Abstract
Background
In 1999 the Claimant (D.O.B.: 09.12.1946) was diagnosed with throat cancer for which he received radiotherapy (including irradiation of his jaw) and chemotherapy in 2000. The Defendant, his dentist, was aware of this and the treatment was clearly recorded in his dental notes.
In November 2004, the Claimant attended the Defendant for a tooth extraction. The Claimant's radiotherapy had left him at risk of developing osteoradionecrosis following surgical trauma and the Defendant should have given him antibiotic cover when performing the extraction to guard against the risk of osteoradionecrosis developing. He failed to do so and following the extraction, the Claimant developed osteoradionecrosis of his jaw which the Defendant identified at a review in January 2005. An immediate referral was made to an oral and maxillofacial surgeon.
Initially, the Claimant was treated with antibiotics and hyperbaric oxygen dives in order to promote bone healing and to prevent further deterioration. Unfortunately, these treatments were not successful and the Claimant had to undergo numerous surgical procedures to excise the dead bone and tissue. He then underwent numerous bone and skin grafting procedures. His arms, legs and chest were used as donor sites and he suffered with wound breakdown and infection which prolonged his treatment.
The surgery left him with extensive scarring to his face and neck. The tightness of the scarring caused pain, weakness and restricted movement of his right arm and he was to undergo further surgery to release that. He also had scarring at the donor sites on his arms, chest and legs.
During his treatment, his tongue was tethered to the side of his mouth. The tether could only be partially released leaving him with numbness and restricted jaw opening which affected his speech and his ability to eat and drink.
He had several teeth removed during his treatment and required dental implants.
As a consequence of his prolonged hospital treatment and the extensive scarring, the Claimant developed an adjustment disorder in or around December 2005. By February 2006, this had progressed into a major depressive disorder which was in partial remission but ongoing at the date of settlement. He also had an anxiety disorder associated with anxiety about his physical appearance. This had led to him becoming socially isolated and withdrawn. Psychiatric evidence obtained during the claim recommended he undergo a course of cognitive behavioural therapy (CBT). At the date of the settlement, the Claimant had not undergone this and its costs were included in the settlement figure. The delay in CBT taking place was due to the Claimant wishing to complete the additional surgical procedures that would be necessary before he engaged in CBT.
At the time of the negligence, the Claimant was a self-employed plumber. As a consequence of the osteoradionecrosis and its effects he had to give this up.
Issues
Liability was admitted following a letter of claim. The Claimant obtained evidence in support of causation and quantum which was accepted by the Defendant. Shortly before the settlement, the Defendant forwarded a letter of apology to the Claimant.
Settlement
The claim settled for a global sum of £189,000 plus payment of the Claimant's costs. The award can be broken down as follows:
£ 75,000.00 £114,000.00
The special damages included claims for travel and care, including sums for his family's travel and time spent visiting him in hospital. These were justified on the basis that his psychological reaction to events necessitated regular visitation by his family to maintain his spirits. There was also a claim for household and D.I.Y assistance as the Claimant had been an active man who undertook most of the household maintenance himself. The Claimant shares a house with his wife. There were also claims for lost earnings and pension loss. Costs for future psychological treatment and medical treatment to revise the scarring were included.
The Claimant's life expectancy was not affected by the negligence.