Atlanta—A Fulton County State Court jury found in favor of a dentist whose patient allegedly suffered permanent nerve damage in her tongue affecting her sense of taste following an injection of local anesthetic during a dental procedure. June Martin-Graham v. Andrew J. Newsome DDS et al. (13EV018698).
According to documents filed in the case, June Martin-Graham was a longtime patient of Dr. Newsome who visited him on January 10, 2010, to get two crowns replaced. Dr. Newsom administered an injection of a local anesthetic to Martin-Graham that contained a 4% strength solution of Citanest, the trade name for prilocaine.
Martin-Graham stated in a deposition that, in addition to the injection, she received general anesthesia and was asleep during the procedure as a result. She reported being extremely groggy when she woke up. She later went to work for the remainder of the day, although she felt somewhat groggy. Her mouth remained number the entire day.
The next day, Martin-Graham reported that her mouth was completely numb, and she called Dr. Newsome. She also stated that Dr. Newsom told her that the numbness would go away in a few days. She never saw Dr. Newsome again. However, when the numbness persisted, she consulted with other dentists, including Dr. Shahrokh Bagheri, an oral surgeon, who examined her in April, 2010. By that time, she had regained the sensation in her tongue but was experiencing constant pain, frequent drooling, and unusual taste sensations in her mouth that continued until the date of the deposition.
After examining Martin-Graham, Dr. Bagheri told her that the damage to her tongue could not be repaired. Her only choices would be to permanently live with the tongue in its present condition or to undergo surgery to completely numb the tongue, which she had not done.
Plaintiff’s theory of negligence, as explained by Dr. Mark Brenner, plaintiff’s expert witness in his affidavit, was that the 4% strength Citanest solution administered was too strong, and that a number of studies available to Dr. Newsome at the time of the procedure so indicated. According to the studies, using a 4% strength solution exposed patients to an increased risk of permanent paresthesia in comparison to a 2% strength solution, which was also generally available. In Dr. Brenner’s view, Dr. Newsome violated the applicable standard of care by using the 4% strength solution of Citanest instead of a 2% solution. He also believed that the injection of Citanest more likely than not caused Martin-Graham’s injury, which would not have occurred had Dr. Newsome used the less concentrated anesthetic.
In his pleadings, Dr. Newsome noted that 4% strength Citanest had been approved by the FDA and was commonly sold in solutions of that strength. In fact, he had given Martin-Graham similar strength injections of Citanest without incident several times in the past during other dental procedures he had performed. He stated that he spoke with Martin-Graham after the procedure and that she reported that the numbness was going away and that she could manage her pain with Motrin. He asked her to return to have the temporary crowns replaced but she never did so.
The defense pleadings also noted the deposition of Dr. Leroy Loving, an oral surgeon Martin-Graham consulted in January 2010 a few days after her procedure. Dr. Loving examined Martin-Graham and conducted various tests. In his opinion, her prognosis was good and that she would continue to improve. However, Dr. Loving never saw Martin-Graham after February, 2010.
Dr. Newsome also noted in his pleadings that the purpose of the injection was to deaden the inferior alveolar nerve, which governed the sensation in the teeth being operated upon. However, that nerve is in close proximity to the lingual nerve, which governs sensations in the tongue. Because the dentist has no way to determine exactly where the two nerves are when giving the injection, it is a known and unavoidable risk that the needle might nick or come in contact with the lingual nerve. In his view, there was no way to determine the cause of the damage to the lingual nerve.
Courtroom View Network will provide updated information on this case, including trial clips, as soon as it is available. Steve Silver can be reached at [email protected].
Attorneys involved in the case include Curtis Thurston of Thurston Law Offices of Atlanta and Robert Fleming of Katz, Stepp, Wright & Fleming of Decatur for June Martin-Graham and Shaun Daugherty of Coles Barton of Lawrenceville for the defense.
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