Adverse events during pediatric dental anesthesia and sedation: A review of closed malpractice insurance claims

Maggie C. Chicka, Jeffrey B. Dembo, Kavita R. Mathu-Muju, David A. Nash, Heather M. Bush

Research output: Contribution to journalReview articlepeer-review

61 Scopus citations

Abstract

Purpose: The purpose of this study of closed malpractice insurance claims was to provide descriptive data of adverse events related to child sedation and anesthesia in the dental office. Methods: The malpractice claims databases of two professional liability carriers were searched using predetermined keywords for all closed claims involving anesthesia in pediatric dental patients from 1993-2007. Results: The database searches resulted in 17 claims dealing with adverse anesthesia events of which 13 involved sedation, 3 involved local anesthesia alone, and 1 involved general anesthesia. Fiftythree percent of the claims involved patient death or permanent brain damage; in these claims, the average patient age was 3.6 years, 6 involved general dentists as the anesthesia provider, and 2 involved local anesthesia alone. Local anesthetic overdoses were observed in 41% of the claims. The location of adverse event occurrence was in the dental office where care was being provided in 71% of the claims. Of the 13 claims involving sedation, only 1 claim involved the use of physiologic monitoring. Conclusions: Very young patients (≤3-years-old) are at greatest risk during administration of sedative and/or local anesthetic agents. Some practitioners are inadequately monitoring patients during sedation procedures. Adverse events have a high chance of occurring at the dental office where care is being provided.

Original languageEnglish
Pages (from-to)231-238
Number of pages8
JournalPediatric Dentistry
Volume34
Issue number3
StatePublished - May 2012

Keywords

  • Ethics
  • Local anesthesia
  • Medicolegal issues
  • Sedation

ASJC Scopus subject areas

  • Medicine (all)

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