According to the Academy of General Dentistry, dentists are the defendant in approximately 11% of the medical malpractice claims. Dentists may encounter emergency medical situations involving patients during treatment. A medical emergency may occur where a patient is having a physiological or psychological problem in the course of dental treatment. These emergencies may be a random patient event such as a heart attack, or a risk associated with treatment such as a patient fainting amid the sight of a needle for injection. Dentists, and their staff, should be properly prepared for such problems if they arise.
Understanding Medical Malpractice
To prove a claim of malpractice there is a burden on the plaintiff to show that the following are true:
- The dentist had a duty (obligation) to care for the patient
- That this obligation to care was breached
- The dentist’s action or inaction was the cause of damages (injuries)
When treating patients, dentists have a duty to care as it relates to dental matters. What if the patient has a medical emergency (non-dental) during the course of treatment? No definite standards exist in these scenarios; however, the dentist may still find themselves facing a lawsuit, as a patient, or their surviving family, could still proceed with a claim. With no standard of medical care that applies to dentistry in these unrelated medical emergencies, the key question is whether the dentist acted in a reasonable manner. Did the dentist respond to the situation in a reasonable way as someone else would have under the circumstances?
A study was conducted by the Raven Maria Blanco Foundation (RMBF), an organization that advocates for patients. This study asked 500 dental patients about their feelings regarding how prepared for a medical emergency (non-dental) a dentist should be. The findings showed that patients viewed their dentist as a health care provider that should have some limited capabilities of responding in medical emergencies. Essentially, dentists should have some aptitude in being a first responder up to their level of training and education.
Most dentists assume that in these situations they would be held harmless in litigation because they did not create the emergency. The concept of “mitigating damage” may also exist. This principle looks at whether a party present during the emergency did anything to further worsen the situation? This means that although the dentist in the scenario was not the cause of the medical event, they created additional damage in the course of the situation.
Dentist Preparedness for Medical Emergencies
There are various best practices for a dental provider to consider regarding preparation for a medical emergency:
- Training in CPR
- Making sure that other staff have an understanding of how to respond to emergencies
- Reviewing the emergency response procedures with staff—perhaps through mock drills
- Putting the emergency response procedures in writing—an “emergency manual” to reference
- Maintaining key medications including aspirin, an inhaler for asthma, epinephrine, glucose, ammonia inhalant kit etc.
- Basic equipment including a stethoscope & sphygmomanometers
- An automatic external defibrillator