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Teenage girl died after routine dental surgery, inquest hears Teenage girl died after routine dental surgery, inquest hears
(about 1 hour later)
Denisa Alexandra Stefanoaia, 15, stopped breathing during procedure at Great Ormond Street hospitalDenisa Alexandra Stefanoaia, 15, stopped breathing during procedure at Great Ormond Street hospital
A teenage girl died while going for routine dental surgery so she could have a brace fitted, an inquest has heard. A 15-year-old girl died after she stopped breathing while undergoing routine dental surgery so she could have a brace fitted, an inquest heard.
Denisa Alexandra Stefanoaia, known as Alex, died at Great Ormond Street hospital (GOSH) in London after complications during an operation to have four teeth removed. Denisa Alexandra Stefanoaia, known as Alex, died at Great Ormond Street hospital in London in February after complications during a 19-minute procedure to have four teeth removed.
The 15-year-old was told the surgery would take no more than an hour, was put under general anaesthetic, and was said to be pleased that it would eventually result in fixing her smile. St Pancras coroner’s court heard that Alex, from Watford, Hertfordshire, was “severely obese”, with mild asthma and sleep apnoea.
St Pancras coroner’s court heard Alex, from Watford in Hertfordshire, was “severely obese”, with mild asthma and sleep apnoea. Despite being a higher risk patient, neither the teenager nor her family were warned about the risk of death before the operation.
Experts told the coroner, Mary Hassell, that the chance of Alex dying during the procedure on 14 February 2020 was “less than one in 100,000”, and that the risk was therefore deemed so low that Alex and her family were not warned about this. Alex was told the surgery would take no longer than an hour, was put under general anaesthetic, and was said to be pleased that it would eventually result in fixing her smile, the inquest heard.
The procedure lasted 19 minutes and was deemed by the surgeon to have been “very straightforward”, the inquest heard. Experts told the coroner, Mary Hassell, that the chance of Alex dying during the operation on 14 February was “less than one in 100,000”, and that the risk was therefore deemed so low that Alex and her family were not warned.
But medics discovered Alex had bitten down on the endotracheal tube and had stopped breathing. The procedure was deemed by the surgeon to have been “very straightforward”, but medics discovered Alex had bitten down on the endotracheal tube and had stopped breathing, the inquest heard.
She was taken to intensive care but was pronounced dead five days later, her brain having been starved of oxygen.She was taken to intensive care but was pronounced dead five days later, her brain having been starved of oxygen.
Giving evidence remotely on Thursday, Dr Atheer Ujam, a senior registrar at GOSH who carried out the surgery, told the coroner that while the patient was a higher risk, he had no qualms about proceeding with the surgery. Giving evidence remotely on Thursday, Dr Atheer Ujam, the senior registrar at Great Ormond Street hospital who carried out the surgery, told the coroner that while the patient was a higher risk, he had no qualms about proceeding with the surgery and would not do anything differently were he to be faced with a patient similar to Alex.
He told the inquest: “I remember looking at her and her dad (before the operation) and there was a sense that although she was having an operation, it was something that was going to be associated with a good outcome – she was going to have her teeth straight.” Ujam described the procedure as “uncomplicated” but said he later noticed there was a problem when Alex had turned blue and a short time later he could see blood coming from her mouth. It was at that point, he said, that he could not find a pulse and a colleague said they had to start CPR.
Dr Ujam described the procedure as “uncomplicated” but said he later noticed there was a problem with the patient. Dr Akane Iguchi, a consultant anaesthetist at Great Ormond Street hospital, was also in the operating theatre at the time and said she began to become concerned when she was unable to ventilate Alex’s lungs after the procedure.
He said: “I stayed in the theatre to make sure the patient was stable. “We were trying to improve her lung capacity,” she said. “I looked over at Alex’s face and she was biting the ET [endotracheal] tube and she was becoming blue.”
“I finished my notes ... I went (back to the operating table) to see what was going on, that’s when I saw Alex – she was blue.” Iguchi told the coroner that Alex’s obesity meant she may have been deprived of oxygen for only “a matter of seconds” before turning blue.
Dr Ujam said a colleague told him it was a problem with Alex’s lungs, but that a short time later he could see blood coming from her mouth. “Less than one minute – much, much less than healthy children. In her case, because of her severe obesity, her oxygen consumption is very high. All the factors combined make her very risky.”
He said: “I began to feel for a pulse and we couldn’t find one. At that point (a colleague) said we have to start CPR ... within 10 or 15 seconds there were many people coming into theatre.”
Dr Ujam said he would not do anything differently were he to be faced with a patient similar to Alex.
Dr Akane Iguchi, a consultant anaesthetist at GOSH, was also in the operating theatre at the time and said she began to become concerned when she was unable to ventilate Alex’s lungs after the procedure.
She said: “We were trying to improve her lung capacity. I looked over at Alex’s face and she was biting the ET (endotracheal) tube and she was becoming blue.”
Dr Iguchi told the coroner that Alex’s obesity meant she may have been deprived of oxygen for only “a matter of seconds” before turning blue.
She said: “Less than one minute – much, much less than healthy children. In her case, because of her severe obesity, her oxygen consumption is very high. All the factors combined make her very risky.”
In a statement to the PA news agency, Alex’s mother, Angelica Stefanoaia, described how the death of her daughter – her “best friend” – had affected her life.In a statement to the PA news agency, Alex’s mother, Angelica Stefanoaia, described how the death of her daughter – her “best friend” – had affected her life.
“I have cried every day since she died, desperate to bring her back,” she said.“I have cried every day since she died, desperate to bring her back,” she said.
“I begged them on my knees to do everything they could for her and save her and they simply said she wouldn’t wake up. When they told me she was poorly after the surgery, I never for one moment thought she would die.“I begged them on my knees to do everything they could for her and save her and they simply said she wouldn’t wake up. When they told me she was poorly after the surgery, I never for one moment thought she would die.
“Please, no other family should have to go through this terrible pain.”“Please, no other family should have to go through this terrible pain.”
Mark Bowman, a partner at Fieldfisher, which is supporting the family at inquest, said: “Going through an inquest investigating the death of your daughter is a horrific experience.Mark Bowman, a partner at Fieldfisher, which is supporting the family at inquest, said: “Going through an inquest investigating the death of your daughter is a horrific experience.
“The hope is that the family will receive some answers which will allow them to properly grieve for Alex.”“The hope is that the family will receive some answers which will allow them to properly grieve for Alex.”
The inquest continues.The inquest continues.