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Doctors and dentists may not be able to charge a fee for treatment against medical standards. This is the case if the treatment was ultimately useless for the patient and even aftercare can only lead to an “emergency solution”, the Federal Court of Justice (BGH) in Karlsruhe ruled on Thursday, September 13, 2018 regarding dental implants (Az .: III ZR 294/16).
In the event of a dispute, a woman from Lower Saxony had eight implants inserted, i.e. pins, on which crowns or bridges can then be placed. Due to persistent pain, she stopped the treatment and changed to another practice. The first dentist charged her 34,277 euros for the implants and other services.
However, the patient refused to pay for this. All implants are unusable because they have not been inserted deep enough into the jawbone and have been incorrectly positioned. A professional prosthetic restoration is therefore not possible. For the after-treatment there is only "the choice between plague and cholera". In addition, the bill is far too high.
Experts had confirmed the shortcomings. Nevertheless, the Higher Regional Court (OLG) Celle awarded the dentist almost half of the fee, specifically 16,957 euros. Despite the shortcomings, it is still possible to use the implants for a prosthesis.
As the BGH now decided, the implants are “objectively and subjectively completely worthless”. Because there is no post-treatment that leads to a "condition that at least essentially corresponds to the rules of dental art". If the implants were used, the artificial teeth placed on them would probably not be durable; there would also be a high risk of inflammation. The dentist is therefore not entitled to a fee even if the patient decides to continue treatment in order to avoid further interventions to remove the implants.
In general, the BGH emphasized that medical or dental treatment is a contract for "higher-quality services". Patients could therefore terminate the treatment contract "at any time without greens". The doctor did not owe any success in treatment, but a treatment according to the rules of medical or, here, "dental art". The dentist did not do this in the event of a dispute.
The OLG Celle should now check to what extent the other items on the invoice are justified. Here too, the patient complains to the dentist that the treatment was unnecessary or inappropriate. If there are still justified items on the invoice, the OLG should clarify whether there was an agreement between the dentist and the patient about the amount of the permissible fees. mwo