In legal malpractice cases, the burden of proof requires establishing direct causation between the alleged negligence and the specific injury suffered; mere dissatisfaction with outcomes or indirect connections to events do not constitute sufficient legal causation for liability.
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Patient Uses Internet Photos to Sue Dentist For MalpracticeAdded:
This as I looked at it sort of sounds like a claim for dental malpractice.
So why don't you go ahead and tell me what you think happened and what you think you want in terms of damages in this case.
>> Your honor, uh I paid Dr. hours for a crown and um due to documented issues with that crown from two different dentists that you'll see in the evidence um I went to Dr. office five times and a new new assistant did the procedure for the temporary crown which is when the uh the crown is molded and sized and uh placed on and she seemed to be struggling with how to do things and Dr. of ours was not in the uh operatory room and [snorts] she uh was struggling to get the cord packed on the the crown and it kept falling off and it was just one thing after another that she was struggling with but I don't think she wanted to ask for help and um Dr. Dr. Bowers did not come back and check the work before I was sent home and I couldn't bite [clears throat] down and I felt that the crown was the temporary was on backwards. So I had to go back in and um she admitted that it was on backwards and Dr. Bowers corrected it, popped it out and and put it the right way. And I feel that the initial part of the crown was where the error was made and the sizing and the uh bulkiness of my crown because when I got the permanent crown, there was a lot of pressure in my jaw and I was getting things stuck in that tooth and it it just did not feel right.
Um the floss got stuck. I had to cut the floss out. Uh and then I went to Dr. Gunderson and got um an examination and he noticed that there were there was a ledge on the lingual side and that I would have to use a water pick or something uh every day in order to prevent gum disease on that tooth.
And then I went to the attorney general and tried to negotiate with uh Dr. Bowers.
And that didn't work. He didn't respond.
And then I went to um once I didn't get that response, I asked for my money back and was refused except for $8007 and something. uh but only if I only if I provided records from Dr. Gunderson uh in some way would he compensate me and he would only pay Dr. Gunderson uh directly. I decided to go to a different dentist that was highly recommended by a friend who had gotten a whole mouthful of crowns from this dentist. [snorts] And uh he actually took pictures of the instrument going into the ledges on both sides of the crown.
And I had the restorative treatment done and it was replaced.
and uh I'm just asking to be compensated for those costs.
>> So, your claim was for $3,823.90.
That was on the document. What does that represent?
>> Uh compensatory damages for uh the first crown having to be corrected and replaced.
It was a it was more than a usual procedure. It was um lengthy and uh they had to take the crown off and um drill a lot more to get the crown to fit right.
I'm asking for compensatory damages.
>> So you paid Dr. power is $1,858.
Is that right? [clears throat] [clears throat] >> All right, Dr. Bowers, your thoughts.
>> Yes. So, your honor, as an initial matter, um I want to point out Miss Davis has not present any expert testimony on her behalf. or Washington law dental malpractice case requires a qualified expert to testify regarding the applicable standard of care and how the alleged conduct vi violated that standard of care. Because Miss Davis has no expert, her claim fails. I would like to move for a direct direct verdict.
>> Well, small claims court evidence comes in, evidence rules are are kind of relaxed. I understand what you're telling me. Why don't you tell me more about what transpired?
>> Very good. If uh if you'd uh be pleased, I'd be happy to present my case. So, um your honor, the treatment provided by myself and clinical staff was wholly within the standard of care. Miss Davis primary concern is in regard to a dental crown that was provided at my office.
While I understand that Miss Davis isn't happy with the result, the crown itself is perfectly functional and does not need to be replaced. Um, exhibit one in the chart notes. The first visit, I saw Miss Davis on 92325.
She presented to the clinic seeking a second opinion on a dental issue as she expressed some concern at the estimated cost provided by the other dentist. So, this is before crown is completed. She's already coming to me as a second opinion. At the visit, I diagnosed issues with tooth number 14, confirming what the first dentist had uh diagnosed and that a crown would be needed.
