The case was settled prior to trial for $155,000. Kenneth P. Liroff, D.D.S., J.D., of THE DENTALAW GROUP, Ft. Lauderdale, FL represented the plaintiff. Charles E. Sinclair, Esq., Miami, FL for the defendant.

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Plaintiff was a 55 year old school teacher who had been under the almost continuous care of her general dentist from 1963 until 1995. During her 32 year course of treatment by the defendant, the plaintiff diligently and almost religiously returned to the office for periodic prophylaxes (cleanings) which were performed by the defendant and not by a dental hygienist. In 1970, the defendant made a full mouth series of dental x-rays, and made cavity-detecting (bite-wing) x-rays at many of the cleaning visits.

She was never told about the onset or progression of periodontal disease until December, 1995, when she developed a periodontal abscess and the defendant made a new full mouth series of x-rays. Even then, the dentist didn’t tell her about her periodontal disease but, instead, referred her to a periodontist who “had to tell her the bad news.” The plaintiff lost several teeth and required four quadrants of periodontal surgery.

The case settled during the presuit investigation period for the defendant’s policy limits of $100,000.00. Dade County, Florida. Kenneth P. Liroff, D.D.S., J.D., of THE DENTALAW GROUP, Ft. Lauderdale, FL represented the plaintiff. Mary Lou Donovan, Claim Representative for St. Paul Fire & Marine Ins. Co., for the defendant.

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The plaintiff was a thirty-eight year old mail carrier who had been receiving regular dental care from the defendant general dentist for several years. He complained about a “white spot” on his gums above a maxillary central incisor tooth and later noticed pus exuding from this spot. The defendant suggested that the plaintiff see a partner defendant dentist. That dentist performed periodontal surgery which resulted in significant recession of the gingiva around the necks of the upper anterior teeth revealing considerable tooth and root structure. The plaintiff claimed that he should have been referred to a periodontist. The plaintiff’s subsequent treating dentist found a maxillary anterior bridge constructed by the first dentist to be defective and the source of the periodontal abscess. The plaintiff was referred to a periodontist who was critical ofthe second dentist’s attempt at periodontal therapy. The plaintiff required replacement of his three unit bridge and gingival graft surgery. All dental expense was paid by dental insurance.

The case settled for $24,000 prior to trial. Kenneth P. Liroff, D.D.S., J.D., of THE DENTALAW GROUP, Ft. Lauderdale, FL represented the plaintiff. Michael L. Von Zamft, Miami, FL for the defendants.

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The plaintiff, age forty-eight, went to the defendant general dentist in October 1985 for dental extractions and dentures. The medical history given to the defendant included squamous cell carcinoma of the left mandibular retromolar mucosa which was treated with radiation in 1982. He also listed the names, addresses and phone numbers of his physicians. The defendant did not call either of the physicians and made no investigation of the plaintiff’s history. The defendant extracted twelve teeth, one of which was a root fragment in the mandibular left molar region. The tooth was directly in the path of the 1982 radiation. Two months after the extractions, the dentist inserted dentures. The plaintiff returned four times during the next three months complaining that the lower left extraction socket hadn’t healed and that there was a foul odor and taste, to which the defendant advised the plaintiff that the symptoms were the result of “radiation infection” and would get better in time. The plaintiff returned eight months later with advanced osteoradionecrosis requiring resection of his mandible producing a discontinuity defect. Over the next seven years the plaintiff underwent three bone grafts, a pectoralis myocutaneous flap and other soft tissue grafts. The plaintiff claimed that the defendant was negligent for failing to consult with or refer to an oral surgeon. That the extraction was negligent and improperly monitored and that the defendant failed to obtain his informed consent. The defendant claimed that there was no need for a consultation or referral, that the extraction socket fully healed and that the plaintiff never voiced any complaints about the extraction socket. The defendant claimed that the plaintiff’s failure to follow-up with his cancer doctors and continued smoking and drinking habits was comparative negligence. The defendant also claimed that the head and neck surgeon, radiation therapist and hospital were negligent for not having the tooth extracted prior to radiation and that the reconstructive surgeon who operated on the plaintiff after the oseoradionecrosis developed was also negligent.

