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Caruth v. Clark

United States District Court, E.D. Virginia, Alexandria Division

April 12, 2017



          Liam O'Grady, Judge.

         Plaintiff Leonora Caruth has sued Dr. C. Benson Clark and his dental practice, King Centre Dental ("Defendants") for breach of contract and various torts relating to her dental treatment between 2011 and 2014. After receiving treatment from Dr. Clark, Ms. Caruth eventually abandoned Dr. Clark's practice and went to a different provider who determined it was necessary to replace all of Ms. Caruth's teeth and consequently remove all of Dr. Clark's work. Following this series of events, Ms. Caruth brought claims for: (1) medical negligence; (2) battery; (3) breach of contract; (4) fraud; and (5) a violation of the Virginia Consumer Protection Act (VCPA). Defendants have moved for Summary Judgment on all claims. (Dkt. No. 34). The parties fully briefed the matter and the Court heard oral argument on March 24, 2017. For the reasons that follow, the Court hereby GRANTS summary judgment as to the VCPA claims, but DENIES the motion in all other respects.

         I. BACKGROUND

         In May 2011, Plaintiff went to see Dr. Adrian Wilson for advice about her dental treatment options after her braces were removed. Plaintiff was concerned that, once the upper and lower braces were off, she might need additional work to ensure that the teeth stayed in place. Dr. Wilson recommended that Plaintiff go see Dr. Clark for an opinion on treatment options. Dr. Clark is a general dentist who specializes in implants. On Dr. Wilson's advice, Plaintiff first visited Dr. Clark on June 17, 2011.

         A. Initial Visit on June 17, 2011

         At the initial consultation on June 17, 2011 Dr. Clark recommended implants, ''although there was some discussion of partial dentures and bridges" as well. It is undisputed that Dr. Clark did not provide any formal written treatment plan during this first visit. The best evidence of the treatment plan is a 2008 image of Plaintiff s mouth with some handwritten notes on it. Defs.' Mem. in Supp., Ex. F-3 (Dkt. No. 35-4). Beyond that, the parties dispute the scope of the agreed-upon treatment. Nonetheless, they seem to agree that some of the work would focus on Tooth 21, which was the anchor for a bridge is Ms. Caruth's mouth at the time of the visit. Ms. Caruth alleges that Dr. Clark told her the entire treatment (the scope of which is disputed) would cost $24, 000, and she therefore obtained a loan for that amount from a company called CareCredit.

         B. First Treatment Visit on June 21, 2011

         Ms. Caruth received her first treatment from Dr. Clark on June 21, 2011. During this visit, Dr. Clark removed an old bridge that encompassed Tooth 21. Dr. Clark asserts that, once the bridge was removed, it became clear that Tooth 21 was compromised and that a new crown would not provide sufficient support for a new bridge across Teeth 18-21. At that time, Dr. Clark determined that he would have to remove Tooth 21 and replace it with an implant. Ms. Caruth challenges whether removal of Tooth 21 was necessary. She suggests that Dr. Clark's financial problems give the jury enough information to believe that Dr. Clark unnecessarily removed the tooth at a cost of $5, 920 rather than charging $900 for the crown.

         The parties further dispute the extent of the discussion that happened before the tooth removal. Ms. Caruth stated that, after she was numbed, Dr. Clark told her "he has to take out the tooth, and he took out the tooth." Ms. Caruth was charged an additional $5, 300 or $5, 800 (beyond the original $24, 000) for this visit. Ms. Caruth spoke with Ms. Franklin (an employee at Dr. Clark's office) about the bill, but did not protest at that time.

         C. Subsequent Issues and Charges

         Ms. Caruth alleges the following issues that arose after this initial visit: (1) the implant on Tooth 21 needed to be ""re-installed" or replaced in or around November 2011 and again in or around February 2012; (2) Ms. Caruth's temporary crowns were deteriorating, chipping, breaking, and falling out of place; (3) Ms. Caruth's tooth enamel and gum health was deteriorating; (4) on September 15, Dr. Wilson informed her that her mouth was in "a state of disrepair."

         Ms. Caruth was charged a total of $22, 773 above and beyond the $24, 000 that was initially agreed upon. That figure breaks down to: (1) $5, 300 on June 21, 2011; (2) $2, 100 on October 22, 2012, which was reduced to $638; (3) $14, 835, reduced to $6, 835 on April 10, 2013; (4) $10, 000 on June 26, 2013. Of these additional charges, Ms. Caruth only actually paid $5, 511 beyond the initial $24, 000. Throughout the course of her treatment, Dr. Clark asserts that there is an array of services for which Ms. Caruth was not charged. All told, these "service discounts and office adjustments" totaled $12, 884.

         D. New Treatment Plan and Involvement of Other Dentists

         On July 9, 2012, Ms. Caruth endorsed a new treatment plan that included TENSing and electromyography to fix her bite. The cost of this new treatment plan is unclear. On October 12, Ms. Caruth enlisted the help of her previous dentist, Dr. Wilson, to address a billing issue. Dr. Wilson, Ms. Caruth, and Dr. Clark then all met together to discuss the bill, and Dr. Clark reduced a $2, 100 bill to $638. On September 10, 2013, Ms. Caruth again enlisted the help of her dentists at Connecticut Avenue Dental, who telephoned Dr. Clark to discuss his treatment plan, the expected date of completion, and billing.

         E. The February 4, 2014 Proposed Final Restoration

         Nearly all of the facts surrounding the proposed restoration are in dispute. Most prominently, the parties dispute both the quality and the value of the work performed on Ms. Caruth prior to February 4, 2014. This includes a dispute over whether the bite work was "complete" and when and how the billing discussions took place.

         Defendants contend that Ms. Caruth's bite work was complete and she was ready for permanent restorations or permanent crowns. They further contend that Ms. Spriggs-the front office administrator at Clark Dental-informed Ms. Caruth that the work was estimated at $47, 600. When Ms. Caruth stated that she would not pay that amount, Dr. Clark offered to complete the work for $20, ...

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