Specifically, she had crack syndrome as well as decay on the messial side, which is the front side of the tooth, a cavity on the inner side. The proposed treatment plan was a dental crown. Um, exhibit 3, the estimate for the treatment was $1,512.
Miss Davis returned on uh 102, so octo October for the buildup and crown, which was completed that day. During appointment, all old fellings and decay removed from the tooth. This will sometimes leave the tooth compromised and misshapen to accept and retain a dental prosthetic uh crown. The tooth is then built up using dental restorative filling gels to make it the proper shape and to accept a dental crown for proper retention. That's the build portion. At this visit, I was assisted by dental assistant Kimberly Marorrow who is practicing with her scope and under my supervision. Industry standard is for dental assistants to fabricate, adjust, and cement dental temporary crowns. Um, an assistant will make a custom mold of the tooth and then make a temporary crown in the original shape of the tooth. This is then adjusted and polished and cemented temporarily. It is meant to come off again in a week and be replaced with a permanent prosthetic.
Now, in exhibit 5, Mrs. Mara um was a new hire at the office but had prior experience as a dental assistant of nine years. New to my office though. She was [snorts] properly licensed and had no disciplinary history on her license.
Exhibit three in the estimate um in the ledger. Um, unfortunately due to an administrative oversight, my office staff and the original estimate did not include the cost of the buildup for the crown, which was an additional $346, which brings us to the grand total of $1,858.
Miss Davis returned to the office the next day on 103 with some discomfort and issues related to the temporary crown.
Specifically, she reported some sensitivity and her belief that the crown was backwards. I could not confirm that the dental crown was backwards.
However, I could see that it could be improved. So, to try and um resolve any concerns with the temporary, um I remade the crown myself, which is not customary, but that was a service, and I wanted to make sure that she went away happy. Um I replaced the temporary crown with a new one, fabricating it from new.
Miss Davis was not charged for the service. Temporary crowns can be dislodged and will need to be remade. It is common practice to remake a crown if it is dislodged or if there's a complaint with the fit of the temporary crown. This is routine and common practice in the industry. Four days later on 107, Miss Davis presented for seating of the final permanent crown.
The crown was placed without complication and Miss Davis reported no complaint with the appearance or feel of the crown that day. Um, exhibit uh two X-ray taken after the crown. The post seat radioraph of [snorts] the crown shows proper crown crown contours and margins. The margin is significant because it is where the prosthetic meets the natural tooth. The margin needs to be free of openings or overhangs. The radioraph shows that the dental crown is free from these defects. Do we have that exhibit that that you could look at?
Because I think that'd be important for me to demonstrate.
>> Chase, is that something you can access?
It should be I mean it should be in the 19 file.
Where on here do I find that?
>> Oh, yeah. Here.
>> Yeah.
Right there.
And what was the exhibit number you were referencing?
>> Um that is exhibit um two.
>> It should be titled X-ray.
>> All right. I think I have it.
>> Have it pulled up there.
Yeah, I don't think I we can't get it up on the big screen, can we? No, I can describe it.
>> I have it, your honor. Right here.
Okay, go ahead, doctor.
>> So, as seen, um the second tooth from the back, the one in the very center shows a um crown and then also a root there. The crown is the very, um light colored portion of the dental prosthetic. When we look at crowns, we want to make sure that they're they are free from openings and overhangs there.
We want to see that there's an unbroken seam from the root up to the dental prosthetic.
That is the X-ray that was taken on the day of the seat to confirm that there's no defects with the crown. And so that's what we go off of in the industry to make sure that the crown is um effective and that it is a good prosthetic. Now um that's what we have as the exhibit to go off with. Now Miss Davis left um without any complaint that day.
Miss Davis returned to my office um 4 days later with concerns about the crown. She reported sensations of tightness and cold sensitivity. I examined the crown and the contacts and occlusion were clinically acceptable.
