When a pediatric sedation goes fatally wrong, the fallout — lawsuits, board investigations, media scrutiny — can follow a dentist for years, according to one DSO exec.
Barry Lyon, DDS, the director of provider recruiting and onboarding at Dental Care Alliance, recently spoke with Becker’s about clinical and legal risks facing pediatric dentists.
Editor’s note: This Q&A is part of a weekly series featuring Dr. Lyon focused on topics in the dental industry and DSO field. The views expressed are those of Dr. Lyon and do not necessarily reflect those of Dental Care Alliance.
This response was lightly edited for clarity and length.
Dr. Barry Lyon:
Recently, there has been news of two pediatric dentists who’ve had sedation deaths in their offices. While thousands of pediatric dental sedations are performed safely each year, when a death does occur, it is catastrophic to the family and to the dentist. The consequences place the pediatric dentist under intense clinical, legal, regulatory and public scrutiny.
Fortunately, pediatric sedation-related deaths are uncommon. However, when they do occur, a cascade of events develop that can be seriously damaging to the dentist. Widespread media attention, malpractice litigation, state dental board investigations, and, in some cases, criminal charges may be filed. Even if the standard of care was met, investigations may continue for years, creating significant financial and emotional burdens. Many clinicians involved in adverse events experience anxiety, depression, burnout or symptoms consistent with the “second victim” phenomenon that has been well documented across healthcare. Tragically, post-event audits often reveal there were safe treatment alternatives the pediatric dentist failed to employ.
Guidelines from the American Academy of Pediatric Dentistry and the American Academy of Pediatrics emphasizes a systems-based approach to safety. Recommendations include, but are not limited to, a comprehensive pre-op medical evaluation, adherence to fasting guidelines, precise medication dosing, continuous monitoring, availability of age-appropriate rescue drugs and equipment and structured recovery protocols before discharge.
While the legal, regulatory and financial repercussions of a sedation-related death can be extraordinary, they are ultimately overshadowed by the immeasurable human tragedy of losing a child entrusted with your care. For most pediatric dentists, that reality would be the greatest consequence of all.
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