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"To lose the baby and to lose the uterus all at once, it was heartbreaking," she said. Respondent Exhibits U and V; hereinafter abbreviated thusly: RE). Whether NICO even exists as a pathology in its own right is a question which has provided the source of not an inconsiderable amount of debate within the dental community. (Record as a whole). This nation's leading proponent of NICO is Respondent's witness Dr. Jerry Bouquot, presently the Director of Research at the Maxillofacial Center for Diagnostics & Research in Morgantown, West Virginia. He has been a licensed dentist since 1971, and is Board Certified in Oral Pathology. He specializes in oral and maxillofacial pathology. He has had a long and distinguished career. (12:74; RE120). He is widely and extensively published on the subject of NICO. (SE 25,45;RE 128, 129, 150). According to Dr. Bouquot, "NICO is just the-the jawbone version of a disease that occurs and has been reported in virtually every bone in the human body, as well several animals"." (12:82). However, again according to Dr. Bouquot, NICO is a lesion histologically unique from other forms of osteomyelitis. (SE45). Therein lies the claim by Dr. Bouquot which has generated widespread opposition to, or at least withholding of, acceptance of NICO by the majority of the dental community as a whole. Put in Dr. Bouquot's words, "The real question is whether NICO differs from classic forms of acute or chronic osteomyelitis?" Dr. Bouquot wrote in a 1992 article published in Oral Surgery, Oral Medicine, and Oral Pathology, of four conditions he claims supports his contention that the correct answer to that question is "it does." (SE45). First, Dr. Bouquot writes that in "acute osteomyelitis, pain intensity is directly related to the presence of significant suppuration and considerable relief is immediately noted on cortical perforation and free egress of pus from the medullary spaces. Such does not appear to be the case with NICO lesions." Second, "the character of local pain differs between these two diseases. Acute osteomyelitis produces much more intense bone pain on palpitation (tenderness) and is often very painful even without palpitation. NICO cavities, while known to trigger lancinating, paroxysmal attacks on palpitation, may be only mildly tender themselves and seldom demonstrate sharp local pain without palpitation." Third, is "the virtual absence of new bone formation or healing contrary to chronic osteomyelitis.and. a surprising lack of active resorption of nonviable or necrotic bony flakes and spicules." Fourth, "Chronic osteomyelitis typically contains foci of isolated suppuration (acute inflammation) and presents a course of acute exacerbations admixed with periods of quiescence." "True chronic osteomyelitis encompasses a group of diseases usually categorized under the term chronic nonsuppurative differs substantially from NICO. (SE45; all emphases added but the last). It appears that in most instances Dr. Bouquot qualifies the differences between chronic osteomyelitis and NICO which he listed in this exhibit. Additionally, Dr. Bouquot concedes in this article that it is purposed as a "preliminary microscopic evaluation and characterization of a large number 224 of NICO lesions and to differentiate them from other forms of osteomyelitis." As Dr. Bouquot seems to recognize, 224 tissue samples is not a large enough sampling to provide conclusive evidence. He also wrote of his hope that "enough interest will be generated to lead to controlled prospective studies of the relationship between jawbone infections and facial neuralgias." Evidently there had been none by 1992. Dr. Bouquot, quite forthrightly, includes as a part of his conclusion to the article his statement: "The present analysis, of course, has several flaws that stem from its uncontrolled, retrospective nature.:" Also bearing mention is the fact that this article was published under the journal's heading "Controversies in Oral pathology," itself indicating a large measure of rejection of NICO by members of the profession. The journal invited commentary on the article, and received and published such in the form of a critique written by William C. Donlan, DMD, MA, at the University of the Pacific. He opined as to Dr. Bouquot's paper,"The content of this paper and its theories are nonscientific." Dr. Donlan concludes "This paper does not define a new pathologic lesion, explain the pain caused by said lesions, or lend any additional credence to this hypotheses." In your discussions with parents regarding protective stabilization, remind them that active stabilization - stabilization by the dentist and/or dental assistant - is described in the list of behavior management methods that they approved when they signed the health history form. Review this type of stabilization with the parent again, if necessary. 715 Newkirk testimony, 11/21/1991, p. 167, lines 16 P. 169, line 4, p. 170, line 1. Specialist in Cosmetic, Implant & Cerec Dentistry - James Mahooti practices general dentistry, cosmetic dentistry, CAD/CAM dentistry, and cerec dentistry in San Diego. Law Firm Temple Texas
Secondary Sources 7 Witkin, California Procedure (4th ed. 1997) Trial, � 349, 359 4 California Trial Guide, Unit 91, Jury Deliberations and Rendition of Verdict, � 91.303b (Matthew Bender) 28 California Forms of Pleading and Practice, Ch. 326A, Jury Verdicts, � 326A.14 (Matthew Bender) Job Search Keywords: Dental Assistant Leominster I Leominster Jobs the aggregate limit on non-economic damages�applying to each incident regardless of the number of claimants�serves precisely the same legitimate interest served by individual caps: by reducing damage awards, limits on damages make medical malpractice insurance more affordable and quality healthcare services more available. A cap applicable to each occurrence, in cooperation with caps individually applicable to each claimant, reduces damage awards as a matter of mathematical certainty, enhances needed predictability, places a calculable limit on the exposure of healthcare and insurance providers, reduces malpractice insurance premiums, and promotes the availability of quality healthcare. Dr. Michael Mashni, a sedation expert and a past president of the American Society of Dentist Anesthesiologists If you do not have medical or health insurance we work with doctors and medical professionals that can see you on a loan basis
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