An accident happens in your office.
What you should do, and who pays the bill?
A patient who experiences a reaction to local anesthetic or medication or a patient who swallows a crown are fairly common occurrences in a dental office. Taking the number of patients most dentists see during their careers into account, it is likely a situation similar to those described above will happen. If it does, remain calm, have a plan ready, and execute it.
The most common approach when a patient experiences a reaction to medication or local anesthetic is to administer oxygen, recline the patient, monitor his or her vital signs, and check whether the patient is able to respond appropriately to questions of time, place, events, etc. A staff person should record these details. Summon paramedics for an independent patient assessment and determine whether transport to the nearest hospital is warranted. Make sure to document the incident and outcome in the patient's chart.
Refer patients who swallow objects for a chest radiograph to ensure they did not aspirate it. Call 911 if a situation develops that you cannot address appropriately within your office. If the patient was transported to the hospital and released after observation or went for a radiograph with no adverse outcomes, consider offering to either pay for the radiograph or the patient's co-pay for the ambulance transport and ER visit.
Another possible situation is an accident that could be as innocent as a patient who is not paying attention and trips and falls while in your office. Attend to the patient's immediate needs first. Always check for injuries. If the patient needs or requests medical attention, call 911. If the patient is not injured, or refuses medical attention, fill out an incident report that memorializes the occurrence, your response, and the outcome. Both you and the patient should sign the report. Make sure any witnesses write and sign statements as to what they saw.
TDIC's professional liability policy addresses these and similar situations with a "no fault" provision for medical payments (Med-Pay) up to $10,000. Your TDIC professional liability will pay "...necessary and reasonable expenses incurred for medical, surgical and dental services, including prosthetic devices and necessary ambulance, hospital, professional nursing and funeral services..." if an accident causing bodily injury occurs at your premises or extended premises.
Follow up with the injured party after one of these events to see how he or she is feeling. This is also the time to discuss rescheduling, if there is unfinished treatment from the prior appointment. If the patient starts talking about negligent care, pain and suffering, or lost wages, contact the Claims department right away, as the situation has graduated from a simple incident to formal allegations covered through other provisions of your liability policy.
Despite the fact that medical expenses may be covered, attend to the patient's needs first. You may be able to mitigate a lawsuit in a few easy steps while fostering positive patient relations. Call the TDIC Risk Management Advice Line at 800.733.0634 if you find yourself facing this sort of situation in your practice.
*Ms. Davenport is Risk Management Senior Analyst, TDIC, Sacramento, California.