Oral Cancer Malpractice Claims Increasing
1/10/2006 Tallahassee, FL Cliff Rapp, LHRM First Professionals Insurance Co. Every year, oral cancer kills more people in the United States than cervical cancer, malignant melanoma or Hodgkin’s disease. Ninety percent of all oral cancers are squamous cell carcinoma, and oral cancer has one of the lowest five-year survival rates of all major cancers. Malpractice claims alleging “failure to diagnose oral cancer” often are the most difficult to defend and are the most expensive of all dental claims. An analysis of Physician Insurer’s Association of America (PIAA) closed-claim data reveals oral cancer claims are on the rise nationwide. Indefensible cases fall into three categories: failure to follow up on a lesion with marginal clinical suspicion (most often a failure to biopsy); failure to re-examine a lesion and the patient’s medical history; and office-systems failure, allowing a patient or diagnostic reports to slip through the cracks. Dentists should view all lesions, lumps and bumps as possible cancer. Although most lesions are benign, squamous cell carcinoma often is found on the mucosa – facilitating the argument that diagnostic measures are readily available. Closely monitor patients who have suspicious lesions until a definitive diagnosis is made. Thoroughly document possible traumatic origin of a lesion. When patients explain a suspicious clinical sign or symptom, get “ proof” and consider a biopsy. Institute a fail-safe follow-up system. Refer patients to a specialist for further diagnostic workup or care, and send a consultation request to promptly facilitate the referral. Include the referral process in your follow-up [...]