A Hawaiian pre-schooler died after lapsing into a coma in a dentist’s chair. Now state authorities are investigating her dentist, according to a report by Susan Essoyan of the Honolulu Star-Advertiser. (The articles are behind a paywall but AHCJ has been given permission to republish them here.)
“The state Department of Commerce and Consumer Affairs has begun an investigation of Kailua dentist Dr. Lilly Geyer after a 3-year-old girl fell into a coma while she was in the dentist’s chair and later died,” Essoyan reported on Jan. 8.
“Finley Puleo Boyle, the only child of Ashley and Evan Boyle of Kailua, never awoke after losing consciousness and suffering massive brain damage following heavy sedation at the dentist’s office Dec. 3, her mother said.”
The little girl died Jan. 3 at a local hospice.
Boyle’s family has filed a negligence lawsuit and is preparing a wrongful death suit, Essoyan reported. And their lawyer is raising questions about dentist’s diagnosis as well as the level of sedatives administered to the 38-pound girl. He told the Star-Advertiser the child was given the maximum doses of Demerol and Hydroxyzine and 40 percent more than the maximum of chloral hydrate for a child her size – if just one of those drugs were being administered, Essoyan reported.
Meanwhile the state’s investigation of the dentist is being handled by the Regulated Industries Complaints Office, which enforces dental licensing regulations. Geyer’s practice, Island Dentistry for Children, has shut down. Neither the dentist nor her attorney have commented on the case.
Sadly, the case brings to mind other stories of children dying while receiving dental treatment under sedation or general anesthesia.
Children with diagnoses of extensive decay who may not be able to sit still for care are sometimes placed under general anesthesia before undergoing treatment. But sedation, a drug-induced depression of consciousness, “is increasingly popular and viewed as lower-risk in community settings” such as dental offices, according to a August 2013 report in Pediatric Anesthesia.
The authors of the study, “Trends in Death Associated with Pediatric Dental Sedation and General Anesthesia” reviewed 44 media reports of American children who died after receiving anesthesia for dental work between 1980 and 2011.
They found most of the deaths occurred among 2- to 5-year-olds in an office setting and with a general/pediatric dentist as the anesthesia provider.
“In this latter group,” they noted, “17 of 25 deaths were linked with a sedation anesthetic.”
The researchers, led by Helen H. Lee, of the University of Washington’s Department of Anesthesiology and Pain Medicine, concluded the media reports they reviewed “likely represent only a fraction of the overall morbidity and mortality related to dental anesthesia.”
“These data may indicate an association between mortality and pediatric dental procedures under sedation, particularly in office settings,” they noted. “However,” they acknowledged, “these relationships are difficult to test in the absence of a database that could provide an estimate of incidence and prevalence of morbidity and mortality. With growing numbers of children receiving anesthesia for dental procedures from providers with variable training, it is imperative to be able to track anesthesia-related adverse outcomes. Creating a national database of adverse outcomes will enable future research to advance patient safety and quality.”