Lack of antibiotics costs dentist $2.6 million

2008 08 14 09 28 46 88 000003074613 70

An Oklahoma dentist's decision not to pretreat a diabetic patient with antibiotics prior to extracting her abscessed tooth may cost him $2.6 million. That is the amount a Comanche County jury has awarded the husband of Linda Culberson, who died in January 2004 from an infection after Robert Morford, D.D.S., of Lawton, OK, pulled her tooth.

Mrs. Culberson, 58, went to Dr. Morford's office in April 2002 with "a chronically abscessed tooth," according to Ed Culberson's attorney, Mike Markey. Dr. Morford opted to pull the tooth but did not give Mrs. Culberson any antibiotics. She then developed a "life-threatening infection," according to Markey. The infection became so serious that she spent 20 months on life support and died in January 2004. Mr. Culberson filed his malpractice lawsuit later that year.

The key issue put before the jury was whether Culberson should have been given antibiotics prior to the extraction, Markey said -- especially because she had poorly controlled diabetes. The ADA recommends that dentists "consider systemic antibiotics for uncontrolled diabetic patients who have frequent infections or heal poorly," and numerous studies have found that infection is a risk for diabetic patients and can make it more difficult to control blood glucose levels. For example, a 2000 study published in the Journal of the American Dental Association concluded that, because insulin-dependent diabetics are particularly susceptible to infections, "antibiotic coverage for invasive dental procedures is recommended in patients with poorly controlled or uncontrolled diabetes" (JADA, March 2000, Vol. 131:3, pp. 366-374).

"The defendant's position was that the antibiotics weren't necessary, and our position was that they were, given her history of health problems," Markey said.

However, the jury found that Mr. Culberson was partly at fault because he did not adequately inform Dr. Morford of Mrs. Culberson's diabetes, Markey said. Culberson's lawsuit originally sought $4 million in damages.

"The jury found that there was some negligence on the part of the husband," Markey said. "One of the issues they raised is that he should have gotten her to the dentist sooner."

Michael Hill, Dr. Morford's attorney, told that Dr. Morford met the standard of care in that removing the source of the infection -- the tooth -- was the appropriate treatment for the infection, and that antibiotics were not required.

"We did then, and do now, feel as though Dr. Morford met the standard of care," Hill said.

The verdict could be appealed, according to Markey. The court is already considering various post-trial motions, Hill said.

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