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5 y/o girl dies after dental procedure...

post #1 of 27
Thread Starter 
This is just heartbreaking. This beautiful little 5 y/o girl was sedated to do dental work...somehow she ended up not breathing and on life support. After 4 days on life support, she died yesterday.

I pray for comfort for her family, and that the investigation finds some answers.

http://www.chicagotribune.com/featur...l=chi-news-hed
post #2 of 27
What a terrible tradegy . This just shows you why you should never be put under anesthesia in a dental office. They are not equipped or trained for any type of emergency.The poor parents.
post #3 of 27
Quote:
Originally Posted by gardenandcats View Post
What a terrible tradegy . This just shows you why you should never be put under anesthesia in a dental office. They are not equipped or trained for any type of emergency.The poor parents.

i have to disagree with that. not all dentists are incompetent at sedation. i have to be sedated for dental work, and my dentist has never had any problems with me, nor anay other patient that I'm aware of. i have intravenous sedation just like that little girl did. what i dont understand is why they gave her "a liquid sedative, intravenous sedation, and nitrous oxide". what the HECK(really like to use a stronger word there). i cant imagine why any dentist in his right mind would use nitrous with IV sedation. it doesn't even make sense. nitrous is to make you relaxed and calm (and sometimes a bit euphoric), so you can't panic as you're being worked on, or be afraid, but you are completely awake during nitrous. IV sedation is for putting you almost out, to completely out. I get IV and i go out completely and have no memory of the dental work, which is what i want. it doesnt even make any sense to mix the two. PLUS "a liquid sedative"? I t hink the doctor messed up, big time.

how horrible for the family..i can't imagine losing someone out of the blue like that, during what you think will be a routine procedure.
post #4 of 27
I didn't mean that the dentist is incompetent.I mean that if anyone has never been put under who knows if they might have a allergic reaction to that type of anesthesia.A dentist office is not set up with the proper equipment to handle any type of emergency that might arise when things go wrong. Years ago when I was going to have all 4 wisdom teeth out in the dentist office and be put out. My MD was horrified he told me NEVER let a dentist do that insist on being in the hospital. I took his advice and did just that. Its a personal choice. And for me I'd rather be safe then sorry.
post #5 of 27
This is soooo sad!!! My 4yo has to have dental work done in about 2 weeks.. So I'm very nervous now... Uggghhh..

Heather
post #6 of 27
I'm no medical professional, but that sounds like too much medicine for a 5-year-old body...liquid sedative followed by nitrous oxide and intravenous sedation??? Did a small body need THAT MUCH to anesthetize her???
post #7 of 27
My prayers are with the family. I think something needs to be done about the dentist using that must medication on a 5 yr old. 3 different types seems like over kill. I got my wisdom teeth cut out with only the IV sedation and was fine.
post #8 of 27
Quote:
Originally Posted by gardenandcats View Post
I didn't mean that the dentist is incompetent.I mean that if anyone has never been put under who knows if they might have a allergic reaction to that type of anesthesia.A dentist office is not set up with the proper equipment to handle any type of emergency that might arise when things go wrong. Years ago when I was going to have all 4 wisdom teeth out in the dentist office and be put out. My MD was horrified he told me NEVER let a dentist do that insist on being in the hospital. I took his advice and did just that. Its a personal choice. And for me I'd rather be safe then sorry.
my dentist is set up for emergencies. He's one of the best dentists in san francisco, he's worked on heart transplant patients and even someone with an artificial heart. He has a plan in place if something were to go wrong-i specifically asked him about that, because I have heart problems myself and wanted to make sure that if something went wrong, they could get me help in time. They are set up for that. some dentists, like mine, are set up properly to do it. People just have to ask questions, like I did.
post #9 of 27
Quote:
Originally Posted by ugaimes View Post
I'm no medical professional, but that sounds like too much medicine for a 5-year-old body...liquid sedative followed by nitrous oxide and intravenous sedation??? Did a small body need THAT MUCH to anesthetize her???
That's what I'm saying.. why did they give her all that medication? It doesn't make any sense. If she was getting IV sedation they shouldn't have given her anything else, IMO. Just find a vein, inject the medication, and she should be out. im not sure where the nitrous or liquid sedative would come in. I don't know what that doctor was thinking :/
post #10 of 27
That is AWFUL!! I pray for that family...how horrible that must be for them.
post #11 of 27
Quote:
Originally Posted by ugaimes View Post
I'm no medical professional, but that sounds like too much medicine for a 5-year-old body...liquid sedative followed by nitrous oxide and intravenous sedation??? Did a small body need THAT MUCH to anesthetize her???
EXACTLY!! That was my first thought! Why in the HECK would they give that little girl so much? Ughh....
post #12 of 27
IT sounds like there is alot more to the story than what is already mentioned
post #13 of 27
Well, I just talked to my dad about this, who just happens to be a dentist (general family, not specifically pediatric) in Chicago as well and apparently she was iven halcion, which is inapporpriate for kids, PLUS Nitrous at 70% when for a kid it should be 30% max, PLUS 20mg of sodium thiopental when for a kid getting this combination of drugs it should be about 5mg. The impression I got in talking to him was that the girl was underweight for her age (she only weighed 30 pounds) to begin with and was then overdosed.

