The 72-year-old plaintiff underwent a crown procedure in May 2018. The dentist dropped the crown into the woman’s throat. The crown landed in her trachea – but the dentist believed the lost crown fell into her esophagus. To work its way through the digestive tract, ending you know where. An x-ray would have ended the mystery. The dentist did not order an x-ray, and instead recommended his patient drink water and eat some crackers. Plan B.  

Time passed. The patient developed respiratory problems and sought care at a local hospital. The hospital performed a CT scan, which detected the presence of a foreign object in the patient’s lungs. Can you guess what it was? 

Here’s where the plot thickens: The radiologists mentioned the foreign object in their report, but this detail was missing in the summary and introductory paragraphs. 

The doctor who ordered the CT scan (and received the report) never learned a foreign object was in the patient’s lung. And the radiologists made no additional efforts to bring this detail to his attention.  

Uh-oh. 

Let’s advance to September 2018. Five months have passed. The patient/plaintiff is now in the ER. She’s septic. Both lungs collapsed. The crown was eventually identified and removed at a different hospital. The advanced nature of the patient’s infection kept her in the hospital for several weeks. The patient eventually recovered after a month of intense in-patient rehabilitation. 

So, who got sued? The dentist? His practice? The hospital? 

All the above. 

The patient claimed the dentist acted beneath the standard of care by neglecting to use a dental guard when placing her crown. The fact the dentist did not order x-rays after he dropped the crown injured his defense. As to why the patient failed to cough out anything in the trachea is a mystery. Perhaps she was sedated.  

The claims recently settled. 

The hospital settled for $675,000. 

The dentist for $550,000. 

Thus the $1.225 million headline. 

The plaintiff’s attorneys stated: 

“We were able to show through the depositions of those two radiologists that their improper documentation of the dental fragment, coupled with their failure to report their finding directly to our client’s attending physician—known as non-routine communication—was a significant deviation from the acceptable standard of care.” 

The take-home-points: If you lose an object in the patient’s body, you must take ownership of tracking said object down. The dentist assumed the crown landed in the patient’s stomach. If it did, the object would likely pass through the patient’s system within a few days. 

But if the crown landed in the patient’s lungs (an object dropped into the throat can only travel one of two roads), it will turn into a problem – potentially a life-threatening problem. 

An x-ray could have identified the location of the crown and expedited its removal. 

Though we can’t be certain, it is possible this simply wasn’t a conversation the dentist wanted to have with the patient. The crown probably landed in the patient’s stomach. Why create anxiety (or risk a malpractice claim) if the object didn’t make its way into the patient’s lungs? 

Would you bet your license on a coin flip? 

Let us know your thoughts in the comments below.   

Jeffrey Segal, MD, JD

Chief Executive Officer and Founder

Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. Dr. Segal is a Fellow of the American College of Surgeons; the American College of Legal Medicine; and the American Association of Neurological Surgeons. He is also a member of the North American Spine Society. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

Dr. Segal was a practicing neurosurgeon for approximately ten years, during which time he also played an active role as a participant on various state-sanctioned medical review panels designed to decrease the incidence of meritless medical malpractice cases.

Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.

In 2000, he co-founded and served as CEO of DarPharma, Inc, a biotechnology company in Chapel Hill, NC, focused on the discovery and development of first-of-class pharmaceuticals for neuropsychiatric disorders.

Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. Byrd Adatto was selected as a Best Law Firm in the 2021 edition of the “Best Law Firms” list by U.S. News – Best Lawyers. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.