A patient who was “extremely sensitive” to sedatives died five days after suffering a cardiac arrest while undergoing a routine procedure to insert implants at a dental clinic in Dublin two years ago, an inquest has heard.
A sitting of Dublin District Coroner’s Court heard there was a dispute over whether two dental surgeons who treated the patient, Margaret O’Doherty (72), had been informed by the deceased and her family about her intolerance of sedative medication before the surgery.
Ms O’Doherty, a mother of three from Merrion, Gorey, Co Wexford, suffered a cardiac arrest while undergoing a procedure to have seven dental implants at the Dublin Specialist Dentistry on Furze Road, Sandyford on August 18th, 2020.
The former teacher and Aer Lingus hostess, originally from Churchtown, Dublin, died five days later in the intensive care unit of St Vincent’s University Hospital in Dublin.
The deceased’s husband, Michael O’Doherty, a GP who runs a large medical practice in Gorey, said he was “amazed” to learn there was nothing on the clinic’s notes about his wife’s issue with sedatives, and a fall she had suffered in 2019, as they had “laboured” it as a point during consultations with oral surgeon, Seamus Rogers and prosthodontist, Maurice Fitzgerald.
Counsel for the O’Doherty family, Sara Antoniotti SC, said the deceased’s family believed she had been given too much dosage of the sedative, Midazolam, during the procedure given the patient’s age and low weight.
However, Mr Rogers told the inquest that the first he heard about Ms O’Doherty’s sensitivity to sedatives was on Wednesday night.
“That was never said to me at any of the consultations we had,” said Mr Rogers.
He added: “I would not have given sedatives to someone who told me they were sensitive to them.”
Dr Fitzgerald also claimed he had no recollection of the couple raising the issue of sedatives and said such a concern would have “raised a large red flag” if mentioned.
In evidence, Dr O’Doherty told the inquest that his wife had decided to undergo the procedure after suffering injuries to her face in a fall in the driveway of their home on February 11th, 2020 and was referred to Dr Fitzgerald.
He said Dr Fitzgerald had repaired her bridge but said she would need further extensive work and he had recommended multiple dental implants.
Dr O’Doherty recalled that he and his wife had stressed that she was extremely sensitive to sedatives at a consultation with Dr Fitzgerald on May 17th, 2020 that was also attended for part of the time by Mr Rogers.
The GP told the inquest his wife’s own dentist would only give her a fraction of the normal recommended dose of sedatives, and she had suffered a fall in 2019 due to the effect of taking Night Nurse.
Dr O’Doherty said she was in good form as he drove her to the clinic for the procedure on August 18th, 2020 after having also attended five days earlier for what was uneventful preparatory work.
However, as he was returning to collect his wife from the clinic just before 1pm he received a phone call to say there were problems.
The GP said he ran up the stairs of the clinic and came across “a situation of chaos”. He recalled he did not feel distressed at the time and was “optimistic”.
The inquest heard Ms O’Doherty was brought by ambulance to St Vincent’s University Hospital.
Dr O’Doherty said he was told by a hospital consultant that they suspected his wife has sustained a prolonged lack of oxygen to the brain.
Dr O’Doherty, who had been married for 46 years, said the death of his wife was “extremely devastating”.
“It was a tragic and possibly avoidable death,” he added.
Mr Rogers told the inquest that he had recommended what he regarded as routine surgery for Ms O’Doherty as she also had old and failing dental work in addition to a fracture of her bridge sustained in the fall.
The surgeon said he had explained the risk to the patient and had advised about sedation.
Before the procedure on August 18th, 2020, Mr Rogers said he had confirmed that Ms O’Doherty had no known medical issues and did not suffer from any allergies.
He recalled that the patient was comfortable and stable during the first 2½ hours of the procedure despite having an occasional cough that was “not unusual”.
Mr Rogers said Ms O’Doherty suddenly became agitated and jumpy at about 12 midday and he decided to reverse the sedation and give her oxygen.
The inquest heard he began compressions on the patient after her heart continued to drop sharply, while Dr Fitzgerald was instructed to alert emergency services.
Mr Rogers said the reason for Ms O’Doherty’s sudden cardiac arrest was still not clear to him.
Questioned by his own counsel, Nathan Reilly BL, Mr Rogers said he did not believe the patient had received too much Midazolam as she had been alert and talking for the vast majority of the procedure while maintaining normal vital signs before her condition suddenly deteriorated rapidly.
The inquest was adjourned and will continue on Friday morning.