A 12-year-old patient attended a dentist for routine examination and to start a series of extractions recommended by his orthodontist. His mother requested that the extraction of the upper left canine be made first because it was labially placed.
The dentist administered about one and a half cartridges of local anaesthetic (prilocaine with felypressin). The extraction was straightforward and the patient went back to the reception area. Other practice staff then saw the patient faint and he was attended to by the practice first-aider. He appeared to recover and returned home with his mother.
Negligence alleged
The following week the dentist received a letter from solicitors, alleging that he had injected the patient five times before the anaesthetic had taken effect and had not allowed sufficient time to elapse between each administration to see if the injection that taken effect.
It was further alleged that the excess anaesthetic caused the patient to faint and suggested that, although the child had recovered from the physical injuries, he was still emotionally scarred and upset by the experience so that he would not be attending further dental treatment.
The outcome
The DDU established that the dentist had administered the anaesthetic through a series of small injections around the tooth. We obtained a copy of the manufacturer's datasheet to confirm that the administration of one and a half cartridges of this anaesthetic was well within the normal range for a 12-year-old child.
We then explained to the solicitors the clinical reason for providing a series of small injections and that our member had judged the cumulative dose of anaesthetic to be the minimum required in order to achieve adequate pain and anxiety control for the patient.
We indicated that the faint may have been a side effect of the anaesthetic or have been caused/contributed to by other factors, but asserted that the dentist's treatment had been in accordance with practice accepted as proper by a responsible body of dentists. Some months later the solicitors confirmed that their client would not be proceeding with the claim.
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