AUGUSTA — Oral surgeon Jan Kippax was in court Tuesday defending himself against a civil claim that he failed to comply with the standards of care when treating a Minot man whose jaw became infected after tooth extractions.

The embattled Lewiston doctor also is facing questioning before the Maine Board of Dental Practice in its effort to determine whether Kippax should keep his license to practice in Maine in the wake of patients’ complaints.

Steven Darnell Jr., 35, filed a complaint against Kippax in Androscoggin County Superior Court in Auburn claiming he failed to treat Darnell for a post-operative infection that led to weeks of hospitalization and long-term treatment for a bone infection.

Through his lawyer, Kippax claims Darnell didn’t have an infection during the times he visited Kippax’s office, then refused to see Kippax after he had developed an infection.

In opening statements in Kennebec County Superior Court, the opposing attorneys previewed their respective cases before the seven women and three men who composed the jury. The Androscoggin County case was moved to Augusta because of pretrial publicity.

Scott Lynch, who represents Darnell, said Tuesday his client had no infection nor disease when he came to Kippax’s Lewiston office on Friday Dec. 31, 2010, to have two molars removed.

The simple extractions took only minutes. Darnell was in and out of the office in less than an hour.

Three days later, Darnell was in “excruciating” pain, Lynch said. His left cheek and jaw had started to swell. A bad odor emanated from his mouth and he couldn’t keep down solid foods and had been vomiting.

He had followed Kippax’s instructions to gargle with saltwater, use an ice pack for swelling and take prescribed pain medication.

But Darnell’s symptoms had him back in Kippax’s office on Jan. 3, after repeated calls to his office to be seen.

Kippax told Darnell to keep taking his pain medication. He didn’t schedule him for a follow-up visit, Lynch said.

“Kippax does nothing,” Lynch told the jury.

Despite Darnell’s plea, Kippax didn’t prescribe antibiotics for the apparent infection.

Darnell’s condition worsened, Lynch said.

He developed a tingling in his numbing lower lip and was unable to open his jaw.

Darnell called Kippax’s office, but the only response he got was a prescription for pain medication.

On Jan. 7, after getting no response from Kippax’s office, Darnell was rushed by his sister to the emergency room at Central Maine Medical Center in Lewiston (he had been seen there on Jan. 5) as his symptoms continued to worsen.

Doctors admitted Darnell for an infection, putting him on an intravenous drip of antibiotics. He underwent two surgeries to drain pus from his swollen jaw.

Darnell was released from the hospital two weeks later, still taking antibiotics, Lynch said. A week later, Darnell was told he would need regular antibiotic infusions at the hospital until April 21 to treat a bone infection.

“That’s how concerned they were about the extent of the infection,” Lynch told the jury.

As a result of that infection, Darnell lost several more teeth, Lynch said.

Mark Lavoie, attorney for Kippax, told the jury that medical care only works when there’s a good partnership between doctor and patient.

“When that breaks down, then problems result,” he said.

The medical records in Darnell’s case show he hadn’t developed an infection when he visited Kippax on Jan. 3 and that his symptoms were typical of someone who’d recently had teeth extracted.

Darnell had been made aware of possible complications from tooth extractions at the time of his Dec. 31, 2010, visit and had signed a document acknowledging them.

“A doctor can’t promise everything will be perfect” and can’t guarantee or assure “complete satisfaction,” Lavoie said.

Kippax responded to Darnell’s complaint of symptoms by seeing him Jan. 3. He noticed no signs of infection, so he didn’t prescribe antibiotics, Lavoie said. Kippax also checked for other signs of complications and saw none.

A CMMC physician assistant noted in a document from Darnell’s Jan. 5 emergency room visit that his vital signs had been normal and there had been no sign of infection at the extraction site, Lavoie said.

It was apparently a couple of days later that Darnell’s status had changed, Lavoie said. But Darnell and his family had requested that Kippax no longer be involved in his medical care, Lavoie said.

The trial is expected to take four days, with experts testifying for both sides.

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