Despite the lack of observable defects, I nevertheless use a sanding strip to loosen the contact between um that tooth and neighboring tooth, adjusting the bite. Um I also explained that acute acute cold sensitivity and tightness sensation after dental work, especially on cracked teeth, is normal. Miss Davis reporting feeling better after the adjustments. A at that same visit, Miss Davis also reported a a perception that her teeth were shifting. I explained that while number 14, the tooth that was worked on, uh may be more visually noticeable due to her regular arch form.
Um [snorts] she had stairstepping between 13, 14, 15, just where where the teeth were misaligned. I I reassured her that her teeth are not shifting in the space of a week. Um that takes weeks and months.
That's orthodontia um for that to occur. Um in the um following notes by Dr. Gunderson, uh two days later, Miss Davis presented to another dentist. According to his note, he found that the contacts were normal. The contacts being where you floss between there and that shifting was not a genuine issue. Dr. Gunnerson felt that the crown had a large ledge on the lingual side um but that use of a water pick ought to keep the tissue healthy. Alternatively, he offered to smooth what he thought was a ledge. Dr. Gunderson felt no further treatment was needed and he did not recommend replacing the crown. Um I'd like to um ask your honor to please pull up the um demonstrative exhibit. Um that would be number That would be number nine.
>> Okay. Go ahead.
>> Okay. So, um, in that exhibit, you'll see two, uh, red circles in that exhibit that shows overhangs of a crown or ledges that demonstrate an improper fit of a dental crown. Um, when we compare that to the crown that I placed, my crown is smooth and has proper contours and is free of overhangs. Um, that demonstrative exhibit demonstrates of what an improper crown would look like.
So, in that I disagree with Dr. Gunnison's opinion that there was a large ledge. I provided the court an X-ray from the internet showing a crown with large ledges on both sides. If you compare that images to Mrs. Davis's crown. You can see that there are there are no similar ledges on her crown.
So in in moving on, Mrs. Davis sent another email on 10:30 2025. She demanded a full refund for all dental work completed plus Dr. Gunnerson's fees contending that the crown was defective.
So she's not only asking for a refund on anything that that we had done. She's asking re refund for for work that she is that Dr. Gunderson did for for exam and X-ray and um and then some. So I requested and reviewed Dr. Gunderson's notes which confirmed that the crown did not require replacement. I requested that Miss Davis come in into my office to very verify Dr. Gunnerson's findings of alleged on the crown margin. However, she refused to return to a follow-up exam. Because I pride myself on customer satisfaction, I offered to pay for half of her elective procedure of having the crown replaced by Dr. Gunderson. This came with the limitation of having it replaced in the following six-month period, and payment would be made to the dentist performing the procedure directly.
In summary, there is nothing objectively wrong with the crown that would require placement at this time. The crown is functional and is and its installation was within the standard of care. There's no evidence that additional care is needed for the crown at this time or any evidence that will prematurely require replacement. Accordingly, I respectfully request that the court deny Mrs. Davis's claim and her judgment my favor.
>> Thank you.
>> M [clears throat] Davis response >> your honor. Would you like a copy of my evidence in paper form as I speak so that you can just flip through the pictures?
>> I do.
>> Let me see.
>> I do have photos from Dr. Gunders or Dr. Yamaguchi >> showing the ledges with an instrument. He was able to get his instrument into the crown, but I did bring a packet for you if you'd like. That's easier. I find it easier to flip through papers. [snorts] >> All right. I'm looking at uh Dr. Amaguchi's before photos.
>> Okay. And he was able to and if you look at the the before photos, the crown is very very large compared to the other two uh teeth that are are near it.
