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Wednesday, March 14, 2007

I thought it was a regular dental procedure: An anesthesia error

When five-year old Diamond Brownridge broke her arm, doctors had no problem in sedating her. Then, when her mother brought her to the dentist last September to fill two cavities and cap her front teeth, her mother said, “They did tell me they were going to sedate her, but I thought it was a regular dental procedure.”

Improperly administered anesthesia led to her death.

The 35-pound girl had received two injections of diazepam or Valium within five minutes, followed by oral Valium, lidocaine, several other medications, and nitrous oxide. The Illinois Department of Professional Regulation said the dentist had failed to properly monitor her blood pressure, pulse and respiration during her treatment. The Cook County Medical Examiner’s office found that the anesthesia caused a lack of oxygen to her brain, causing her death.

Children often need drugs to reduce anxiety, relieve pain, or reduce movement during dental procedures and some medical tests, like MRIs. Children may unintentionally become too deeply sedated, and so must be monitored very carefully until they are fully awake. The American Academy of Pediatric Dentistry and the American Academy of Pediatrics have recently jointly issued guidelines (summarized here) for safe pediatric sedation. The guidelines make clear that the clinician must have advanced airway training, use a pulse oximeter to measure oxygen levels in the blood, and take other precautions, according to AAPD spokesperson Dr. Stephen Wilson.

Advice to parents whose children need sedation: Beforehand, ask your dentist or doctor if s/he follows the new guidelines. If not, consider whether it could happen to your jewel.

Read another anesthesia story, or read the sources: Judy Foreman in Monday’s Boston Globe, Christian Nordqvist in Medical News Today, and CBS2chicago.com.

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