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Office negligence? or office dilemma?

So I would like some input. Patient came in – family friend of Dentist, going through some severe stress – patients father about to pass away. Pt is clearly under the influence of something. Describes to hygienist what meds were taken over last two days. Pt weighs maybe 95 lbs. Hygienist informs doctor which its felt that time in chair would be good for patient. Biggest concern for hygienist is the driving aspect. Patient had 4 bite wings and cleaning. Doctor came in for exam. After much discussion, Doctor was unable to keep patient at office and allowed patient to leave and DRIVE. Now understanding – this was a close family friend, I was a bit disturb that the ending did not turn out different. I even offered to drive the patient home in their car and return to office then, but the doctor did not even relay this option to the patient. My concern: if patient drive out of parking lot and gets in accident, does the office hold any amount of responsibility? Wouldn’t the office be negligent in some form because we allowed the patient to drive away, without doing something, knowing full well of the patients condition? As a hygienist, I documented everything. Its just one of those ethical problems discussed at school that I thought i would never have to deal with.



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2 Answers

Great that you documented everything! This is a tough situation – things always get sticky when its a friend of the DMD. I believe I’ve heard that knowing a pt is under the influence and letting them leave can leave an office liable. However, I’ve also heard the opposite where ‘you can’t stop someone from leaving’ – therefore documentation may be the only way to protect yourself. I would have maybe tried to call the emergency contact for a ride. If the pt. refuses and ups and leaves on his/her own I suppose all that’s left to do is document the situation. I know when I was in school a pt came in drunk/on pills and the school let him leave but documented the situation thoroughly.. I’m interested to see what others say as well!

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I have been in this situation. I had a patient that had a substance abuse problem. We always documented what we noticed with the patient and we always offered to call a taxi for her. Her husband was a police officer and we even called him one time to tell him that we were uncomfortable with her leaving our office and driving. It was a terrible and difficult situation and she always ended up just leaving before we could help her. We eventually excused her from the practice because it was putting the practice in a bad position legally although we were doing all we could up to calling 911.
Just 2 months past when we had sent her a letter excusing her from the practice, we got a call from her son telling us she had died from an overdose.
It was a very tough and sad situation. I think the best thing to do is to call your state dental board and ask them exactly what is expected of a practice in a situation like this.

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