Pediatric dental anesthesia is in the news again after a Houston district court jury awarded a verdict of nearly $100 million to the family of a brain-injured little girl named Nevaeh Hall. The award will be subject to reduction by the court to comply with Texas tort reform laws, but still communicates the jury’s outrage at what happened to this four-year-old dental patient.
Bethaniel Jefferson, DDS was Nevaeh’s treating dentist. The following information is from the dental malpractice lawsuit pleadings.
When Nevaeh’s parents brought her to Dr. Jefferson’s office, they weren’t allowed back to the treatment room. The dentist strapped Nevaeh to a physical restraint device called a “papoose board” and gave her large doses of anesthetics and sedatives.
Dr. Jefferson disregarded the signs that Nevaeh was having a seizure, including crying, movements, and shaking. Experts for the plaintiffs contended that the dentist should have recognized that Nevaeh was having a seizure and called 911 for help. Instead, Dr. Jefferson went to the waiting area to ask the parents if their daughter had any medical problems or had ever had “the shakes.”
The dentist proceeded to administer more medications. The monitoring equipment showed inadequate oxygen levels for about five hours. The lawsuit alleges that the vital sign data showed that Nevaeh was being chemically suffocated.
In August 2016, the Texas Dental Board revoked Dr. Jefferson’s license to practice dentistry following this incident. According to the board order, Nevaeh began experiencing seizures or seizure-like symptoms. Instead of immediately calling 911 for help, Dr. Jefferson attempted treatment with oral medications. This caused a delay of several hours during which Nevaeh was in a dangerous hypoxic (abnormally low levels of oxygen) state.
Dental anesthesia
The tragic case arising from Nevaeh’s dental care posed two alleged issues: (1) anesthesia and medication mismanagement; and (2) delayed response for help.
Fortunately, this combination of alleged incompetence and malpractice is rare. However, when there is an adverse event involving anesthesia in a pediatric dental office resulting in a claim, the consequences can be devastating. One study published in the peer-reviewed journal Pediatric Dentistry found that 53% of claims involved patient death or permanent brain damage. Of those cases, the average patient age was 3.6 years old. In over one-third of the cases, the general dentist was also serving as the anesthesia provider.
Whether the patient is a minor or an adult, here are some points that will help improve patient safety when receiving dental anesthesia:
• With dental treatment, the anesthetic plan is sometimes treated as an afterthought. This should be an important part of the informed consent discussion.
• Ask for an explanation of the type of anesthesia that will be used. Will it be a local anesthetic or will someone be putting the patient to sleep?
• Make sure you understand who is providing the dental anesthesia. Will the dentist be dual-tasking, managing the dental procedure itself, while also being responsible for the administration of anesthesia and monitoring of vital signs? Or will a separate anesthesia provider be present?
• If the plan includes having a separate anesthesia provider, is that person an anesthesiologist or a certified registered nurse anesthetist (CRNA)? How many cases or patients will the anesthesia provider be handling at once?
If you’ve been seriously injured because of poor dental or dental anesthesia care in Texas, then contact a top-rated, experienced Texas medical/dental malpractice attorney for a free consultation about your potential case.
