up suing the oral surgeon and his dental practice for professional negligence, claiming by vicarious liability. The case went to trial twice. The first trial resulted in a verdict for the dentist but a new trial was granted. The second trial resulted in a significant verdict for the plaintiff.

Published on: October 4, 2024

Georgia Dental Malpractice and Fraud in Atlanta

by Robert J. Fleming

According to recent news coverage and the Fulton County Deputy District Attorney, a dental “practitioner” in northeast Atlanta has been arrested and accused of, among other things, of practicing dentistry without a license. (WSB-TV, October 3, 2024).As the story unfolded, patients showed up expecting dental work, but were instead surprised to see district attorney investigators and local police who had raided the dental offices.

Dentistry in Georgia means “the evaluation, diagnosis, prevention, or treatment, or any combination thereof, whether using surgical or nonsurgical procedures, of diseases, disorders, or conditions, or any combination thereof, of the oral cavity, maxillofacial area, or the adjacent and associated structures, or any combination thereof, and their impact on the human body provided by a dentist, within the scope of his or her education, training, and experience, in accordance with the ethics of the profession and applicable law, including, but not limited to, the acts specified in Section 43-11-17 of the Georgia Code.” In order to practice dentistry in Georgia, one must be a graduate of an accredited dental school (a school or college or university with an education program accredited by the Commission on Dental Accreditation of the American Dental Association), and be a dentist licensed and in good standing in this state pursuant to Chapter 11 of Title 43 of the Georgia Code. The Georgia Board of Dentistry is charged with examining dental applicants, issuing dental licenses and investigating dental complaints made by the public.

Under the Code, any person who performs any of the following procedures, operations, or services shall be regarded as practicing dentistry within the meaning of chapter 11:

Published on: August 9, 2024

Understanding Dental Nerve Injury: Consequences, Damages and Legal Options in Georgia

by Robert J. Fleming

Dental care is essential to overall health, but sometimes, dental procedures lead to unintended dental injuries. One of the most significant risks associated with dental treatment is nerve damage. This blog post will explore which dental procedures often result in nerve damage, the impact of such injuries on you, and how to find a Georgia attorney specializing in dental malpractice — if you or a loved one has suffered an injury from dental malpractice.

Dental Procedures Most Often Resulting in Nerve Damage

Many dental procedures carry a risk of nerve injury, with the inferior alveolar nerve (IAN) and the lingual nerve being the most common nerves injured by malpractice. The following are the procedures most frequently associated with dental nerve damage in Georgia:

Published on: July 29, 2024

How to Pick a Georgia Dental Malpractice Lawyer

by Robert J. Fleming

You’ve been injured by a dentist and need a lawyer. Choosing which lawyer to represent you in a dental malpractice case is no small task, especially since the lawyer will be representing you through all phases of litigation. If the case does not settle pre-suit, the lawyer will be filing a dental malpractice complain on your behalf, usually in state court. So, choosing the right lawyer for you is critical in the proper resolution of your case. Asking co-workers, family members, or other professionals with whom you have a relationship for a referral to a lawyer can sometimes be helpful. However, Georgia Dental Malpractice litigation is such a specialized area that these resources may not be entirely helpful. However, asking the right questions and doing the proper research will put you in an excellent position to find the right dental malpractice lawyer for you. Here are some considerations to take into account and to ask any lawyer you are contemplating hiring to represent you in a Georgia dental malpractice case:

How long have you been practicing? In many professions, there simply is no substitute for experience and the law is no exception. This is especially true in dental malpractice litigation. You want a lawyer that has substantial experience practicing law, and (more importantly) regularly handles dental malpractice cases in Georgia. So, it would behoove you to ask any prospective dental malpractice attorney how long they have been practicing law and what percentage of their practice is devoted to dental malpractice.
Do you have trial experience? While most dental malpractice cases do not go to trial, sometimes the only way to get the proper compensation in a dental malpractice case is to try it in a Georgia court before a jury of your peers. You want a lawyer who is ready, willing and able to go to bat for you in the courtroom. You owe it to yourself to hire a lawyer that you feel is comfortable in the courtroom and who will not shy away from taking your dental case to trial.