[clears throat] And this is what was causing me to think that my teeth were shifting because it just looked it looked like my my teeth were dwarfed um compared to how large the uh the crown was. and it's more bulky going from the facial to the the lingual side, just the the width of it. Um, and it was it was very very uncomfortable, your honor. I I don't like going to the dentist and um for me to be excited to go to the dentist to get that work done was very unusual for me. And it was quite the relief to get it replaced, but it was quite the appointment. And I was there for 3 hours while they uh took off the old crown and uh did the buildup so that they could put a new newer uh smaller crown on that was more fitting for my teeth.
And if you compare the the before and after, you'll see how much smaller the new crown is.
It just doesn't seem like it was carefully measured by Kimberly.
>> Your honor, if I may on that All right, Miss Davis, anything else you want to tell me?
>> No, your honor.
>> All right, Dr. Bowers.
>> Yeah. Um the the assistant has nothing to do with the final crown.
Impressions and um scans for the final crown and seating has to be done by the licensed dentist. Now a dental crown is manufactured at a third party at an actual dental lab. And so that's why we actually take X-rays and examine final seedings before that is done. Um, but I think I I just think that's worth clarifying.
Um, the assistant kind of really just doesn't have a whole lot to do about this, but I think it was great to clarify that um that a third party makes a dental crown, designs a dental crown, then it's up to the provider to ensure that it is proper. And um, all the evidence that I have is that it was properly seated. It was properly manufactured.
Um, I don't I wasn't able to see the what, you know, the other found that was put on there. So, I I I guess I can't have any sort of opinion on it. Um, but all the evidence I have on that is that um that it was proper and within the standard of care and functional.
>> Mr. Davis, last remarks. Any >> Yes. Um, did you did you not Dr. hours see the evidence posted online.
>> The evidence I mean the discussion is to me.
>> Okay. Okay. Um I did did post the evidence online and and I do have an extra copy if Dr. Bowers would like it, but the p the photos do show that uh that the two crowns are very much different in size and it does not get caught anymore. And I'm the way it is.
>> Let me ask you this question, Miss Davis. When you saw Dr. Gunderson, um, he indicated that he could smooth or shave off part of that ledge, >> right?
>> Correct.
>> Yes.
>> Do you give you any idea what he would charge you to do that?
>> I didn't. And to be honest, your honor, I I already suspected that something was wrong with the tooth.
And I didn't want to just shave something down to to kind of try to fix the the issue. I I could feel it from the inside and the pressure in my jaw and I just I I just didn't want to um try to jimmy it around. I wanted it done correctly. Your honor, it was very important to me.
I don't have dental insurance and I I pay out of pocket for all of my dental work and it's a priority for me.
Well, I did read and look at all the exhibits that have been posted by both parties in this case. And as I said when I started this open this case, it sounds in the nature of dental malpractice.
Dr. Bowers is right in regards to malpractice of any sort. You need to have an expert that will testify that the work that is being complained about it does not meet the industry standard is beyond is below that standard.
I didn't see anything in Drs. Anderson's remarks or Dr. Amaguchi's remarks that said that it didn't that it did not meet the standard of care. As far as that part is concerned, not every poor outcome of medical treatment or dental treatment or legal treatment um means or qualifies as being malpractice. You know, having been an attorney for 40 years, I've had clients that were unhappy with the outcome, and I'm sure some of them went home and blamed me for that outcome. uh in some instances maybe I did contribute to that. I don't know.
But it didn't constitute malpractice.
>> May I say that I didn't think that I wasn't looking for a malpractice.
I I just want to be compensated.
>> I understand. But in order to have a a basis in order to do that, um there has to be some causation that that leads to that being the case. Um understand you were unhappy [snorts] with the the feel of that. Uh arguably should have gone back to Dr. Bowers and let him look at it again. Quite frankly, looking at these radioraphs that I'm seeing here from Dr. Ber's office, Dr. Amaguchi's office.
I guess it could be argued that one is smaller than the other. I can't say that for sure. There's no measurements that, you know, um show that completely.
