Facts

In 2006, plaintiff Albert Yermazyan, age 18, presented to defendant Arsen Oganesyan, D.D.S., for an examination.

Having examined plaintiff's oral x-ray, Dr. Oganesyan found a radiolucency, which he concluded represented an external root resorption in the area of teeth #'s 28 and 29. Teeth #'s 28 and 29 were then extracted, and Dr. Oganesyan installed a dental bridge.

In 2008, plaintiff presented to Dr. Oganesyan for a follow up examination. Having examined plaintiff's oral x-ray, Dr. Oganesyan documented that the extraction site (of teeth #'s 28 and 29) showed adequate healing process. On April 3, 2009, plaintiff presented to Dr. Oganesyan for an examination. On that day, having examined plaintiff's oral x-ray, Dr. Oganesyan concluded that the radiolucency (in the area of teeth #'s 28 and 29) changed its appearance from 2006 and 2008 and showed irregular margins with bone destruction. He immediately referred plaintiff to an oral surgeon, Raffi Margossian, D.D.S.

Subsequently, following a biopsy, plaintiff was diagnosed with a fibrosarcoma of the right mandible (lower jaw). On May 6, 2009, at Los Angeles County/USC Medical Center, plaintiff underwent a right partial mandibulectomy, a right level I neck dissection, and a fibular free flap from the left leg; the surgery was performed by ENT surgeon, Uttam Sinha, M.D.

PLAINTIFF'S CONTENTIONS:
Plaintiff claimed that, in 2006, Dr. Oganesyan negligently failed to refer plaintiff to an oral surgeon. Plaintiff also claimed that Dr. Oganesyan's alleged negligence caused the tumor to grow resulting in injuries and damage to plaintiff, including the loss of mandibular bone, a neck scar, and the orthopedic limitations associated with the removal of plaintiff's left leg fibula.

DEFENDANTS' CONTENTIONS:
Defendant Dr. Oganesyan claimed that at all times during his care and treatment of plaintiff, he complied with the applicable standard of care, and that no act or omission on the part of Dr. Oganesyan caused or contributed to plaintiff's alleged injuries. Specifically, dentist Dr. Coye testified that plaintiff's x-ray findings in 2006 and 2008 did not show anything suspicious to warrant a referral to an oral surgeon. Pathologist Dr. Dry, a fibrosarcoma specialist, testified that plaintiff did not have cancer – i.e. he did not have a fibrosarcoma (a malignant tumor); instead, plaintiff had a desmoplastic fibroma (a benign lesion with no potential for metastases). Plaintiff's treating ENT surgeon, Uttam Sinha, M.D., testified that even if plaintiff's lesion was 1 cm smaller (i.e. even if it was diagnosed in 2006) and regardless of whether it was a malignant fibrosarcoma or benign desmoplastic fibroma, all aspects of plaintiff's tumor resection surgery would have been the same – the resection of the lower jaw, the neck incision / scar, and the removal of the left leg fibula.

Injuries

Plaintiff underwent a right partial mandibulectomy, a right level 1 neck dissection, and a fibular free flap from the left leg.

Result

Directed verdict for defense.

Other Information

MEDIATOR: M. Lawrence Lallade Sr., Esq. FILING DATE: Feb. 18, 2010.