Published on: July 19, 2024

Premises Liability Atlanta Businesses Liable for Inadequate Security

by Robert J. Fleming

There has been a number of large Georgia verdicts recently in inadequate security premises liability cases. The landscape is ever-chaning for these cases because the law evolves over time in the courts and the codes are interpreted more narrowly. A thorough and timely evaluation is essential to the ssuccessful pursuit of these cases. Some of the initial steps are: talking to the police; requesting crime history reports for the surrounding area; and securing statements from witnesses. Additionally, a thorough anlysis of what insurance is available to cover the incidetn is essential.

When someone gets injured or attacked on a business premises (such as a big box store, hotel, motel or restaurant), the most commong defenses are based on legal arguments of experiration of the applicable statute of limitation, assumption of the risk, trespasser status of the injured plaintiff, equal knowledge of the unsafe condition and contributory negligence. Other common defenses are that the incident did not happen on the property or that the incident was the sole responsiblity of a third party tortfeasor (the attacker).

Inadequate security can often be the basis for liability against the defendants. Most businesses have some type of secuirty measure in place, but the issue is usually crafted around whether the security measures were sufficient to protect against incident that occurred based on the totality of the circumstances. Some common security measure that may or may not be adequate to defend against liability are the organizations policies and procedures related to safety and security, criminal backgound checks of all employees, subcontractors etc., an on-site security guard, adequate fencing that is well-maintained (many incident are the direct result of third parties gaining access to the property through holes in the fence which are regularly used as cut throughs), a security gate for pedestrian access, a security gate for vehicular access, community engagement for safety, adequate reporting of incidents and potential dangers, courtesy officers on site showing a presence, and a documented effort to combat crime.

Published on: July 1, 2024

Lower Jaw Dental Work Common Cause of Dental Nerve Damage in Georgia

by Robert J. Fleming

Dental malpractice can occur during various procedures, but some common dental procedures result in a much higher percentage of dental malpractice claims. The reason for this is probably the complexity of the procedure, the proximity of the procedure to certain anatomical structures in the mouth and tongue and jaw and the severity of the injury when these structures are violated by the dentist performing the procedure. Some of the procedures which tend to cause the most Georgia Dental malpractice claims are:

Tooth Extractions in the Lower Jaw: Improper extraction techniques during complex extractions can lead to damage of the jawbone, nerves that run along the jaw and tongue and other parts of the face. This results in nerve damage and has leads to signs and symptoms such as pain, numbness, (pain and numbness together) and loss of feeling in the lip chin gums, teeth and face.
Root Canals Procedures in the Lower Jaw: Not complying with the applicable standard of care when performing root canal therapy (root canals) results in errors during root canal procedures, such as perforations of the root, over-instrumentation of the canals, apllying too much pressure whine filling the canals, using the wrong type of filling material, incomplete cleaning, or overfilling of the canal. These can call cause cause infection, pain, nerve damage and or damage to surrounding tissues and, even at time, damage to the surrounding bone when the malpractice causes and infection and the infection is not treated in a timely manner or is treated ineffectively. This can lead to osteomylitis, a very serious bone infection that is extremely hard to treat due to the lack of blood and oxegynation in the infected bone..

Published on: June 20, 2024

Top Dental Injuries from Dental Procedures in Georgia

by Robert J. Fleming

While three of the top dental injuries are toothache, jaw pain and broken teeth, the most prevalent injuries from dental procedures or dental malpractice in Georgia are quite different. Among the most common injuries from dental procedures are a numb tongue, numb chin, numb lip and teeth, and nerve injuries of the face, jaw and tongue. While this may be stating the obvious, to pursue a dental malpractice claim in Georgia, the plaintiff must prove: (1) that she sustained and injury from a dental procedure; and (2) that the injury was caused by negligence on the part of the dentist during the performance of a dental procedure such as a root canal or dental implant. In other words, it is not enough that there is an injury, but rather the plaintiff must prove that the injury was caused by malpractice.

