Early childhood cavities (ECC) is the single most common chronic childhood dental disease. In the treatment of ECC, children are often sedated under general anesthesia. An estimated 100 000 to 250 000 pediatric dental sedations are performed annually in the United States. Many of these procedures are not necessary and are performed by “suspect” children’s dental clinics under the auspices of treating the caries aggressively to stay ahead of the game. As we see below, most times, it is not worth the risk of general anesthesia complications to perform restorative work on a child’s baby teeth.
In 2016, the American Academy of Pediatric Dentistry (AAPD)1 announced, “Because restorative care to manage ECC often requires the use of sedation and general anesthesia with its associated high costs and possible health risks, and because there is a high recurrence of lesions following the procedures, there now is more emphasis on prevention and arrestment of the disease processes.” The AAPD’s policy statement goes on to enumerate methods of chronic disease management, active surveillance, and interim therapeutic restorations and states, “Non-surgical interventions should be implemented when possible to postpone or reduce the need for [previously accepted] surgical treatment approaches.”
A common rationale for aggressive surgical treatment with sedation or general anesthesia has been the vastly overstated association between tooth decay in primary teeth and subsequent decay in permanent teeth. In fact, this connection is modest, with the relative risk ratios ranging from 1.4 to 2.6.2,3 One reason the association it not strong is that the shedding of decayed primary teeth eliminates sites for bacterial colonization in the mouth and thus reduces risk of caries in the permanent dentition. The loss of primary teeth with replacement by permanent teeth is a normal developmental process that requires no professional intervention.
Georgia patients are injured every day from dental procedures. Common dental procedures are not always as safe, effective, or durable as we are meant to believe. As a profession, dentistry has not yet applied the same level of self-scrutiny as medicine, or embraced as sweeping an emphasis on scientific evidence. “We are isolated from the larger health-care system. So when evidence-based policies are being made, dentistry is often left out of the equation,” says Jane Gillette, a dentist in Bozeman, Montana, who works closely with the the ADA committee on evidence-based dentistry. “We’re kind of behind the times, but increasingly we are trying to move the needle forward.”
The article also cites Trish Walraven, who worked in a dental office for 25 years and now manages a dental-software company with her husband, and recalls many troubling cases: “We would see patients seeking a second opinion, and they had treatment plans telling them they need eight fillings in virgin teeth. We would look at X-rays and say, ‘You’ve got to be kidding me.’ It was blatantly overtreatment—drilling into teeth that did not need it whatsoever.”
Seven (Yes, 7) pit bulls escaped from their yard and attacked a female neighbor outside her home and another woman in the dog owner’s home off Windy Hill Road. The owner, of the 7 pit bulls had been cited six times between February 2018 and March of this year for the dogs roaming the neighborhood, injuring a chicken and biting another animal, according to citations and incident reports obtained by The Atlanta Journal-Constitution from Cobb County through an open records request.
Clearly, if the facts as reported by the AJC are true, the owner of the seven (Yes, 7) pit bulls is liable for all of the damage the pit bulls have caused in attacking the innocent neighbors. The first inquiry in a case like this is: did the owner know or have reason to know that the dogs were dangerous. In this case, the interesting reported fact is: Cobb County Animal Services Division Director Shana Luke said the agency had no reports of the dogs biting people before the incident. So, one of the interesting legal questions in this case is: Should the owner of the seven (Yes, 7) pit bulls have known that the dogs were dangerous since the owner had been cited numerous times for roaming the neighborhood, injuring a chicken and biting another animal, but not for biting a human being. The answer, in my opinion, is yes.
We at Katz Wright Fleming Dodson & Mildenhall have handled cases similar to this and recovered for our clients when the dog involved in the attack did not bite other people before but did have a history of vicious behavior toward other animals and a history of getting loose and causing problems in the neighborhood. Couple this with the clear violation of the local leash law (in this case Cobb County’s animal leash law) which states as follows:
Dentists and dental offices in Georgia, and throughout the country are liable for all of the injuries that stem from malpractice. This includes claims for wrongful death that results from dental care that is below the standard of care. I have seen dental patients choking, drowning and bleeding to death in the dental chair–or shortly after the treatment.
A university has paid $225,000 to settle lawsuits filed over the treatment of a man who bled to death after having 12 teeth extracted in preparation for a liver transplant.
The university issued the following statement, “[We] would like to extend again its heartfelt condolences to [the] family. Under any circumstance, the passing of a patient is devastating to faculty and staff. [W]e do our collective best to heal, save lives and advance health. Patient privacy laws prevent us from discussing the case further.”
According to a recent article in the Boston Globe, when veterans need nursing home care, the VA can place them in agency nursing homes or in other facilities at VA expense. Taxpayers pay $1,125 each night to house a veteran in VA nursing homes. That’s far higher than the average $296 each night in private facilities or $174 in state-run nursing homes where the VA pays a portion of the cost, according to agency budget documents. VA officials said the rates are not directly comparable because VA nursing home costs include hospital care and “more expensive medical services that just aren’t available in most non-VA facilities.” The agency told the Government Accountability Office in 2013 that about 40 percent of VA nursing home costs account for “core” services and would be comparable. At that percentage, the current VA core cost would be $450 a night, still 52 percent more than the agency’s cost for private placement. Despite the sizable public spending on VA nursing homes – more than $3.6 billion in 2018 – the agency until recently had kept the findings of inspections of its nursing homes confidential.
Despite the extremely high costs and apparent secrecy, according to the article, at the Veterans Affairs nursing home in Brockton, Massachusetts, a severely impaired veteran with dementia sat trapped in his wheelchair for hours, his right foot stuck between the foot rests. Inspectors watched as staff walked past the struggling man without helping. Veterans moaned in pain without adequate medication at VA nursing homes in Dayton, Ohio, and Augusta, Maine. A unit at the VA nursing home in Lyons, New Jersey, had no functional call system for residents to summon caregivers.