A $2.96 million verdict was returned following a two-week jury trial which was reduced for five percent comparative negligence and twenty-five percent apportionment of fault against the hospital. Kenneth P. Liroff, D.D.S., J.D., of

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The plaintiff was a twenty-five year old legal secretary when in June, 1981, she visited the offices of a general dentist for a routine examination. The dentist suggested that she consult with the defendant who was an orthodontist and who worked in that general dentist’s office one day per month. The defendant orthodontist owned family dentistry clinics throughout south Florida where he would see patients one day a week in each location. After examination of the plaintiff, the defendant made an entry in his office record describing his patient as an “extraordinary case”. Notwithstanding this, he made no study casts, took no photographs and failed to conduct a cephalometric analysis to determine whether the patient had any skeletal defects and to determine the relationship between the jaws or the teeth to the jaws. The defendant decided that his patient needed space for the repositioning of her teeth so he ordered the extraction of four premolar teeth. After the teeth were removed he applied orthodontic brackets and elastic traction. A couple of months later, his patient complained of headaches and muscle pain in her neck and shoulders. He saw her monthly and made adjustments and she repeated her complaints each time stressing their increasing severity. The defendant apparently made no connection between her complaints and his treatment. At some point during treatment, the patient started complaining of pain in her temporomandibular joints, yet the defendant did nothing. The patient began seeing ENT surgeons, internists, neurologists and chiropractors. One of the many chiropractors she had seen suggested that she had TMJ Dysfunction Syndrome and referred her to a dentist who limited his practice to treatment of that disorder. He told her that the orthodontic treatment was causing the TMJ symptoms and referred her to another orthodontist for a second opinion. The consulting orthodontist concurred and suggested she have her braces removed. She returned to the defendant and he referred her to one of his orthodontic employees who worked in one of his other clinics. That orthodontist told her that the braces were moving her teeth in the wrong direction and removed the appliances. The patient started orthodontic treatment again, this time in the right direction and shortly thereafter had jaw repositioning surgery which she apparently needed from the outset. The defendant never realized the need for surgery since he never took the necessary cephalometric x-rays. Claim was not made for the surgery inasmuch as the patient had the skeletal defect upon presentation to the defendant who merely delayed that aspect of treatment. The case was settled after jury selection for $85,000, representing intangible damages only, inasmuch as the patient had full health insurance. Kenneth P. Liroff, D.D.S., J.D., of THE DENTALAW GROUP Ft. Lauderdale, FL represented the plaintiff. Carl M. Jenkins, Esq., Ft. Lauderdale, FL represented the defendant.

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The plaintiff, a thirty-one year old homemaker and executive recruiter for local and national firms, was referred to her general dentist, by the defendant orthodontist, to attempt the retrieval of a palatally-impacted maxillary cuspid (upper eye-tooth embedded in the roof of the mouth). The defendant, without the benefit of cephalometric x-rays, diagnosed her as having a Class II maloccusion with a nearly “ideal facial profile”. There was a relative retrusion of the mandible of six millimeters, a deficient chin and obvious vertical maxillary excess. Notwithstanding the six millimeter maxillo-mandibular discrepancy, he ordered the bilateral first bicuspids extracted. His plan was to use elastic traction to bring the lower posterior teeth forward on the lower arch wire and, with the same elastic attached to the surgically-exposed palatal cuspid, to bring the palatal cuspid down. Optimistically, he ordered the extraction of the deciduous, or baby, cuspid which was rock-solid in the site into which he hoped to move the palatal cuspid. Retrieval of the palatal cuspid failed. According to the defendant, this was because of poor patient cooperation. He then ordered the removal of the palatal cuspid and the contralateral cuspid “so that it would be symmetrical”. After one and one-half years of appliance therapy, the plaintiff started over with four large spaces in her mouth caused by the extractions on top and bottom. After another year or so the plaintiff sought another opinion and was told that she wasn’t being treated properly and that the spaces might never close without surgery. After a year of orthodontically trying to close the spaces by the second orthodontist, he referred her to an oral and maxillofacial surgeon. Following a thorough work-up, the plaintiff was proposed either fixed bridgework to close the extraction spaces or orthodontic surgery which would not only close the spaces but also correct for the retruded lower jaw and minimize the vertical maxillary excess. She elected the surgical approach and underwent a segmentalized maxillary Le Forte I osteotomy and mandibular sagittal split osteotomy. The plaintiff contended that she lost approximately six months of employment as a professional executive recruiter although admitting that she had been laid off before the surgery and that her employer denied that the lay-off was related to her impending surgery. Out of pocket medical expense was less than $5,000. There was no permanent disability or injury.

