Litigation and the lingual nerve

Purpose: A "malpractice crisis" exists in the United States. Litigation analysis helps to understand the causes and may be useful in prevention of suits. This study reviews litigation regarding the lingual nerve. Materials and Methods: Jury verdict reports were obtained from a computerized legal database for the years 1987 through 2000. The study reviews all state and federal civil trials in the United States. Reviews compile information on plaintiffs and defendants, allegations of wrong-doing, reasons for litigation, anatomic sites of injuries, specialties of expert witnesses, verdict results, and awards received. Results: Thirty-three suits from 12 states were obtained. Dentists or oral surgeons were involved in 87%, and otolaryngologists were involved in 13% of suits. Tooth extractions were involved in 79%, and 50% of these resulted in financial awards. Lack of informed consent was alleged in 52% of suits overall and in 46% of tooth extraction suits. Expert witnesses were of the same specialty for both sides in 81%. Inadequate training and selection of the wrong surgical approach were alleged in 18% and 15%, respectively. Anatomic variations were thought to be present in 15%. Conclusions: Surgeons must be aware of anatomic variations and regions in which injury to the lingual nerve frequently occurs. Written informed consent may help decrease litigation in known risk regions.