1) Damage of a tooth in connection with intubation

A patient had an endotracheal tube inserted for the duration of general anaesthesia in connection with a medically indicated procedure. The intubation was absolutely necessary to safeguard the patient's respiration and the procedure had been performed in accordance with acceptable treatment practice according to the information obtained. One of the patient's premolars was damaged in connection with the intubation. The tooth in question had previously had four sides filled.

Teeth with healthy periodontium that have not been filled endure the insertion of a tracheal tube and the strain on the teeth that is inevitable while the tube is in place without being damaged. On the other hand, teeth in poor condition, that have weak periodontium and that have many fillings, as well as prosthetic structures, such as bridges or crowns, do not endure strain similarly to healthy teeth.

A tooth in poor condition being damaged in connection with intubation was a consequence associated with the procedure performed on the patient that could not be avoided in spite of the appropriate implementation of the treatment.

The case did not meet the criteria for an injury compensable under the Patient Injuries Act.

2) Nerve injury caused by block anaesthesia

A patient's chipped left molar was repaired under block anaesthesia. Pain and numbness occurred on the left side of the mandible and cheek after the procedure, and opening the mouth was painful. The pains had alleviated six months after the procedure, but the lower lip was still numb. The symptoms were considered to be probably due to damage to the mandibular nerve branch.

The block anaesthesia was performed by way of a "blind injection" without opening up tissue, making it impossible to find out the location of the nerve in relation to the syringe. In this case, the nerve can be damaged either from contact with the needle or injection of the anaesthetic. In addition, tissue pressure caused by the anaesthetic can also cause nerve damage. When anaesthesia is performed using a "blind injection", damage to the nerve is always possible even if the procedure was performed appropriately.

Based on the documents, the treatment received by the patient was medically indicated and it was performed appropriately and in accordance with generally acceptable treatment practice. The nerve damage caused to the patient could not be avoided in spite of the procedure being performed appropriately, so this was not a compensable patient injury referred to in the Patient Injuries Act.

3) Breaking of a needle in a root canal

Root canal treatment was carried out on the patient’s tooth no. 22 (upper left front tooth). During the treatment, the root canal instrument broke in the root canal. Considering that, based on the X-rays, the root canal was not narrow, the Patient Insurance Centre holds that the breaking of the instrument could have been avoided with due care. If the root canal is narrow or markedly curved, it is always possible that the root canal instrument will break during the treatment, even if due care is exercised in performing the treatment. In this case, at issue is a complication that cannot be avoided with a different procedure, and the injury will not be compensated for under the patient insurance.

The patient had to make three additional visits to the dentist because of the injury, the costs of which were compensated for under the patient insurance. Additionally, EUR 200 was paid to the patient as compensation for temporary incapacity.

15.06.2016