In another example cited in the article, a severely impaired veteran with Parkinson’s disease went without adequate pain medication day after day at the VA nursing home in Augusta, Maine, as nursing staff treated a sore at the base of his spine that had penetrated to the bone. “The resident moaned throughout the wound care and the moaning increased during wound cleansing and measuring,” noted an inspector who witnessed the episodes in July. Inspectors cited the Augusta facility and 28 other VA nursing homes for failing to ensure veterans didn’t suffer from serious pain. This is barbaric and would not be tolerated in any other facility in the country, unless it was a VA facility. The issue has been a long-standing problem at VA nursing homes – flagged more than seven years ago by the GAO, which found a high percentage of veterans were in pain. Specialists said caregivers should assess and adjust medications or try other methods to make sure residents get relief.
As an Atlanta injury lawyer who has been handling personal injury and malpractice cases for over 25 years, I have seen a lot of potential new clients. Many have asked, in one form or another, some version of the following questions:
My wife fell when leaving our neighbors house. She broke her ankle in 3 places, can we recover for her injuries?
I have a quick question, my husband was hit by that train that was in the news and we need help.
If anyone has attended an event in downtown Atlanta lately such as a Falcons game Georgia State basketball game, you may have noticed the proliferation of scooters and the drivers’ total disregard for vehicle traffic and signal lights. With all of the congestions surrounding events in downtown, scooters are a quick and easy way to negotiate the bitter downtown traffic and get to where you are going faster than by walking or driving. But, are they safe, and what are the rules of the road in regard to the use of scooters.
According to the Atlanta Police Department (“APD”), the city of Atlanta ordinance that applies to scooters (which are called “shareable dockless mobility devices and dockless mobility devices”, scooters “may operate in vehicle travel lanes, in bike lanes, and along shared use paths throughout the city,” according to the ordinance. All applicable state and local laws should be followed, it notes.
It goes without saying that electric scooters must obey all traffic laws and are not allowed to be ridden on sidewalks and pedestrian only areas. The ordinance allows scooters to be operated within city parks, but they cannot be used on sidewalks or spaces solely for pedestrians. When on a shared use path, the riders “must yield to pedestrians in all cases,” the ordinance notes.
The #metoo movement is on everyone’s mind. It is real and it is a problem that everyone in our society must take seriously, address and come up with a solution. One way to do this is to expose all of the ways that unwanted touching, unwanted sexual advances, and other types of violations are perpetrated in our society. A few years ago, a popular massage company that had aggressively expanded into Atlanta was in the news for instances of unwanted touching. The most common scenario: females being massaged by male employees of the massage company were being touched on parts of their body that were: (1) not what they wanted; (2) too intimate for a massage; (3) sexual in nature; and (4) beyond what they consented to when they agreed to the massage. The message that can be taken from this is: while this is the most common scenario, many types of unwanted sexual advances take place today. Many go unreported, others are reported but not taken seriously by the organization through which the sexual aggressor work, and still others are covered up by the organization (the very same organization that is responsible under the legal theories of agency, respondeat superior or joint venture for the acts of the perpetrator). While the act of unwanted touching is a crime in and of itself, putting someone in the position to commit this act (such as a massage therapist) when they are not sufficiently vetted and or trained, is an act of negligence on the part of the company and gives rise to a claim against that company for allowing this to happen.
Wide scale sexual abuse has been in the news seemingly all the time during this decade. The boy scouts, the catholic church, and national massage chains have all been associated with these claims of allowing sexual predators to operate within their organizations. However, the prevalence of these crimes is not restricted by any stretch of the imagination to these organizations. The following is an example of how unwanted touching can affect almost anyone in our society. How it can occur via a slippery slope and how the victim, many times remains quiet and “suffers in silence” because they somehow blame themselves, at least in part, for either allowing the unwanted touching to happen; or not stopping it once it happens; or not standing up for themselves and reporting it immediately; or not reporting it at all. Then again, this example exemplifies the suffering after the fact that is almost inevitable. The facts have been changed to protect the victim, but the moral of the situation is clear: This can happen to anyone, at any time. It does not matter if you are a woman, man, young boy, young girl, teenager, retiree, child, etc. It can happen to anyone and it can affect anyone. Just because we seemingly hear and read about woman and young boys being the victim of this crime, it is not limited to them. Here is one example that may be an eye-opener to many:
I took a vacation with my family. We were all excited to be headed to the beach and have a few well-deserved days off from the grind. My wife and I decided to spend the day together and we saw a popular massage place in the area. We wandered in and scheduled massages. They happily took us right away and we were in separate rooms. I lay on the massage table and the lady came in. I was getting a full body massage, and was naked under the sheet and towel on the massage table. I have gotten many massaged before and have always felt more comfortable removing all my clothes. Perhaps this was a mistake, I don’t know. The massage therapist came in and whispered “Hi Honey,” a bit unusual, but I did not think much of it as massage therapists usually talk very low and serene, as does everyone in a massage parlor, at least that is my impression. Was this a signal of things to come? I don’t know, perhaps it was, but I had no idea at the time.
To add a party defendant into an existing Georgia state court lawsuit, leave of the court must be sought and the complaint must be amended to add the additional party. Plaintiff would move under these circumstances for Joinder and would typically file a brief in support of her motion for joinder, such as the following:
This case arises from Defendant’s failure to pay for agreed upon labor and materials to renovate the Defendant’s restaurant located in Atlanta, Georgia (the “Project”).