On June 23, 2022, I was fortunate in obtaining a $5,000,000 verdict in a dental malpractice action from a Brooklyn jury following a three week trial. The patient (then 58 years old) sought treatment from the dentist after an oral surgeon extracted an upper right molar which left a hole (fistula) between the maxillary sinus and oral cavity. As can be expected, this fistula or communication with the oral cavity led to an infection in the maxillary sinus. As per the dentist, pus was leaking into the patient's mouth from the sinus and the patient complained of one sided facial pain below his right eye. The dentist thought it would be a good idea to flush out the sinus cavity using a liquid medication called Chlorhexadine. This prescription medication was only approved by the FDA for topical use as a mouthwash.
On each of three visits over 10 days, the dentist injected chlorhexadine and saline through the patient's fistula into the maxillary sinus to flush out pus. The dentist knew there was a risk of irritation from the use of Chlorhexadine (11.6% alcohol content) and admittedly did not discuss the risks with his patient or disclose that the FDA had never approved the use of this product to irrigate the sinuses. Three days after the third injection, the patient's severe right sided facial pain spread to above his right eye indicating the maxillary sinus infection had extended to the frontal sinus. A few days later he developed a brain abscess or empyema with stroke like symptoms. An emergency craniotomy to evacuate the infection was required to save the patient's life. The trial featured dueling experts in dentistry, infectious disease, neurology and otolaryngology. The jury found that the dentist had departed from accepted standards of dental care on each of the three visits and failed to obtain a proper informed consent - all of which led to the brain infection. John Doe v Boris Pikman, DDS, (Sup. Ct. Kings County, Index No. ).