He also said that this dentist made a pretty obvious mistake and needs to admit to that, maybe go back to school and have his license suspended. My dad's had his practice for almost 25 years and regulalry goes to classes and conventions to stay up on things. Personally, I think that should be required of all medical professionals...vets included. We talk about how vets undrestimate the effects of declawing and recommend the outdated practice of all-dry diets...well, the effects of this ignorance can be devastating in people as well as animals. Although, in this case it sounds like this guy and his staff were extremely sloppy and failed to take a lot of things into account.
post #14 of 27
Quote:
Originally Posted by gardenandcats View Post
What a terrible tradegy . This just shows you why you should never be put under anesthesia in a dental office. They are not equipped or trained for any type of emergency.The poor parents.
I'm going to kindly disagree with you on that statement. All dentists as well as dental hygenists are highly trained to administer those types of medication to their patients. (I am a dental student). There is always a risk anytime sedation of any form is administerred to a patient...especially if they have sleep apnea or certain heart/breathing conditions. Her doctor should have thoroughly questioned her parents on any possible medical conditions before ever giving her those drugs. Also, in pediactric dentistry, many times they will actually weigh the patient before hand to determine the amount of sedative that should be administered to the patient. I'm wondering if they did this before sedating her. Also, It sounds like that patient was given way too many sedatives.....between the nitrous oxide, liquid sedative, and the iv....that is too much for a 5 year old! My mouth about dropped when I read that! I'm wondering about the quality of dentist she was taken to, but I also wonder about underlying medical conditions the child may have had unknown to her parents or doctors before this. This is so tragic...and as a dental student, it scares me a bit...but I definitely want to encourage patients to keep going to their dentists and not shy away because of this tragic event- just make sure your dentist ...and hygenist- I can't stress that enough, hygeneists are the ones you will spend most of your time with! - make sure you ask them questions about your overall health...not just your dental health, before you consent you or your child to any procedure which requires sedation....make sure your dentist is thorough and asks you questions and takes time with you...this is very important in finding a good dental care professional.While an event like this is tragic...it is rare. It is horrible and my heart goes out to their family....but until the autopsey comes in ...the dentist shouldn't be accused of murder until a formal investigation is carried out. My prayers are definitely with the family. / I just wanted to clear up that misconception about the amount of training that dentists and hygeneists have when it comes to sedation techniques- they are highly trained before they ever recieve that degree
post #15 of 27
Quote:
Originally Posted by lionessrampant View Post
Well, I just talked to my dad about this, who just happens to be a dentist (general family, not specifically pediatric) in Chicago as well and apparently she was iven halcion, which is inapporpriate for kids, PLUS Nitrous at 70% when for a kid it should be 30% max, PLUS 20mg of sodium thiopental when for a kid getting this combination of drugs it should be about 5mg. The impression I got in talking to him was that the girl was underweight for her age (she only weighed 30 pounds) to begin with and was then overdosed.

He also said that this dentist made a pretty obvious mistake and needs to admit to that, maybe go back to school and have his license suspended. My dad's had his practice for almost 25 years and regulalry goes to classes and conventions to stay up on things. Personally, I think that should be required of all medical professionals...vets included. We talk about how vets undrestimate the effects of declawing and recommend the outdated practice of all-dry diets...well, the effects of this ignorance can be devastating in people as well as animals. Although, in this case it sounds like this guy and his staff were extremely sloppy and failed to take a lot of things into account.
In the US, all medical professionals are required to do CE if they have a license or certificate of some sort... even pharmacy technicians and CNAs!
As a pharmacist, I am required to do over 30 hours a year of CE credit. They usually involved a free meal at a nice restaurant, so I don't mind.

That combo of drugs... I am just floored. That should NOT have happened, those doses could have even put an adult into a coma if given together like that! At least I guess we can say she died peacefully and happily. As far as I know, there isn't an IV Halcion/triazolam, unless manufacturers make them only for dentists. There is a similar drug that is given IV that is less potent, but longer acting... Versed/midazolam. Maybe that is what she was given, or maybe she was given triazolam orally before appointment which is common around here.

I'm all for sedation at the dentist... the drugs are generally safe, as long as you only use one or two of the options available (which is another reason I am floored... that girl shouldn't have been getting all three drugs to begin with) I wouldn't survive an appointment without some nitrous and Halcion!
post #16 of 27
Thread Starter 
Quote:
Originally Posted by angelkitty View Post
This is soooo sad!!! My 4yo has to have dental work done in about 2 weeks.. So I'm very nervous now... Uggghhh..

