Oral Surgery Leads to Muscular Necrosis

Oral Surgery Expert WitnessThis case takes place in Nebraska and involves a female patient who developed an abscess following a dental crown procedure who, despite attempts at incision and drainage of the abscess, developed sepsis and eventual multi-system organ failure and death. At autopsy, the original wound which had undergone the incision and drainage procedure was clean with rubbing tubing in place. However, purulent material had tracked from the original site of abscess along the right mandible into the temporalis region on the right side and showed underlying necrosis of the temporalis muscle.

Question(s) For Expert Witness

  • 1.) Do you routinely treat patients like the one described in this case? Have you ever had a patient develop this outcome?
  • 2.) Have you ever reviewed a similar case in the past?

Expert Witness Response E-006955

I routinely treat infection cases; this is an unusual and unfortunate outcome. Whether a breach of the standard of care was causally related is dependent on the early recognition and management of the infection. The patient’s past medical history, previous dental care, and compliance are also a key variables. I have taught the prevention and management of odontogenic infections to students and practicing dentists for over 20 years. I have been an expert witness on dental infection cases.

Expert Witness Response E-006671

Yes, I do treat patients with this severe type of dental infections. The issues to review include what type of pre-existing medical issues the patient had and how where the symptoms addressed as they developed. Were appropriate antibiotics at the correct doses administered, was timely treatment rendered based on the clinical condition of the patient and were appropriate imaging of the infection obtained.


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