Um Dr. Bowers makes a point about, you know, you had a a badly cracked tooth that causes problems trying to build that thing up and so forth. um is a difficult proposition all around. Um [clears throat] You know, in in order to recover in any kind of generalized tort claim, there has to be a duty duty of care. There has to be a breach of that duty of care and there has to be a causation and damages have to result from that. Um, at this point I I you know the duty of care is obvious. Dr. Bowers is treating you. Um, you know, we could arguably say that unfortunately the dental assistant who didn't work out very well may have made some mistakes. I don't know what happened and why you left or were escorted out of the office before Dr. Bowers had a chance to see you again. I don't know what that circumstance was.
You know, perhaps that's something of a breach of a duty there that he should have checked you before you left. Um, but again, I I can't find that that the work that Dr. Bowers performed was below the standard of care.
And yes, you can argue that there was some damage because you had to pay Dr. Gunderson for the evaluation and you had to pay Dr. Anaguchi for another another tooth, another crown to be imposed under the circumstances. So, fortunately, Miss Davis, I just I can't find for you in this case.
It is one of those situations where there was an unhappy outcome, but I don't believe it was because of malpractice on Dr. B's part or less than the standard care that should have been imposed in that case or been uh followed in that case. So at this point I'm going to find for defendant in this matter.
You both wait a minute. We'll give you a copy of this to take with you.
Step up here. We'll give you each a copy of this and then you'll be free for today.
No, that's it. You're finished. Thank you. Have a good day.
>> You always I've reviewed the uh pleadings that have been filed in this case. Mr. Boyd, you're claiming for essentially lost wages for a period of time while you recovered from uh a broken foot or some damage to your foot.
And you alleged that that damage occurred in an incident involving um Jennifer Boyd that resulted in police being involved and so on and so forth. Uh kind of a ugly looking situation.
>> Go ahead, Mr. Boyd. Tell me what you want me to know in addition to that.
>> Yes, your honor. So, Jennifer, um there's a a police report where, you know, she showed up to my residence. Uh she was clearly the aggressor in the situation. Um I asked her to stay in her vehicle. Uh she she didn't listen. She >> All right, that part I get I I get all the the the preliminaries that it came to at some point a confrontation, a physical confrontation involving you and Miss Boyd. Let's go from there.
>> Yeah. And then I was working at FedEx and I had to because of the broken foot, I couldn't work anymore. So, I ended up having three months worth of lost wages that um because of Jennifer's actions, your honor.
>> So, tell me about the broken foot. Where [clears throat] did that come in?
>> Uh so, the broken foot, it was the neighbor who um who came to intervene between my girlfriend and Jennifer. Um I was in the middle of him. He kind of some hip toss and and that's that's where I sustained the broken foot. Uh is because the neighbor um I guess he came to intervene and get me out of situation because he he thought I was the the aggressor in the situation. Um he so and then he took me to the ground and and that's how I sustained the the broken foot.
Okay.
>> You were off work for nearly 3 months.
>> Yes, your honor. Three months.
>> Okay.
[snorts] >> Um Jennifer Boyd, what's your response?
Um, your honor, I do not believe that I am responsible for his foot injury. The police report indicates um from several witnesses that Michael came across the yard because he thought that Eric and seen that Eric uh punched me and he thought he was attacking me. Um, and then he, as the police report indicate, jujitsued Eric to the ground. Um his girlfriend indicated in the police report as well that Michael was pounding on Eric which also caused his caused the other injury uh to his brow that the police report indicates. Um so I do not believe that I am responsible for his lost wages or his injury. However, I was arrested on the scene as the aggressor of the situation. All charges against Mr. Boyd were dismissed. Um, and the court had found no evidence that I had assaulted him.
>> You say the court found no evidence. You you you had a negotiated resolution in court, correct?
>> I to Rachel, your honor.
>> Right.
And Miss Boyd, did you put your hands on Mr. Boyd at all that day?
um to protect myself from him uh hitting on me and him and Rachel both pushing me up against the car and uh him trying to break us up. And that moment he was uh hitting on me as well, which is why Michael felt the need to come across the yard. And >> so did you at any time push Mr. Boyd to the ground? No, your honor, I did not.
