A man left with a permanent scar on his face after a mouth tumour ‘burst through’ his cheek is taking legal action against his dentist after he mistakenly diagnosed it as a problem related to a wisdom tooth.
Victor Heath said he was ‘absolutely horrified’ when his cheek suddenly started weeping as he sat at home, developing into hole about the size of a 2p coin.
Panicked by the situation, his wife called the hospital immediately and they were told to apply a bandage which they held together with a plaster.
Mr Health underwent 14 hours of surgery the following day in which doctors removed the tumour and carried out an operation which left a 6cm hole in his cheek.
As part of the surgery, he had to have part of his jaw removed and replaced with bone taken from his fibula, the smaller bone in his leg. Skin from his leg was also used to graft the hole left in the side of his face.
He remained in hospital for three weeks and had six weeks of radiotherapy and two courses of Chemotherapy, needing regular appointments afterwards to check the cancer had not returned.
Mr Heath is now pursuing legal action against his dentist, alleging his failure to spot the developing tumour almost three months before it ‘erupted’ amounted to negligence.
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In a legal case through dental negligence specialists Hudgell Solicitors, it has been alleged the dentist’s failure to identify the tumour caused delays in Mr Heath’s referral to specialists and ultimately denied him the chance to remove it earlier before it caused serious disfigurement. Mr Heath said:
I am devastated about what happened to me and I am very upset by the facial disfigurement I have been left with.
It upsets me to think it was almost three months before it happened that I first went to my dentist in lots of pain and with a lot of swelling. It has knocked my confidence significantly because people stare at me and ask me what happened when they see me, and I have been told corrective surgery would not be effective.
Mr Heath had attended his dental surgery on January 31 having suffered constant pain and swelling for two to three weeks. His dentist noted him to have a ‘very large swelling in the gum’, which he concluded was due to a deeply embedded wisdom tooth causing inflammation.
The dentist told Mr Heath that as he did not carry out compound wisdom tooth removals, he would refer him to Hillingdon Hospital, and he placed him on antibiotics.
Having heard nothing back from his dentist, and concerned that it may be something more sinister after reading up on the Internet, he returned a week later to question what was happening, to be told the referral had not yet been sent. Mr Heath added:
I was getting very worried myself as I had gone home and looked on the Internet and a few things relating to my symptoms came up saying it could be cancer. It was for that reason I chased up the referral and was told it hadn’t been sent as they didn’t have my NHS number.
It seemed strange, but as my doctors were nearby I went there and got it straight away. I was concerned about the delay and wanted it chasing up.
When receiving the referral, Hillingdon Hospital made a routine appointment for March 13, where an Oral Surgery department consultant requested an ‘urgent biopsy’, which was carried out four days later.
Mr Heath was informed on March 21 that his swelling was a cancerous tumour, and when seen again on April 2 to plan treatment, was told by a consultant that it was a stage four tumour.
He was booked in for surgery on April 14, 2014, at Mount Vernon Hospital, but says that in the days leading up to his scheduled operation, the growth became more painful and bigger every day, leading up to it ‘erupting’ through his cheek the night before he was due for surgery. He said:
Over the period of a week the pain in my lower left mouth became much worse every day and what had been a pimple at the start grew larger each day.
It suddenly grew at a rapid rate and to my absolute horror the tumour erupted through the surface of my left cheek at the same site where the pimple had been. It was absolutely horrific. The hole was about the size of a 2p coin, and I understand it was about a third of the size of the actual tumour. It was weeping really badly.
My wife was very worried and although we knew I was to be admitted the following day for surgery, she contacted the hospital who advised that we apply a bandage held together with a plaster.
Now clear of the cancer for almost four years, Mr Heath is hoping lessons will be learned as part of legal action against the dentist. He said:
They say when you get to this long without it returning you are pretty much in the clear, which is a massive relief. I owe it to the specialists at Mount Veron Hospital as they saved my life, they were incredible.
However, when I think about what has happened, I feel angry that the dentist didn’t even consider it could have been something serious. I was able to come away from that appointment and look it up and come up with the right diagnosis, so why couldn’t he?
It was when I was seeing specialists that people made comments like ‘I can’t believe he missed this’ and others made comments about how it could have been life-threatening that I decided to take legal advice. I want lessons to be learned.
Dimple Raja, a specialist in handling medical negligence legal claims at Hudgell Solicitors, and who is representing Mr Heath, says the dentist’s failure to recognise potential signs of oral cancer and request the required investigations, amounts to a breach of duty, which led to a crucial 28-day delay in his treatment. She said:
Given the pain Mr Heath had been suffering and the substantial swelling in his mouth, it would be expected that a dentist would ensure he was checked for something more sinister.
This should have resulted in an urgent referral to see specialists to identify the correct diagnosis which would trigger treatment he so desperately needed as quickly as possible. Instead, there was a delay in making the referral, and even then only a routine referral was made for an extraction. It did not make any reference to any concern over cancer, meaning Mr Heath’s case was not treated as urgent, causing further delay.
Had Mr Heath been sent as a potential cancer referral there is every likelihood that the cancerous tumour, which transpired to be an aggressive tumour, would have been discovered almost a month earlier than it eventually was.
That is a highly significant amount of time in the context of oral cancer, which often comes on very suddenly and develops to advanced cancer far more rapidly than other cancers. They lost vital weeks which would have offered a life-changing opportunity to prevent the growth of the tumour and avoid such radical and invasive surgery, which we believe would have averted the need for such a large skin graft and permanent scarring.
This has had a dramatic impact on Mr Heath’s life and we will be looking to recover damages to reflect his pain and suffering. Living with the scarring has had a major impact on his life and confidence, and could have been avoided with the appropriate medical care from his dentist.
Mr Heath, 60, said:
It has had a big impact on my life. I work as a builder and immediately after it had happened and I had my operation I used to go and see people to discuss work and I could see that they were looking at me funnily and they found it awkward. I don’t blame people, it wasn’t nice to look at but it did impact on some work.
Thankfully I had a lot of long-term clients who were very supportive. Even now though it impacts on my confidence. Due to the radiotherapy I grow no stubble or beard on the left side of my face and because of my loss in confidence, I do not socialise as I did prior to the surgery and avoid talking to new people.
If I do go out to a restaurant I make sure I am sat somewhere in a corner against a wall so that not many people can see me. I don’t think they’ll want to see it.
My lower left lip is permanently numb as is the skin on my cheek. I feel as though I am dribbling which agitates me. That my facial appearance could have been preserved or if not, marred by just minor scarring breaks my heart.
That the tumour progressed so rapidly makes me feel that every day made a difference and that therefore if the delay was for nearly a month, my entire outcome could have been radically improved. I am grateful that there has been no tumour recurrence and that my life has been saved, but I am an entirely different person as a result of the scarring.
It is a lifelong reminder, but as I say, I feel the hospital specialists saved me. They said I am famous there because my case has been talked about and shared by doctors to learn about the operation. I just hope dentists read about my case and learn to so others don’t go through the same I have.
