Pennsylvania Jury Slaps Dentist With $11M Verdict In Tongue Cancer Lawsuit

A suburban Pennsylvania jury hit a dentist with an $11 million verdict Thursday for failing to investigate a sore on a patient’s tongue that turned out to be cancerous.

Woman at dentist office

ByCarolyn Casey, J.D.


Published on April 4, 2024

Woman at dentist office

What Happened?

Dr. Linda Shen, DDS saw Mary Heffelfinger about eight times over approximately seven months for a lesion on the patient’s tongue. Ms. Heffelfinger says that Dr. Shen never instructed her to get a biopsy of the troublesome sore. Instead, for months the dentist prescribed antibiotics and pain-killing mouthwash.

In the ensuing months, Ms. Heffelfinger’s lesion developed into stage IV squamous cell carcinoma. She endured chemotherapy and had to have part of her tongue removed. In a pretrial memorandum, Heffelfinger stated that the delayed cancer diagnosis that required tongue-altering surgery left her with slurred speech.

After she got her cancer diagnosis in 2019, Mary Heffelfinger asked Dr. Shen for her dental treatment records concerning the tongue sore. The dentist said Heffelfinger had to sign a liability waiver and hold harmless agreement before getting the records. Shen never provided the records.

Dental Malpractice Lawsuit

Ms. Heffelfinger filed a negligence lawsuit against Dr. Shen in the Court of Common Pleas in Luzerne County, PA. Heffelfinger claims that if the lesion had been biopsied in 2018, she could have avoided undergoing cancer therapies and the surgical removal of part of her tongue that left her with dysfunctions.

The plaintiff argued that Dr. Shen intentionally withheld or destroyed the dental records after Ms. Heffelfinger would not sign the waiver because the dentist knew she was responsible for the delay in the cancer diagnosis.

Without the dental records, Heffelfinger’s legal team pieced together the evidence based on her memory, records from her pharmacy, and gasoline receipts to establish when she visited Dr. Shen.

Dr. Shen said she attempted to provide the records but couldn’t find them. A bizarre twist in this case -- Shen also stated that she suspected that Heffelfinger’s sister, Shen’s former office manager, stole the records. She also said she didn’t tell Mary about the lesions

Shen, represented by solo practitioner Andrew Katsock III, testified that her care was not negligent. She stated that she had not told the plaintiff about the lesion and the need for an oral surgeon because she thought Hefflefinger was psychiatrically unstable.

Shen further asserted that she sent a referral to an oral surgeon to address Mary’s lesion. Dentist Shen argued that Heffelfinger contributed to the delayed diagnosis when she failed to follow instructions from her doctors.

However, the plaintiff’s counsel, Braden Lepisto a partner at Kline & Specter, tripped Dr. Shen up on this argument when he produced a copy of the referral which had no mention of a lesion.

Dr. Shen left the courtroom after her cross-examination and did not return to the court for the remainder of the trial.

Expert Opinions: Care Fell Short of Standards

Given the size of the verdict, it seems that the jury found the plaintiff’s expert witnesses credible and knowledgeable.

Ms. Hefflefinger’s dental expert stated that Shen’s failure to refer Mary to a specialist for a biopsy, improper antibiotic treatment, and failure to keep dental records all fell outside the acceptable standard of care. This expert also opined that the dentist’s subpar conduct was the cause of the plaintiff’s cancer growth and metastasizing, leading to the tongue surgery.

In the expert’s opinion, Dr. Shen was reckless. He stated that “[A]ny practicing dentist should understand that an unhealing tongue lesion may be a malignancy.”

A board-certified otolaryngologist (head and neck specialists/surgeons) reviewed the dental expert’s report, finding that the dentist’s care was substandard and increased the risk of the cancer’s growth. This expert added that the delayed diagnosis increased the risk of recurrence of the cancer.

The head and neck specialist also maintained that if the cancer had been diagnosed earlier a simple wide local excision would have cured Hesselfinger’s condition. This less severe surgery would have allowed Mary to recover full use of her tongue, including clear speech and the ability to eat a regular diet without difficulty.

Dr. Shen’s expert attempted to support her assertion that she was not negligent.

The Verdict

After a three-day trial, the jury needed only an hour to render a verdict in favor of Mary Hesselfinger. The jurors awarded the plaintiff $11 million, stipulating that $8 million was for punitive damages.


The defendant’s bizarre and contradictory testimony did not help her in the eyes of the jury. One would also question counsel’s decisions to include arguments and information that seemed far-fetched. These factors, coupled with the effectiveness of the plaintiff’s experts, likely swayed the jury to rapidly find in favor of Mary Hesselfinger.

About the author

Carolyn Casey, J.D.

Carolyn Casey, J.D.

Carolyn Casey is a seasoned professional with extensive experience in legal tech, e-discovery, and legal content creation. As Principal of WritMarketing, she combines her decade of Big Law experience with two decades in software leadership to provide strategic consulting in product strategy, content, and messaging for legal tech clients. Previously, Carolyn served as Legal Content Writer for Expert Institute, Sr. Director of Industry Relations at AccessData, and Director of Product Marketing at Zapproved, focusing on industry trends in forensic investigations, compliance, privacy, and e-discovery. Her career also includes roles at Iron Mountain as Head of Legal Product Management and Sr. Product Marketing Manager, where she led product and marketing strategies for legal services, and at Fios Inc as Sr. Marketing Manager, specializing in eDiscovery solutions.

Her early legal expertise was honed at Brobeck, Phleger & Harrison, where she developed legal strategies for mergers, acquisitions, and international finance matters. Carolyn's education includes a J.D. from American University Washington College of Law, where she was a Senior Editor for the International Law Journal and participated in a pioneering China Summer Law Program. She also holds an AB in Political Science with a minor in art history from Stanford University. Her diverse skill set encompasses research, creative writing, copy editing, and a deep understanding of legal product marketing and international legal trends.

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