Alleged negligence

The patient pursued a claim for negligence on the basis that if the DDU member had made a referral in the first instance, a diagnosis of dysplasia would have been made when the gum lesion was reported, and the treatment would have been far less invasive.

Expert opinion

The member approached the DDU for assistance in dealing with the claim, and we instructed an independent expert to examine the details of the case and give an opinion on whether the member was in breach of their duty of care.

The expert was critical about the lack of information in the records. They suggested the member should have recorded where candidiasis was seen or suspected, and what it looked like, together with details of whether an attempt was made to rub away the white spots, to differentiate candidiasis from dysplasia.

We also instructed experts on causation, who concluded that if a biopsy had been done when the inflammation did not resolve, the histological examination was likely to have identified dysplasia in the specimen. If this had been the case, there would have been an earlier referral and the treatment would have been less extensive.

The patient also instructed their own independent experts, who separately concluded that the patient had severe epithelial dysplasia during the material time. If they had been referred in a timely manner, they would have been treated for the dysplasia with surgery, and there would have been a higher probability that they wouldn't have gone on to develop cancer.

Outcome

With the DDU member's agreement, the claim was settled because of the vulnerabilities identified by both sides. The eventual settlement amount did, however, take into account factors such as the patient's delay in attending a follow-up examination.

Misdiagnosis of oral malignancy

Misdiagnosis of oral malignancy