LaRocque v. LaMarche, 97-71
| Decision Date | 06 June 1972 |
| Docket Number | No. 97-71,97-71 |
| Citation | 130 Vt. 311,292 A.2d 259 |
| Court | Vermont Supreme Court |
| Parties | Clarence LaROCQUE v. Robert LaMARCHE. |
McNamara, Fitzpatrick & Sylvester, Burlington, for plaintiff.
Coffrin, Pierson & Affolter, Burlington, for defendant.
Before SHANGRAW, C. J., BARNEY, KEYSER and DALEY, JJ., and LARROW, supr. J.
This is a dental malpractice case. The issue is the sufficiency of the plaintiff's evidence to make an issue for the jury, since the defendant's motion for a directed verdict was granted at the close of the plaintiff's case.
The testimony disclosed that the plaintiff had a broken lower second bicuspid which had to be removed. The plaintiff was experiencing pain and the defendant accommodated him by fitting him in between appointments and removed the tooth. To do this he administered an anesthetic by injection. The tooth was found to be abscessed.
No problem was experienced with the removal. Instead, the claim of injury derives from the anesthetizing operation. After the pain subsided from the tooth extraction, the plaintiff continued to have pain in a slightly different area of his jaw and chin line. Various kinds of relieving treatments were tried, culminating in the surgical severing of the nerve governing sensation in the area which was giving pain.
It is the position of the plaintiff that his difficulty arose from an improper and medically ill-advised injection of anesthesia so as to injure the nerve involved. The nerves governing sensation in the lower jaw, teeth and chin enter the jaw through the mandibular foramen, an opening at the rear of the lower jaw. The nerve involved is called the inferior alveolar and is a branch of the trigeminal nerve, sometimes called the dental nerve. On each side of the jaw the inferior alveolar follows the mandibular canal forward innervating the lower teeth up to the midline of the chin. Fairly well forward on the jaw a branch of the inferior alveolar nerve exits through a jaw opening called the mental foramen. This nerve supplies feeling to the chin and soft tissue of the forward area of the jaw. It is known as the mental nerve or or mental branch. The plaintiff's mental nerve was cut in the area of the mental foramen to relieve pain in that location.
The dispute about treatment relates to the two foramen or jaw openings for the passage of the inferior alveolar. In making injections of anesthesia it is important not to injure the nerve by striking it with the hypodermic needle. The testimony indicated that injection at the rear or mandibular foramen is preferred because of more effective sensory blocking and a lessened chance of injury to nerve tissue. Injections at the mental foramen apparently carry a higher risk of such injury.
Simply stated, the plaintiff claims that his dentist made the injection of anesthesia at the mental foramen, that this was improper procedure and that injury to him resulted. He says that the location of his nerve problems confirms the nature and place of the injury.
The defendant, in his challenge to the plaintiff's case as it came in, denied that the injection was made anywhere but at the mandibular foramen, and also advanced the proposition that an injection at the mental foramen is not necessarily improper procedure. On this basis he argued that the plaintiff had shown no departure from standard dental practice in the area, nor any negligence on the part of the defendant. On this ground he asked for and obtained the...
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