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Adverse Events during Pediatric Dental Anesthesia and Sedation: A Review of Closed Malpractice Insurance Claims

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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 pre-determined 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. Fifty-three 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.
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Keywords: ETHICS; LOCAL ANESTHESIA; MEDICOLEGAL ISSUES; SEDATION

Document Type: Research Article

Affiliations: 1: Practice in Wausau, Wisconsin, USA 2: Professor of oral and maxillofacial surgery, College of Dentistry, University of Kentucky, Lexington, USA 3: Assistant professor of pediatric dentistry, University of British Columbia, Vancouver, BC, Canada. [email protected] 4: Professor of pediatric dentistry, College of Dentistry, University of Kentucky, Lexington, Ky, USA 5: Assistant professor of biostatistics, College of Public Health, University of Kentucky, Lexington, Ky, USA

Publication date: 01 May 2012

More about this publication?
  • Pediatric Dentistry is the official publication of the American Academy of Pediatric Dentistry, the American Board of Pediatric Dentistry and the College of Diplomates of the American Board of Pediatric Dentistry. It is published bi-monthly and is internationally recognized as the leading journal in the area of pediatric dentistry. The journal promotes the practice, education and research specifically related to the specialty of pediatric dentistry. This peer-reviewed journal features scientific articles, case reports and abstracts of current pediatric dental research.
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