A doctor and two dentists should be reported to their governing bodies for investigation as to possible prosecution for professional misconduct, a fatal accident inquiry has heard.

Depute fiscal depute Robert Shiels said the General Dental Council should consider investigating Maurice Beckett, the owner of the clinic in Edinburgh where Darren Denholm suffered a heart attack during a tooth extraction in October 1998.

Darren's own dentist, Paul Shields, was criticised, as was the anaesthetist, John Evans-Appiah.

Doctor Evans-Appiah has been barred until he goes before the General Medical Council's professional conduct committee.

'Category of its own'

Mr Shiels said: "Every fatal accident inquiry is a sad case, but the death of Darren Denholm is in a category of its own, because the demise of a happy, young boy in these circumstances lead to serious public concern."

Appearing for Darren's family, Anne Smith, QC, said: "Words are inadequate fully to convey the catastrophic nature of these events.

"A healthy, vibrant, 10-year-old, who had been having fun with his yo-yo in the waiting room just before 4pm that afternoon, emerged from the clinic about half and hour later, dying, and was dead by about 5.30."

Darren, 10, from West Lothian, is one of several children in the UK who have died after being sedated with halothane.

Dentists have been banned from using the general anaesthetic under which a Scottish schoolboy died during a tooth extraction.

Halothane has been restricted to hospitals only after the government's Committee on Safety of Medicines sent out new instructions on the use of the drug.

Separate restrictions imposed last month by the General Dental Council mean dentists are no longer allowed to offer general anaesthetics in their surgeries unless they have immediate access to emergency care facilities and a specialist anaesthetist is present.

Only a handful of dental surgeries in Scotland have continued to use halothane. Most have adopted an alternative, sevoflurane, which is between 10 and 20 times more expensive than halothane.

Research in the medical journal The Lancet has shown a "strong association" with halothane and arrythmia (abnormal heart rhythms, particularly rapid heartbeats).

Death statistics

The study said: "The use of sevoflurane in preference to halothane could contribute to a decline in morbidity and mortality associated with dental anaesthesia."

About one in 250,000 people given a general anaesthetic for a tooth extraction died in the dentist's chair, which equates to about two patients each year, although there were five deaths in 1998.

According to data from the National Health Service Executive, about half the known deaths in the past 10 years have been among patients under 16.