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The BBC's Emma Simpson
"A catalogue of errors"
 real 28k

BBC Scotland's Nigel Robson reports
"This is a very significant report"
 real 28k

Isla Denholm, Darren's mother
"My son's life appears to have been worth 14"
 real 28k

Alistair McLean, GDC
"I am really shocked by the report"
 real 28k

Thursday, 24 February, 2000, 16:44 GMT
Dental inquiry report welcomed

Dentist graphic
Dr Evans-Appiah was in charge of Darren's anaesthesia

The mother of a boy who died under a general anaesthetic has welcomed the findings of an inquiry which calls for disciplinary action against three people.

Darren Denholm, 10, failed to regain consciousness from the routine extraction at the Peffermill Dental Clinic in Edinburgh in October 1998.

Sheriff Nigel Morrison, QC, has published his 80-page findings from a 16-day fatal accident inquiry, during which evidence was led criticising key figures involved in the operation.

He said: "The practices and procedures at the Peffermill Dental Anaesthetic Clinic exhibited a catalogue of failures.

"The standard was below what the public should expect of a competent dental practice."

Governing bodies

Sheriff Morrison names three people closely involved in the case and says they should be reported to their profession's governing bodies for possible disciplinary action.

They are:
  • Maurice Beckett, the owner of the Peffermill practice

  • John Evans-Appiah, the anaesthetist present at the operation

  • Paul Shields, Darren's own dentist.

The findings, which amount to 18 recommendations, call for changes in dentistry and the use of anaesthetics, after the clinic's procedures were heavily criticised.

Among them is a call for the government to consider restricting general anaesthesia in dentistry to hospitals with intensive care units.

In a statement, Darren's mother Isla said: "Evans-Appiah floated from job to job and nobody seemed to care until Darren died.

Isla Denholm Isla Denholm: "Price of my son's life"
"To Evans-Appiah, Maurice Beckett and Poggo Anaesthetics, it seems to me that our son's life was worth 14, the price paid when a general anaesthetic is carried out."

Dr Evans-Appiah issued a short statement through The Medical Defence Union: "I would like to say that I am very sorry about Darren's death and wish to extend my deepest sympthy to the family.

"I am devastated by what has happened."

A spokeswoman at the Peffermill Clinic declined to comment.

Funding call

Alistair MacLean, Scottish Secretary of the British Dental Association, said: "There needs to be additional funding for sedation and other alternative methods of anxiety control for nervous patients, as well as increased training for dentists to provide this.

"Any death associated with dental general anaesthetist is a death too many. The government could be doing much more to minimise the risk of anything like this happening again.

Darren Denholm Darren failed to come round from the anaesthetic
During the inquiry, lawyers questioned Dr Evans-Appiah's qualifications and training and brought up the issue of two incidents when other medical workers raised concerns.

The head of the anaesthetic department at Borders General Hospital in 1993 was so concerned about his work that he told the General Medical Council that patients were being "put at risk".

He believed Dr Evans-Appiah's medical qualifications, said to have been obtained in Kharkov in the Ukraine in 1970, were fraudulent.

London post

The General Medical Council monitored him for a year but then allowed him to continue practicing.

Months later Dr Evans-Appiah was working at Falkirk Royal Infirmary when an operation he was involved in went badly wrong, leaving a patient temporarily paralysed.

He was sacked and disciplined by the GMC, but still allowed to practice.

Dentist's chair The General Dental Council is studying the report
Since Darren's death, Dr Evans-Appiah has been working at a practice in Walthamstowe in north-east London.

He has been stopped from administering anaesthetics until a final GMC hearing due this year.

Darren's own dentist, Paul Shields, saw the boy on several occasions. On his final visit before referring him to the Peffermill Clinic, he neither examined the tooth nor explained alternative methods of treatment.

The General Dental Council has issued guidelines preventing dentists from carrying out general anaesthetics in their surgeries unless they have a specialist anaesthetist present and have immediate access to emergency care facilities.

The move followed general concern about the use of general anaesthesia in surgeries, particularly on children.

Few dentists now use the type of anaesthetic administered on Darren.

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See also:
24 Feb 00 |  Scotland
Reaction to dental death inquiry
20 Dec 99 |  Scotland
'Prosecute' call at dental death inquiry
29 Sep 99 |  Scotland
Complaint not revealed to police
15 Sep 99 |  Scotland
Anaesthetist sacked over drug mistake
14 Sep 99 |  Scotland
Anaesthetist admits statements 'were wrong'
19 Nov 99 |  Scotland
Death inquiry anaesthetist barred
15 Oct 98 |  Health
Dentists want fewer anaesthetics
16 Nov 98 |  Health
Anaesthesia restrictions for dentists
14 Sep 99 |  Scotland
Anguish of dental tragedy mother

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