Heather
I have 4 kids, and they have been to dentists all their lives. We have never had any problems. If your child will need to be sedated, ask the dentist about his (her) experience with sedation, and if someone will be with the child at all times. In the case of little Diamond, it sounds like the Mom went into the room and found her not breathing. And as lioness stated, the child was simply mistreated.
post #17 of 27
My sister (when she was 6) also stopped breathing after anesthesia at the dentist and they were completely set up for an emergency (the fact that the dentist 'forgot' to mention it to my parents was another story) and that was after she had already had successful anesthesia for something else so it is rarely that simple.

I would say there is more to the story as (as mentioned above) there is no need for a child to have several types of sedation mixed.
post #18 of 27
Quote:
Originally Posted by icklemiss21 View Post
I would say there is more to the story as (as mentioned above) there is no need for a child to have several types of sedation mixed.

Here are some more articles, each with its own little tidbit to offer:
http://www.our-dentalplans.com/
The allegations of 3 medications comes from the family(although IMO they have no reason to lie). The dentist has done thousands of pediatric procedures in which he has administered anesthesia with no complaints on his record. Some of his patients are there because he is widely recommended. He is also the only pediatric dentist in his area who takes Medic-Aid. His office is receiving death threats and he is unable to keep his practice open. No wonder some dentists "play it safe" and refuse to help the poor/indigent for the measly pittance that MedicAid reimburses them
Sad, Sad situation all around. Poor little Diamond - if she required all that medication, she must have been extremely terrified - maybe she had a premonition
post #19 of 27
I feel awful for the dentist... I'm sure he's contemplating suicide now. Medicaid is AWFUL at reimbursement, and when it comes to private practices, the provider is usually a very goodhearted person to take a loss on those patients.

Apart from the nitrous, the thiopental and triazolam/midazolam can both be "overridden" so to speak by the patient's level of anxiety. Little Diamond must have been very anxious, and they might have just been trying to up the dose to see if it would help. I know from experience... when I had an endoscopy, they gave me four times the normal adult Versed dose, and it did not help at all. I remember fighting the procedure the whole way... I wasn't doped up enough to be calm and cooperative or forget the procedure like I was supposed to, but I was doped up enough to fight and be confused. Benzodiazepines can cause paradoxical agitation in very agitated patients.

It's possible the hygienist (if there was one) was given authority to up the nitrous, and perhaps he/she did it without thinking, or perhaps they just gave the wrong dose. Who knows...

Sedation is tricky business... I just feel awful for all involved.
post #20 of 27
Quote:
Originally Posted by ugaimes View Post
I'm no medical professional, but that sounds like too much medicine for a 5-year-old body...liquid sedative followed by nitrous oxide and intravenous sedation??? Did a small body need THAT MUCH to anesthetize her???
When my brother was 6 he had to have a tooth removed because it had a huge abcess under it. They gave him a whole bunch of stuff. I'm not sure exactly what since I was only 11. But they never where able to knock him out because my family has such a high tolerance for meds. During surgery we all take way more to knock us out and keep us under then most people. So they might not have been able to get her how they wanted her (those arent the right words.) So they kept giving her more. Not the brightest thing to do but they probably didnt think it would hurt her.
post #21 of 27
I know my dentist uses valium and demerol to knock me out (I ask. I have a heart condition. I ask a LOT of questions ). I'm hooked up to a heart/respiration monitor the whole time. I trust my dentist, he's good at what he does... He did mention to me that he had to give me a bit more than most people. I'm a recovering addict, and even though it's been years since I used anything, my body still has a bit of a tolerance, and that'll never go away, so he needs to give me slightly more. Only slightly though - just enough to do the job.

The dentist who treated the little girl obviously made a HUGE mistake. StarryEyedTiGeR - so I was right that he shouldn't have given her all three meds at once? I just ask cos you're a dental student It just didn't make sense to me - I thought nitrous was for when you want to be awake during a procedure but not afraid, and the IV stuff is for when you want to be partially or totally knocked out. I couldn't understand why he'd give her both :/
post #22 of 27
This section of the story bothered me

Travis said she entered the office after the procedure and saw her daughter lying motionless on her side in a dentist chair.

The girl's head was rolled back, her eyes were in the back of her head and she wasn't breathing, Travis said.

Paramedics arrived at the office, at 3915 W. 26th St., shortly after, police said, and the girl was taken to Mt. Sinai Hospital and later to Children's Memorial.


