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Discussion Board: Summarize the case and include your most significant finding and elaborate on what you learned from this assignment. I will provide you the PDF to very brifly summerize.respond to one classmate: after reading the discussion from a classmate, provide a response to their summary and include additional terminology or a law or regulation that could align but may have been missed. For full points, response must be constructive and reference details from the Code of Ethics or the DHBC Law and Regulationsplease respond to this:Article Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88605…In this article, the legal case “United States et al. ex red. Simpson v. HQRC et al., No.2017-cv-02823” talks about how a management company by the name of HQRC was found to be doing fraudulent insurance claims. This management company was providing their services for various dental clinics and during the years of 2011-2021, these false insurance claims were being made. The company did a fraud amount of about $754 million and were made to pay the amount of fraud done plus interest on the fee’s. Something I found significant in this was the amount of deception the providers have done. They have not only lied to the insurance company, but also the patients and themselves (as they are doing this unethically). I think the managing company of these dental providers also had to have know about this as they can see what is being charged out and connect it to the patients records. With this assignment I learned how even the smallest things that one may consider “errors” can build up and become something big. In this legal case they claimed to have accidentally sent out the treatment provided under wrong codes, however even if this was the case, the amount of little mistakes they claimed to have had built up to something so big that it ended up doing a lot of damage. Not only were they accused of fraud but they have also misled their patients and even created a burden to those with Medical as the office is no longer able to accept this insurance!
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Legal Case
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Carr v. Dickey
[Civ. No. 17766. First Dist., Div. One. Sept. 11, 1958.]
ARLINE CARR, Appellant, v. LLOYD W. DICKEY, Respondent.
Issue
The case was between Arline Carr (the plaintiff) and Lloyd Dickey (the defendant). Carr filed
charges against Dickey, a dentist, for malpractice, assault, and battery. The case also involved the
extraction of the plaintiff’s tooth by the defendant. According to the case, the lower left wisdom
tooth is designated number 17.
The defendant extracted the tooth before an event came up. The case also states that the defendant
extracted the molar next to the wisdom teeth, the second lower left molar, and the back tooth after
the wisdom tooth was extracted, designated as number 18. The next tooth, designated as number
19, was also extracted after that.
The plaintiff complains about the defendant’s alleged malpractice where he negligently removed
the first lower molar, tooth number 19, which appeared sound and perfect. The plaintiff also
complained that the defendant failed to extract tooth number 18 (the second lower left molar), a
decayed and diseased tooth. The assault and battery, as stated by the court, are accounts of charges
for the defendant. He was asked to extract a designated tooth but a different one without cause and
the plaintiff’s consent.
According to the case, the trial court granted a nonsuit to both accounts. The court claimed no
evidence of negligence in extracting the tooth. Similarly, the court stated that it could not find
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evidence of negligence in the proof presented. Similarly, the court ruled that the assault and battery
could not be sustained because the action of tooth extraction was taken with her consent. In that
case, the plaintiff consented to removing the tooth.
The record showed that the ruling was correct according to the standards applicable to nonsuit.
Dickey was a dentist and an oral surgeon. Dickey stated that he first treated the plaintiff in 1953.
During treatment, the defendant took a full-mouth x-ray and tooth the patient’s dental history. He
also clinically examined her mouth and then filled three of her teeth.
Facts
When the plaintiff later visited the defendant, she complained of pain in the lower left molar area.
After examining the area, the defendant found no emergency that could need immediate tooth
extraction. He then took another x-ray of the two lower left molars, where he discovered a cavity
in the back molar (number 18). The defendant thought the cavity could be filled. Continuing with
the X-ray, the defendant discovered a radiolucent area in the first molar (number 19).
The defendant claimed that the plaintiff complained that both teeth were hurt and requested
extraction. The defendant asked the plaintiff to go home to see if the pain could be localized. The
defendant stated that he knew the plaintiff was a chronic pain complainer. Still, he did not want to
extract the teeth until he was sure the pain was so severe that it required tooth extraction.
The plaintiff returned to the defendant complaining about the pain the two molars conflict. After
reviewing the X-ray, the defendant concluded that tooth number 18 could be saved by filling the
cavity and tooth number 19 should be removed. He also discovered that none of the teeth were
abscessed but were diseased. The radiolucent also indicated that tooth number 19 was decayed.
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The defendant stated that the condition of tooth number 19 was just about to reach the tooth’s
nerve.
After the defendant re-examined the X-ray, he concluded that the plaintiff’s pain came from tooth
number 19. The plaintiff stated that he made the conclusions considering the X-ray results. First,
the radiolucent area was on the back surface of the tooth, below the gum line in the tooth’s root.
He also stated that extraction remains the remedy when decay reaches the tooth’s nerve. He also
considered the plaintiff’s statement that she feels pain due to nerve sensitivity when she takes hot
or cold substances.
Under these circumstances, the defendant told the plaintiff that he could refill tooth number 18 and
save the tooth while he extracted tooth number 19. The defendant showed the plaintiff the X-ray
and even showed her the radiolucent area in tooth number 19 and how close it was to the pulp.
Upon seeing that, the plaintiff accepted the procedure. Since the plaintiff consented, the defendant
filled tooth number 18 and extracted tooth number 19. The defendant extracted the tooth,
considering the X-ray’s outcome and the plaintiff’s symptoms.
The statements given by the defendant have no substantial difference from those of the plaintiff.
The plaintiff also stated that he visited the defendant in 1954. She complained of tooth pain. The
defendant performed an x-ray and told her that it was not tooth number 18 that was hurting but
tooth number 19.
The plaintiff also explained to the doctor that if she ate, chewed gum, or opened her mouth so that
air got in, she felt tooth pain. When the court asked the defendant if she consented to the extraction,
she stated that she told the defendant that he should know what to do. In that case, the defendant
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extracted tooth number 19. The plaintiff then asked the defendant for the extracted tooth. The
defendant gave it to her and took it home. The tooth was also used as evidence in the court.
Court’s ruling
The problem arose when the pain and sensitivity continued after the tooth was extracted. The
plaintiff visited the doctor again and told him she still felt pain. She accused the defendant of
extracting the wrong tooth; thus, she refused to allow him to work on tooth number 18. The
plaintiff visited another doctor, Dr. Brady, who advised her to extract tooth number 18. The
plaintiff took Dr. Brady as her witness. Still, the court granted a nonsuit, considering the evidence
provided.
https://law.justia.com/cases/california/court-of-appeal/2d/163/416.html
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