Dentist has a patient about a prosthetic restoration by means of single crowns or a blockage completely clear

A dentist should fully educate a patient about prosthetic restoration using single crowns or interlocking if both treatments are medically equally indicated and commonplace and have substantially different risks and chances of success so that the patient has a real choice.

Higher Regional Court Hamm, 26 U 54 / 13 of the 17.12.2013

§§ 823, 253, 249ff BGB

The defendant's appeal against the 6. February 2012 announced verdict of the 6. Civil division of the district court Bochum is rejected.

The costs of the appellate court are charged to the defendant.

The judgment under appeal is provisionally enforceable.

The revision is not permitted.

1Reasons:

2.

3Die am 29.12.1942 geborene Klägerin hat von dem Beklagten wegen vermeintlicher zahnärztlicher Behandlungsfehler in der Hauptsache die Zahlung eines mit mindestens 6.000 € für angemessen gehaltenen Schmerzensgeldes, die Zahlung von Anwaltskosten für die Einholung der Deckungszusage der Rechtsschutzversicherung, die Zahlung vorgerichtlichen sonstiger Anwaltskosten an die Rechtschutzversicherung und die umfassende Feststellung weitergehender Ersatzpflicht begehrt.

4Das Landgericht hat die Klage lediglich hinsichtlich der Kosten für die Einholung einer Deckungszusage und hinsichtlich der Feststellung der Ersatzpflicht für vorhersehbare immaterielle Schäden abgewiesen. Im übrigen hat es der Klage stattgegeben und auf ein Schmerzensgeld in Höhe von 6.000 €, die Zahlung der vorgerichtlichen Anwaltskosten an die Rechtschutzversicherung und die Feststellung weitergehender Ersatzpflicht erkannt.

5In contrast, the appeal of the defendant, who continues to pursue the first-instance request for a dismissal, is directed. He further denies the presence of treatment errors. He is also not liable for misinformation.

6Die Klägerin verteidigt die angefochtene Entscheidung.

7Von der weiteren Darstellung des Sachverhalts wird gem. den §§ 540, 313a Abs.1, 543, 544 ZPO n.F. i.V.m. § 26 Nr.8 EGZPO abgesehen und auf die erstinstanzliche Entscheidung sowie die zu den Gerichtsakten gereichten Schriftsätze nebst Anlagen Bezug genommen.

8The Senate personally consulted the parties and provided evidence by obtaining an oral opinion from the expert Dr. B. For the result, reference is made to the rapporteur's note on the Senate date of the 17.12.2013.

9II.

10The appeal is unfounded.

111.

12Im rightly, the district court has granted the claim for compensation in the amount recognized.

13a.

According to §§ 14, 611, 280 ff., 249 Abs.253 BGB, treatment errors by 2 have not been established at the hearing by the Senate. In particular, it can not be ruled out that the bite situation initially presented itself as correct and only subsequently changed.

15b.

16The defendant, however, is liable to the extent recognized in accordance with. §§ 823, 253 Abs.2, 249 ff. BGB for all consequences of the treatment, insofar as this was unlawful due to lack of effective consent of the plaintiff:

17 The applicant complains that it was unsuccessful in informing it of the alternative option of making single crowns.

18Nach der höchstrichterlichen Rechtsprechung, die auch vom erkennenden Senat getragen wird, ist die Wahl der Behandlungsmethode zwar primär Sache des Arztes. Gibt es jedoch mehrere medizinisch gleichermaßen indizierte und übliche Behandlungsmethoden, die wesentlich unterschiedliche Risiken und Erfolgschancen aufweisen, besteht demnach also eine echte Wahlmöglichkeit für die Patientin, dann muss dieser nach entsprechend vollständiger ärztlicher Aufklärung die Entscheidung überlassen bleiben, auf welchem Wege die Behandlung erfolgen soll und auf welches Risiko sie sich einlassen will (vgl. BGH-Urteil v. 15.03.2005 – VI ZR 313/03 -, Juris-Veröffentlichung unter Rz. 10; Steffen / Pauge, Arzthaftungsrecht, 12. Auflage, Rdn.449 m.w.N.).

19On such a genuine and therefore to be discussed with the patient, in particular to safeguard his right to self-determination has existed here in terms of a production of single crowns in the upper jaw.

20Nach den überzeugenden Erläuterungen des Sachverständigen in seiner erstinstanzlichen schriftlichen Begutachtung und bei seiner mündlichen Anhörung vor dem Senat haben Einzelkronen Vorteile gegenüber der Verblockung, weil sie nicht nur ästhetisch ansprechender sind, sondern auch besser – etwa durch den Gebrauch von Zahnseide – zu reinigen sind. Der Sachverständige hat deshalb im vorliegenden Fall für den Oberkiefer die Versorgung mit Einzelkronen sogar als erste Wahl bezeichnet.

21Also, from a medical point of view, he had already considered a corresponding consultation with the patient at his hearing by the district court. In this situation, the Senate also assumes, in the case of a legal assessment, that there has been a duty to provide information regarding the provision of single crowns in the upper jaw.

22The defendant did not have the proof that he had fulfilled this obligation to provide information. He stated at his oral hearing in the district court, whose logging he confirmed to the Senate as correct, that he could not remember talking about single crowns or blocking before treatment. He had carried out the measures he considered medically useful.

23Mangel's sufficient information was therefore the consent of the applicant in the supply of single crowns in the upper jaw ineffective. The defendant is therefore liable for all consequences of blocking in the upper jaw.

On the other hand, the expert did not criticize the mandibular restoration; In particular, single crowns were not a real alternative.

25The Senate is convinced that the complaints described by the plaintiff and considered plausible by the expert for food intake due to lack of mouth opening, the hypersensitivity of all teeth and the right ear pain actually existed.

26On this basis, the compensation awarded by the district court seems justified; the Senate has no reason to deviate from the assessment of the district court.

272.

28Also the statement of determination is justified.

29The defendant is obliged to reimburse all material and unforeseeable intangible damages, insofar as they relate to the blocking of the crowns in the upper jaw.

30The cost decision follows from § 97 Abs.1 ZPO; the decision on provisional enforceability is based on §§ 708 Nr.10, 713, 543 ZPO.

31The revision is not to be allowed because the case has no fundamental meaning and does not require a decision of the review court to advance the law or to ensure a uniform case law.

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