Facts

In February 2005, plaintiff Richard Romanello, who was then 65 years old, sought teeth whitening from defendant Farshad Ettefagh. At that time, Ettefagh discussed the potential use of veneers as a means of achieving even more significant whitening which Romanello desired. Romanello returned again in 2005 due to an emergency when an existing bridge for teeth numbers four through six had come loose and fallen out. The bridge made by a prior dentist was re-cemented by Ettefagh.

In May 2007, Romanello returned to Ettefagh's practice, again on an emergency basis, due to the fracturing of an upper posterior tooth (number 13). Due to noticeable wear on Romanello's teeth, consistent with him being a heavy "grinder," Ettefagh advised Romanello that he no longer considered him an appropriate candidate for veneers and instead recommended the use of crowns, if he was still interested in achieving permanent whitening. Romanello confirmed that he wished to proceed with crowns and a temporary crown was placed on tooth number 13. Romanello returned on Sept. 18, 2007 and had a full mouth series of x-rays performed and a complete clinical examination.

On Sept. 24, 2007 teeth numbers four through 12 were prepared and temporary crowns were placed. The front temporary teeth were adjusted on three occasions as Romanello was complaining the he was biting his lip and because his tongue felt crowded.

On Oct. 16, 2007, permanent crowns were placed on teeth numbers four through 12.

On Jan. 17, 2008, Romanello was seen by Ettegfagh's colleague, Dr. Eskeland, with a complaint of headache that he attributed to the upper crowns interfering with his bite. Eskeland performed adjustments of several teeth and advised Romanello that when crowns were placed on the lower teeth his symptoms would resolve.

Romanello returned on March 11, 2008, again complaining of headaches, at which time impressions were taken for a night guard and a day wear device. In an email sent on March 21, Ettefagh provided Romanello with the contact information for two dentists who specialized in TMJ and pain issues. Romanello was seen on March 31, at which time he was given the two guards made following the March 11 visit and was again given a referral to a specialist in TMJ/pain, Dr. Brad Eli. Ettefagh informed Romanello that if Eli concluded the upper crowns needed to re-done that he would do so at no additional charge. Romanello was seen by Eli on April 17, and was then seen for the last time by Ettefagh on April 23. Ettefagh, on that date, performed additional adjustments of four upper front teeth at the suggestion of Eli. Romanello, in June, opted to transfer his care to prosthodontist, Dr. Ian Aires, who removed the existing crowns and then placed temporary crowns on the involved upper teeth in July. Aires made numerous adjustments and frequently replaced anterior temporary crowns which had been broken by Romanello.

Ultimately, in February 2009, Aires placed permanent crowns.

PLAINTIFF'S CONTENTIONS:
Romanello contended that Ettefagh was negligent in the placement of the crowns and that as a result he experienced a "lost bite." He further contended that Ettefagh was negligent in failing to refer him to a specialist and by failing to obtain Romanello's informed consent for the treatment, because it was not explained to him that the treatment plan for the upper arch was intended to also include the placement of crowns on the lower arch. Romanello contended that, as a result of the negligent treatment causing a loss of his bite, he experienced severe facial and headache pain, weight loss of 30 to 40 pounds and suicidal thoughts. He further contended that, because of an open bite, Aires needed to remove the crowns placed by Ettefagh and re-do the treatment.

DEFENDANT'S CONTENTIONS:
Ettefagh contended that Romanello was not a candidate for veneers due to his heavy bruxism and that a treatment plan was discussed with and approved by him that included the placement of crowns on both the upper and lower arches. It was further contended that, if Romanello had completed the treatment as planned, he would have achieved "ideal" occlusion and would not have experienced any bite related symptoms. The defense also disputed that Romanello had experienced a "lost bite," noting that study models taken in March 2008 near the end of his treatment with Ettefagh did not evidence a lost or open bite. The defense also contended that Romanello's medical records substantiated that he had experienced headaches on a chronic basis preceding the dental care, including during the year before the dental treatment was started, and that the cause of his headaches was ultimately attributed to abnormalities of the cervical spine and not a dental cause. It was also contended that Romanello had experienced severe, excruciating back pain in 2007 and 2008, which had a significant negative impact on his lifestyle independent of any alleged dental related headaches. The defense also contended that the medical records establish Romanello had not experienced any weight loss while under the care of Ettefagh, the period when he was allegedly experiencing his worst pain and an inability to eat solid food.

Settlement Discussions

Ettefagh offered $10,000 prior to trial.

Specials in Evidence

$50,000

Injuries

Romanello claimed debilitating headaches.

Result

Plaintiff's verdict for $297,000.

Other Information

Motions for a new trial and JNOV are pending. FILING DATE: Jan. 8, 2009.

Deliberation

one day

Length

six days