Woman disabled from jaw surgeries awarded $14 million

A Washington woman has been awarded more than $14 million in damages after a series of dental surgeries left her jaw fused shut.

A Spokane County Superior Court jury ruled that the treatment Kimberly Kallestad received from Patrick C. Collins, D.D.S., an oral surgeon practicing in Spokane, was below the standard of care. Kallestad was awarded $10 million in noneconomic damages for pain, suffering, and disfigurement and the rest for economic damages such as loss of wages and medical expenses.

In addition to the civil suit, the Washington State Dental Quality Assurance Commission is considering opening an investigation into the case, according to Tim Church, communications director for the Washington State Department of Health. Two investigations have already been opened on Dr. Collins, he added -- one a standard of care case, the other involving 71-year-old Jon Gellner, who died after palate surgery performed by Dr. Collins, reported the Spokesman Review.

The state dental board came under fire earlier this year for not being thorough in its review of dentistry-related deaths. A series of articles in the Seattle Post-Intelligencer dating back to 2005 has prompted the state to take a harder look at the board's decision-making processes.

Kallestad, 29, a former cheerleader and tennis player who had dreams of becoming a lawyer, is now unable to work and lives under the care of her parents. She was involved in a sledding accident in early 2000 that caused her to develop TMJ symptoms. She was also diagnosed with a slightly displaced soft-tissue disk in her left jaw joint.

After nine months of pain and conservative treatment, she went to Dr. Collins. He treated her with bilateral steroid and sodium hyaluronate injections in her jaw joints, plus open joint surgeries, according to Kallestad's attorney, Mary Schultz. Dr. Collins also performed an arthroplasty with a modified Walker repair on Kallestad's left partially displaced disk, claiming that he had a success rate of more than 95% with the surgery. He then performed the same operation on her right jaw joint.

The Walker repair procedure was originally developed by 84-year-old surgeon Robert Walker in 1987, according to Schultz.

"It was controversial even then," she said. "Dr. Collins has reworked it and made it more risky."

Dr. Collins published a study in 2007 that evaluated the outcome of the Walker repair technique in TMJ patients, concluding that it is an effective surgical treatment (Journal of Oral and Maxillofacial Surgery, October 2007, Vol. 65:10, pp.1958-1962).

According to Kallestad's complaint, first filed in 2004, Dr. Collins did not inform her of the controversy within the oral surgery community regarding the use of invasive and irreversible surgery for pain and minor disk displacement in circumstances like hers and the potential risks associated with the treatment. Also, he did not tell her about alternative treatments that would not carry these risks.

In fact, Dr. Collins assured Kallestad that the arthroplasty procedure had a 95% success rate in reducing pain and dysfunction, but in his hands it was 100% successful, Schultz said.

Kallestad's jaw started degenerating after the surgeries. She developed complex regional pain syndrome, which began spreading from the surgery sites to other parts of her body, and, ultimately, her jaw started to fuse shut.

"He [Dr. Collins] told Kimberly, when she returned with pain, that he had 'fixed' her and that there was nothing wrong with her," Schultz said. He told her "it was all in her head."

Kallestad then consulted with other physicians. Her jaw had to be reopened by a gap arthroplasty, but fused two more times due to the ankylosis.

"Now she is fully disabled," Schultz said. "There is constant burning pain in her jaw."

Schultz took the case in 2004, shortly before the three-year statute of limitations expired.

"We did this to try to protect other patients and provide a voice for the victims," Kallestad told the Seattle Post-Intelligencer.

Dr. Collins' attorney, John Versnel, plans to appeal.

"Any time a jury spends six weeks listening to a case you have to respect the decision, but the dollar amount just does not make any sense," he said. "The jury listened to a lot of inflammatory evidence, and that will be the basis of our appeal. There was a lot of extraneous information, like testimony from unhappy former patients, while we were not allowed to bring in satisfied patients."

Kallestad received considerable additional medical treatment after she left Dr. Collin's care that contributed to her condition, he added.

Schultz argues that Dr. Collins' lawyers are just trying to deflect the blame.

"They claimed everyone except Dr. Collins was to blame," she said. "They blamed her parents, the subsequent doctors, everyone -- except Dr. Collins."

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