Inadvertent pulmonary aspiration of endodontic hand instrument -procedural negligence and litigation: Case report

Aspiration/ingestion in dentistry is rare but serious complication. Dentist should be tremendously conscientious during any intercession, especially in supine position and the management of small instrument. A 21-year-old male patient reported in apprehension with a complaint of aspiration/ingestion of endodontic hand file instrument while undergoing root canal treatment. A prompt Non-Contrast Computed Tomography of the thorax was done, which discovered an endodontic file in the right bronchus. The patient was well-versed about the existence of the instrument and was instantly admitted to the Pulmonary Medicine Department. High-risk consent was duly signed by the patient before treatment. Flexible fiberoptic Bronchoscopy was considered for retrieval of the instrument under local anesthesia. A successful bronchoscopy was performed, and the endodontic instrument was retrieved. The patient was kept under observation for any symptoms. Follow-up chest-X ray done immediately and after 6 months. Consequently, focused Ethical standard practice guidelines, including rubber dam isolation, should be followed in dentistry/endodontic procedure to lessen unreasonable, difficult perilous situations, and negligence litigations.