BBC News | HEALTH | Girl died 'after routine dental work'

The failure of a dentist and anaesthetist to provide proper care cost a five-year-old girl her life, a court has heard.

Karla Selley died in hospital in August 1999 after a routine operation to extract a tooth at the Towngate Dental Surgery in Leyland, Lancashire.

The airway should not have become obstructed if these two professional men were acting competently and properly

Howard Bentham QC
Dentist Michael Lane, 42, of Bolton, Greater Manchester and anaesthetist George Vanner, 67, of Bilsborrow, near Preston, have both denied a charge of manslaughter.

Prosecuting, Howard Bentham QC, told Preston Crown Court that Karla choked to death on blood, mucus and debris after having her tooth removed.

He said a catalogue of errors by the two men was to blame.

Mr Bentham told the court that Karla had been taken to the surgery by her mother Tracey to have a baby tooth removed.

He said the five-year-old was given a general anaesthetic as she had already had an unpleasant experience during a previous visit to the dentist.

Very quick operation

He said: "The operation was completed very quickly and it was uneventful in its early and middle stages.

"The tooth was removed without problems but as young Karla was coming round from the anaesthetic problems arose. From these problems she died."

Mr Bentham said the Crown's case was that both men were criminally responsible because they owed Karla a duty of care.

He said: "They fell well below that high standard of care which they should have exercised and as a result of falling down in that standard of care young Karla died.

"And the fall from the standard they should have achieved was so substantial, so great, that it should be marked by a criminal conviction."

Mr Bentham said problems first became obvious when Karla started to come round following the extraction of the tooth.

But the problems had started before that, the court heard.

Mr Bentham outlined a number of failings:

a hospital had not been notified about the operation, as is normal
Karla's mouth was not swept with suction before the tooth was removed as it should have been.
she was not hooked up to an electrocardiagraph machine or a pulse oxymeter to monitor her heart beat and reactions while she was unconscious
her mouth was not swept for a second time after the extraction of the tooth to remove debris, mucus and blood

In addition, there were only three people present in the room during the operation rather than four as is usual.

Following the removal of the tooth, Mr Lane left the room against regulations, Mr Bentham said.

"It's at this stage that problems began to be apparent.

"Karla coughed, she pushed against Dr Vanner and she changed colour."

Mr Bentham added: "The dentist should have been in the room at that stage, but he was not.

"He returned very quickly then because Karla was obviously in trouble and breathing resuscitation began."

'Hopeless' resuscitation

These attempts, the court heard, were described by one witness as "hopeless".

Mr Bentham said that if this had not been the case Karla's life could still have been saved.

He said Karla was given an electric shock which was much too large for her weight and although this did not lead to her death it was an example of the "competence" of the resuscitation technique used on the little girl.

The court heard there was no adrenaline at the surgery and when the resuscitation team arrived they noticed Dr Vanner was unable to locate a suitable vein to inject with the adrenaline they brought.

Karla was eventually taken to hospital where she died at 4pm.

Mr Benham said that a post mortem examination showed Karla had a "peculiarity" of the heart but it was the Crown's case that this was not responsible for her death.

"It is our case her death was caused by obstruction of the airway, that the airway should not have become obstructed if these two professional men were acting competently and properly, but that even if it did, had they been adequate and competent in the art of resuscitation she could have been held back from the danger she found herself in."

The case was adjourned until Tuesday.


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