Alberta’s dental regulator has suspended a controversial rule that permitted an accredited dentist to both administer anesthesia and perform a dental procedure on a patient.
But the family of a four-year-old Edmonton girl who suffered permanent brain damage in September after receiving general anesthetic at a downtown office by a dentist working under the “lone operator” model says the change has come too late.
“I’m surprised that it came so late, it should have been done years ago and it cost Amber’s future,” said Ramandeep Singh Athwal, father of Amber Athwal, on Monday.
A CBC inquiry found that Alberta was one of two provinces where accredited dentists do both jobs at the same time. The other province, Ontario, is currently reviewing its rules on the standard.
The “lone operator” practice has been sharply criticized by some medical professionals who say it can lead to medical disasters.
The Alberta Dental Association and College says its decision was not related to Amber’s case and that it had been reviewing its anesthesia regulations for over a year.
Athwal, who moved to Canada three years ago, wishes the change would have come sooner.
“We moved to Canada for a better life for our children, for a better system, for better health care. Instead of that it turned to be a nightmare. We never thought this thing could happen to our child in Canada. We trusted the system, we trusted the health care.”
Amber is now recovering at the Glenrose Hospital and remains unconscious. Her father said she sometimes opens her eyes and has uncontrolled movement in her limbs. Her younger sister is two years old, and repeatedly asks her father when Amber will wake up and play with her.
Prayers from around the world
The outpouring of support has overwhelmed Athwal. He said he hopes people continue to pray for his daughter, as they have been doing since news first surfaced about his daughter in a CBC report.
“(There’s been) prayer from each and every person, whether they belong to a different religion, people prayed for her from every community, every religion, every country. We got the messages, the prayers and the blessings.”
Amber went to Dr. William Mather’s office on Sept. 7 to deal with some tooth decay.The dentist administered general anesthesia and the child allegedly stopped breathing after the procedure. It is unclear for how long she stopped breathing before emergency medical attention arrived.
The Alberta Dental College and Association launched an immediate investigation, but has confirmed few details about what happened. It is not known when its final report will be completed. Mather is not permitted to administer deep sedation or anesthesia while the investigation continues.
Dr. Randall Croutze, executive director for the ADA&C, said the decision to suspend the standard which allowed a dentist to perform was made by his organization’s council and was not directly related to the Athwal case.
“(It) was part of an ongoing review of standards,” he said. “This standard was something that had been looked at for about 12 to 18 months, so this was something that was being developed over the last year.”
The decision came into effect on Oct. 28.
Anesthesiologists interviewed by the CBC have noted that when working in hospitals, they have one task: to keep a patient safe when that patient has been given general anesthetic. An anesthesiologist helps to control breathing, blood pressure and heart rate.
Dentists with training recognized by the ADA&C are permitted to administer an anesthetic in accredited facilities. The dental college or society in each province establishes those rules.
Michael Dare, who teaches at the University of British Columbia and operates a private company to train dentists in emergency care, said that to “have someone tunnel visioning in on surgery while also trying to maintain the breathing of the patient is a disaster waiting to happen.”