Case details

Dental damage not caused by removal of brackets: defense

SUMMARY

$0

Amount

Verdict-Defendant

Result type

Not present

Ruling
KEYWORDS
dental
FACTS
On March 25, 2011, plaintiff Michelle Nicolas, 23, underwent the removal of brackets and residual cement from her mouth, at the request of her dentist, Nancy Goebel DDS. Nicolas originally sought orthodontic treatment at Smile by Design in Los Angeles on Jan. 18, 2008, when Nicholas was a 20-year-old student, and subsequently came under the care of Goebel, an independent contractor. She then continued to treat with Goebel and, for most of her visits, Angelita Ramirez, RDA, was the dental assistant involved with her care. Goebel ultimately recommended the removal of brackets and residual cement from Nicolas’ mouth and, on March 25, 2011, the procedure was performed by Ramirez with an air-driven handpiece and a bur. However, Nicolas claimed that during the course of the bracket removal, Ramirez and damaged 26 of her teeth by creating bur marks and removing enamel to the dentin. Nicolas sued Goebel, Ramirez and Gregory Kaplan, who was doing business as Smile by Design Orthodontics. Nicolas alleged that the defendants failed to properly perform the bracket and cement removal and that this failure constituted dental malpractice. She also alleged that the defendants actions constituted battery and that Ramirez was negligent per se based on a violation of the state’s Business and Professions Code § 1752.4. Nicolas claimed that during the course of the bracket removal, Ramirez used a diamond bur instead of a fluted finishing bur, causing damage to her teeth. Plaintiff’s counsel contended that Ramirez was prohibited from removing cement with a high speed motorized drill, per Business and Professions Code § 1752.4, and that Ramirez’s negligence cause injury to Nicolas. The plaintiff’s subsequent treating dentist, Christine Matthews, DDS, testified that she observed damage to Nicolas’ teeth on April 9, 2011. Ramirez claimed that a fluted finishing bur was used during her treatment of Nicolas and would never have used a diamond bur. She noted that diamond burs are used by the dentist, not the assistant, and claimed that she never has used a diamond bur in her practice for any reason. Defense counsel contended that a fluted finishing bur will not cause damage no matter how hard someone might try, noting that one of the defense’s experts testified that he took a fluted finishing bur and tried to cause damage on a removed tooth and couldn’t. Thus, defense counsel argued that Ramirez used the proper bur for the cement removal and that she did not damage Nicolas’ teeth, citing, as evidence, the photographs taken right after the removal. Counsel contended that although the subsequent examination with Matthews showed that there was damage to Nicolas’ teeth, it was not in the location of the brackets or where the cement would be, and that at least one tooth that wasn’t bracketed had damage. Defense counsel argued that it appeared as if Nicolas’ teeth had been prepped for veneers prior to treatment with Matthews and after treatment with Ramirez and Goebel. Thus, defense counsel argued that Nicolas must have gone elsewhere, where the damage was caused., Nicolas claimed 26 of her teeth were damaged with bur marks and enamel was removed from the dentin. Thus, she claimed periodic 10-out-of-10 pain, as well as sensitivity to cold and hot liquids as a result of loss of enamel to her teeth. Nicolas alleged that as a result, she will need the placement of veneers. The plaintiff’sgeneral dentistry expert opined that Nicolas would need full mouth veneers, replaced every five years for the rest of her life, and possibly root canals, costing a total of $750,000. Thus, Nicolas sought recovery of $250,000 in damages for her past pain and suffering and $1 million in damages for her future pain and suffering. Defense counsel acknowledged that Nicolas’ teeth were damages, but argued that the cause of this damage had occurred while being prepped for veneers, after she left the care of Ramirez and Goebel. Thus, counsel argued that any dental injury alleged by Nicolas was not caused by anything Ramirez or Goebel did or did not do.
COURT
Superior Court of Los Angeles County, Central, CA

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