The case settled on the morning trial was to begin for $70,000. Kenneth P. Liroff, D.D.S., J.D., of THE DENTALAW GROUP Ft. Lauderdale, FL represented the plaintiff. Clark Cochran, Esq., Ft. Lauderdale, FL represented the defendant.

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Plaintiff was a banker in her mid-twenties when she underwent a bilateral mandibular sagittal osteotomy and LeFort I maxillary osteotomy because of a facial skeletal deformity. An acrylic interocclusal stent was inserted during surgery and the patient’s jaws closed into the stent. During the immediate post-surgical period, the patient’s lower teeth came out of the stent and the defendant oral surgeon used Class III elastic traction to pull the lower jaw forward so that the teeth would seat in the stent.

Because the osteotomy fragments were rigidly fixed to each other the elastic traction served only to force the mandibular condyles forward in the glenoid fossae and cause dislocation of the TMJ discs. The patient required TMJ arthroscopic surgery and refracturing of the osteotomy.

An incidental finding by the subsequent treating oral surgeon was that the patient’s nasal septum was buckled and deviated which could only have resulted from the defendant’s failure to remove sufficient septum at the time of the original LeFort surgery. This finding necessitated an additional procedure to remove the excess septum.

The case settled during a mediation conference for $230,000.00 (the defendant’s policy limit of $250,000.00 minus defense costs.). Dade County (FL) Circuit Court, Case No. 93-09467-CA24. Kenneth P. Liroff, D.D.S., J.D., of , Ft. Lauderdale, FL represented the plaintiff. Jay Chimpoulis, Esq., of O’Connor & Meyers, Coral Gables, FL, for the defendant.

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The plaintiff, age ten and one-half, visited the defendant dental clinic for orthodontic treatment. The first orthodontist started treatment and extracted six deciduous teeth and four permanent teeth. The second orthodontist continued treatment and estimated two years of therapy and one year in retainers. Nearly four years after therapy began the plaintiff was still in treatment and saw the third clinic orthodontist who told the family that the plaintiff needed an additional two years of treatment. The plaintiff discontinued therapy and saw a private orthodontist who found fault with the excision of the four permanent teeth. The plaintiff underwent two additional years of orthodontic therapy and required head-gear to correct the extraction of the four permanent teeth. The defendants’ position was that the extraction of the teeth was a “Judgment Call”.

The case settled for $7,500 before trial. Kenneth P. Liroff, D.D.S., J.D., of THE DENTALAW GROUP Ft. Lauderdale, FL represented the plaintiff. Rob Barouth, Esq., Miami, FL and Carl E. Jenkins, Esq., Ft. Lauderdale, FL for defendants.

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Plaintiff was a 24 year-old single woman when she first visited the general dentist with complaints referable to her lower third molar teeth. She was told that she should have the teeth extracted and she told the dentist that she wanted a general anesthetic. He offered to refer her to an oral surgeon or, if she was willing to wait for the dentist to receive something from the state, she could return to him and he would be able to do the surgery under general anesthesia. He was, at the time, awaiting receipt of an anesthesia/parenteral sedation permit from the Florida Board of Dentistry.