Why hadn't the dentist call the paramedics? Why didn't they tell the mother? Why did she have to find her daughter this way? Why did the mother have to call the paramedics?
They HAD to have known something!
There is no way they didn't see the mother walk into the room. Someone had to have been there to say "Hey, I'm sorry but....."
Did they just watch her walk in there just to find her child dead? It doesn't make sense to me AT ALL!

I had 9 teeth pulled at once. I'm 5'4 and 145lbs. the dentist gave me the SAME thing and dosage as this baby got and I'm 100lbs heavier then she is!
When my son went to the dentist at 6yrs old, they told me they would use nitrous ONLY because he was so young and that they NEVER use all three at once. Him and I both have a high tolerance to medication. Matter of fact, when I gave birth to him I had an epidural for 5 hours BEFORE I had him and STILL felt everything ...2 years after he was born I had to have my wisdom teeth pulled and the Dentist gave me 19 shots of novacaine... yes 19! and then finally decided that I had to be sedated... the SAME dosage of the SAME medications this little baby had... I am SO furious that this dentist didn't pay attention to the dosage NOR notify the mother of what happened and she had to find out on HER OWN and call the paramedics ON HER OWN!
I'm fuming!
post #23 of 27
Quote:
Originally Posted by arcadian girl View Post
The dentist who treated the little girl obviously made a HUGE mistake. StarryEyedTiGeR - so I was right that he shouldn't have given her all three meds at once? I just ask cos you're a dental student It just didn't make sense to me - I thought nitrous was for when you want to be awake during a procedure but not afraid, and the IV stuff is for when you want to be partially or totally knocked out. I couldn't understand why he'd give her both :/
Absoultely! I wish I knew the amount of each medication he administered, but I don't know. Still....on a 5 year old...reguardless of medication tolerance (which isn't as much as some would think)...that combination is way too much. An experenced dentist should have known better. All dental students are highly trained to preform such procedures and to administer medicine. He definitely should have weighed the child or asked her parents about her weight before ever giving her any type of medication, so that he could have measured out the dose perfectly and administered the proper amount according to her size. (Also, as far as the medicine goes..whether you want to be awake, or under for a procedure....it depends on the amount of medication administered....usually iv's are used for that..but a patienct can also be locally sedated with an iv...it just depends on what you use. Personally, I think nitrus oxide is safe on smaller patients...when measured out properly and administered right. I'm much more comfortable using that on a child than say a liquid or iv. Some would prefer other methods....but i've found that to be the safest on a little one. Also, it depends on the size of the child, what work is being preformed, and if they have any medical conditions...that may not always be the best method. Eithor way, that dentist should have weighed the child or asked her weight and done a thorough medical background check on her before ever touching her. This includes getting background on any medication she'd been on, especially cold medicine if she had any in her system, any other meds, heart murmors...etc..the list goes on . You always want to know the background of your patient before ever working on them. It's only common sense. Now it could be that the dentist was reputable and other patients had success with him previously.....that is all good and fine...but any professionally trained dentist would know that combination of drugs on a 5 year old could be lethal. I just don't have a good feeling about that- she was overmedicated if that is what happened during her visit. It could also be that she had an underlying medical condition nobody knew of ....and the combination of that and the medications she was given had a lethal effect. It is all soo sad. Does anyone know if the autopsey report is in yet and if they are going public with the finidings?? / (In a side note- your dentist sounds excellent from what you've described about your visits with him. Especially that he takes the time to find the right combo of medication for you and your background. He'd definitely get my vote )
post #24 of 27
Has anyone heard about the autopsey results?? I'm curious as to what the medical cause of death was on this little angel.
post #25 of 27
OMG how aweful!!! she is so adorable...prayers to her family
post #26 of 27
Quote:
Originally Posted by arcadian girl View Post
my dentist is set up for emergencies. He's one of the best dentists in san francisco, he's worked on heart transplant patients and even someone with an artificial heart. He has a plan in place if something were to go wrong-i specifically asked him about that, because I have heart problems myself and wanted to make sure that if something went wrong, they could get me help in time. They are set up for that. some dentists, like mine, are set up properly to do it. People just have to ask questions, like I did.
I have had several procedures in the past but under pentothol but will not in the future unless the dentist office has a crash cart in case something goes wrong.

When I was about 3 years old, I had to have dental surgery but it was done in a hospital. Back then they use ether to put you out and when the nurse was with me, I stopped breathing. She panicked and was running down the hall screaming that I had stopped breathing. By the time they got back to the room, I was breathing again but that is when they discovered I was allergic to ether!

My heart goes out to the family of this precious child
post #27 of 27
I had nitrous and IV sedation when I had my knee operated on. It was the first operation since I was a kid, and I was really freaked out about it, and warned them I was a wimp when it came to needles and was really scared. So they gave me gas first to calm me down, and knock me out a bit, then gave me the IV sedation.

I don't know why they gave this little girl 3 types, but I can certainly understand why they would give nitrous and IV.
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