Basic dental malpractrice law requires that the Plaintiff establish duty, breach and causition. Put another way, tin order to prove her case, the Plaintiff in Georgia must prove that there was a dentist/patient relationship, that the dentist had a duty of care to perfrom the procedure in a competent manner, the dentist breached that duty, and that the breach of the standard of care caused the injuries that the Plaintiff is complaining of in the lawsuit. Some of these necessary requirements are satisfied by expert testimony in the form of an affidavit that is attached to the complaint when it is filed with the court. That is why it is essential to retireve Plaintiff’s records from the defendant, as well as all subsequent treating providers such as dentists, doctors, hospitals and pain doctors.

Elements of damages can include, but are not limited to, past lost earnings, future lost earnings, a decreased ability to labor, disfugrement, physical or mental impairment pain and suffering, past medical bills, future medical bills and other damages. These types of damages are proven with documentary evidence, as well as testimony and opinions from dentists, doctors and lay witnesses in order to fill in the gaps and provide a complete picture to the jury.

Published on: June 19, 2024

Georgia Commissions Law for Sales Associates and Account Executives in Atlanta

by Robert J. Fleming

Sales associates and account executives typically work very hard. Successful and hard-working sales people can earn a lot of money and make a good living. Unfortunately, they are not always paid the correct amount of money that they are owed by their employers. Sometimes, this is an honest mistake and can be rectified in short order. Far too often though, there is no mistake and the employer company refuses to pay the full amount of commissions owed, even after the sales associate makes numerous demands for payment.

This is an unfortunate situation that happens all too often. A salesperson is gainfully employed and working hard. She makes a large sale, or a series of large sales, often pushing the limits of the commission plan. The company, while very happen to book the revenue, does not want to pay the large commission. In an attempt to avoid paying the full commission, the company tries to unilaterally change the salesperson’s commission plan after the sale and without the consent of the salesperson. Or, the company will terminate the salesperson before the commission is due and claim that the do not have to pay the commisson. Alternatively, the company will try to negotiate with the saleperson to avoid paying the full amount owed under their agreement.

These type of commission disputes are usually governed by something in writing. It could be an employment agreement, commision schedule, commission plan or some other similarly titled document which explains how salepeople are compensate and under what conditions. There is usually an itemized list of definitions and this document, many times, lays out when the sales is consdered booked and when it is payable. It almost always details the amount of commission that will be paid on each sale, what has to be completed to be paid, how commissions are calculated, any incentives or bonuses that could be applicable and when the commissions and bonuses are payable. While each case is different, this commission document usually forms the basis for the claim for full commissions due and payable.

Published on: May 22, 2024

Georgia Dental Malpractice

by Robert J. Fleming

Dental malpractice in Georgia can take many forms. Some of the most common reasons malpractice occurs is a lack of training by the dentist performing certain procedures (such as root canals, dental implants and oral cancer screenings); a lack of communication between two dentists (whether in the same office or in separate dental offices) who are involved in the care and treatment of a patient; a failure to properly document and observe important anatomical landmarks and measurements (thi is especially important when performing root canals and dental implant procedures); failing to review the patient’s chart and medical history prior to using or prescribing drugs that the patient may be alert to or which may interact with medications that the patient is current taking; and carelessly performing a procedure which results in injury to the patient.

The standard of care for dental malpractice in Georgia requires that all of the above situtions be handled in a fashion that a reasonable dentist would do in like or similar circumstances. Many of the standard of care violations that we uncover occur when general dentists perform dental procedures that should be referred out to a specialist. This occurs most often with complicated extractions, root canals and the installation of dental implants. One area that we have seen that results in a lot of dental malpractice claims is large corporate dental chains who advertise as providing affordeable dentures causing severe dental nerve injuries when the attempt an “all on 4” dental implant procedure. This procedure involves extracting all of the patient’s existing teeth (both top and bottom), placing 4 implants on the top and 4 on the bottom, and then attaching the implants to these implants. Unfortunately, the high volume of procedures preformed result in many serious dental nerve injuires that could be avoided with proper training, careful placement and other quality control processes that don’t happen in high volume dental implant offices that sometimes focus on quantity over quality.

Lawsuits in these situations will focus on duty (from the dentist to the patient), breach (of the standard of care, in other words the procedure is not done properly) and the resulting damages (often dental nerve injuries and other types of dental injuries that result from the procedure. These form the basis of the lawsuit and each of the elements are necessary to pursue a dental malpractice case in Georgia.