More than six months later, he called the patient back into his office to schedule her surgery. The dentist’s wife was a CRNA (nurse anesthetist) and would do the anesthesia. The dentist used a high-speed air turbine handpiece to drill away bone and caused a massive subcutaneous emphysema to develop in the submandibular space which dissected its way down to the clavicles. The patient was sent home and the dentist and his wife made a house call the next day, but did not send the patient to a hospital emergency room. The following day, after seeing just how massive the emphysema was on the previous day, the dynamic duo returned to the patient’s house with five boxes of frozen green peas which they bought at a nearby convenience store; they placed the green peas on the patient’s upper chest and neck in a futile effort to reduce the swelling, mistakenly believing the emphysema to be an inflammatory process receptive to cold compresses.

A few days later, when the swelling had not subsided and the patient’s fears had increased, she visited a nearby hospital emergency room and was reassured that, although she was in danger during the first few days, the danger had passed and she would gradually improve.

Although the emphysema subsided, sensation to her right tongue never returned and she is left with a permanent paresthesia and disturbance of taste on the right side of her tongue which she attributed to the defendant dentist’s negligence. There were no medical specials and no permanent injury caused by the emphysema.

The case settled for $95,000.00 from dentist’s $100,000.00 policy limit and $1,250.00 from the nurse anesthetist. Plaintiff’s expert: Marlon Branitz, D.D.S., oral and maxillofacial surgery, Coral Springs, FL. Defendants’ expert: none disclosed. Suzanne Henoch v. Steven G. Mautner, D.D.S., and Barbara E. Mautner, CRNA.

Broward County (FL) Circuit Court Case Number: 95-12013 (03). Kenneth P. Liroff, DDS, JD, of of Fort Lauderdale, FL for the plaintiff. Steven Billing, Esq., of Billing, Cochran, Heath, Lyles & Mauro, P.A., Fort Lauderdale, FL for defendant dentist. Mark C. Burton, Esq., of Wicker, Smith, et al., Fort Lauderdale, FL for defendant nurse.

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Plaintiff was a 36 year old office worker who underwent the surgical removal of her asymptomatic erupted lower right wisdom tooth by the defendant general dentist, during the course of which surgery her lingual nerve was transected, leaving her with a permanent right lingual nerve numbness and right-sided taste disturbance.

At deposition, the defendant testified that he saw the lingual nerve during his retraction of a lingual mucoperiosteal flap which he had developed so that he could remove bone from the lingual surface of the tooth, and that “the nerve came up and hit the bur.” There was never a discussion of risks of the proposed surgery nor was there a signed consent form. The dentist’s records made no reference to the transection of the nerve by the bur and he never told this to the patient. For many months the patient called the defendant’s office and he avoided her.

Nearly a year after the extraction the plaintiff saw an oral surgeon who told her that her nerve injury was probably caused by the anesthetic injection. Plaintiff faulted the defendant for having performed unnecessary surgery, lack of informed consent, negligent surgery and failure to monitor and refer her timely to a microsurgeon for consultation about possible repair surgery.

The case settled for $140,000.00. Plaintiff’s Experts: John M. Gregg, D.D.S., Ph.D., oral and maxillofacial surgery and microsurgery, Blacksburg, VA.; Richard R. Souviron, D.D.S., general dentist, Coral Gables, FL; Marlon Branitz D.D.S., oral and maxillofacial surgery, Coral Springs, FL. Defendant’s Experts: Fred Alfele, D.D.S., oral and maxillofacial surgery, West Palm Beach, FL; Roger Froelich, D.D.S., oral and maxillofacial surgery, West Palm Beach, FL. Palm Beach County (FL) Circuit Court Case No. 95-4841 AH.

Kenneth P. Liroff, D.D.S., J.D., of the Dental Law Group, Ft. Lauderdale, FL represented the plaintiff. Edwin E. Mortell, III, Esq., Peterson, Bernard, et al., West Palm Beach, FL for the defendant.

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