>> Did you at any time hit Mr. Boyd while he was on the ground? Um, >> no, your honor, I did not.
>> So, Mr. Boyd, here's the [clears throat] key question. Why are we Why are you suing Ms. Boyd and not Michael, the neighbor?
I mean, it's not his. He because he I honestly think, your honor, he was trying to do the right thing. Um, he thought that was what's happening because he didn't see the incident start. He just seen it happening. Um, so he thought being a male I was the aggressor in the situation and that I was putting my hands on a female, which, you know, he's he made a statement saying, you know, that's that's, you know, that's that's not right. Um, so I I honestly feel like, you know, being in his position, being like I feel anybody would do that. Um, and there were no charges. The the police seen the videos. They took other statements from other neighbors [clears throat] that were in the neighborhood. Um, and there were no charges that were brought against [snorts] uh the neighbor Michael for doing what he did. Uh, the only charges that were ever brought up were against Jennifer um for things that she did and things that she said. And >> All right. Well, nothing she said contributed to your foot being broken or caused your foot to be broken. Correct.
>> Um, so in the in the police report, u she is instigating where it does say that she had her phone and, you know, she was antagonizing me, saying, you know, get in my face, get in my face. And these are Jennifer instigating the situation almost as if she she wanted an altercation to happen, you know, if not from herself but from somebody else. Um, and that was that was in the report, your hunter.
>> Yeah, I' I've read that.
>> Okay. Um, and in my practice as a lawyer, I have seen way too many of these unfortunate situations where parties think they can negotiate their own domestic issues and arrange parenting plans without anything formal and things get a little sideways and parties are arguing with each other and stuff like this happens.
The the problem I see, Mr. Boyd, is um the causation of this problem, the physical cause of your broken foot was Michael, the neighbor, taking you to the ground on one or more occasions. And he didn't do that at Jennifer's request.
He did that on his own.
Um, and you may be right that his thought was, gee, I see somebody assaulting a woman. I'm going to intervene in that process.
And that's fine. He can he can do that.
You could do that. I could do that. And maybe we would under a circumstance.
Um, question is whether he used the appropriate amount of force or not.
Maybe you should have never been on the ground. Maybe you should have never quote unquote somebody be pounding on you. I don't know what the circumstances are. I don't know whether this guy knew you from before or not. None of that is here before me today. What's before me is you had a broken foot that looks like it was caused by this neighbor. I don't see any connection, any causation between anything Jennifer Boyd did and your broken foot.
So, Mr. Boy, I'll give you one more shot at this, but I just don't see any way that Jennifer Boyd is responsible for this. Um, >> right. I just I understand what you're saying, your honor. I just I I feel if Jennifer would not have been as aggressive as she was, uh the whole situation with my foot getting broken, um the lost wages, uh that that that wouldn't have happened.
Um so I she's not directly the cause of my broken foot, but her actions I I do think um indirectly was a result. Um, and and that's just that's just me, your honor.
>> I understand [clears throat] and I'm I'm not trying to convince you otherwise, Mr. Boyd. U you know, it could be argued both ways. If each of you had been a bit more courteous to the other uh in this meeting in the driveway, uh the exchange of children would have happened uh without this much conflict, without Miss Boyd being charged with something, without her having to go through that process, without your kids being exposed to all of this. I mean, we could stretch this out indefinitely as to, you know, all the u bad results that came from this. Um, but I I just can't make the connection between anything Jennifer Boyd did and anything any injury that you suffered, Mr. Boyd. So, I'm going to deny your claim today after trial.
All right. All right. Thank you, your honor.
>> You can get a copy of this judgment and sentence from the court clerk's office uh starting on Monday of next week.
>> Okay. Thank you.
>> All right. You both may leave the meeting at this time. Thank you both for being here.
>> Thank you, your honor.
>> You're welcome.
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