Death from simple fluoride treatment

[Guest guest]

[30 years after the death of their child, parents are awarded damages

from dentist]

A Case of Fatal Fluoride Toxicity

Submitted by Dr. Scannapieco, University at Buffalo School of

Dental Medicine

(This article was published in the NY times. Please read the article and

address the questions that follow)

$750,000 Given In Child’s Death After Fluoride Treatment.

By D. McFadden

(reprinted from The New York Times© Sat. January 20, 1979)

A State Supreme Court jury awarded $750,000 yesterday to the parents of a

3-year-old Brooklyn boy who, on his first trip to the dentist in 1974,

was given a lethal dose of fluoride at a city dental clinic and then

ignored for nearly five hours in the waiting rooms of a pediatric clinic

and Brookdale Hospital while his mother pleaded for help, and he lapsed

into a coma and died.

The award - $600,000 for the wrongful death of the boy, Kennerly,

and $150,000 for the pain and suffering he endured in the hours before

his death - was by far the largest ever made in New York State for the

death of a 3-year-old, according to the lawyers for the parents, Clay

Kennerly, 48, an $8,000-a-year city exterminator, and his wife, Inez, 42,

of 300 Dumont Avenue in the Brownsville section.

The child, according to testimony at a four-day trial in State Supreme

Court in Brooklyn, suffered spasms of vomiting and nausea, headaches and

dizziness, and had to be revived from a coma by an injection of

adrenaline into his heart several hours after his ordeal began.

The boy was then made to wait - in shock, another coma and finally in a

state of cardiac arrest - for more than an hour before getting further

treatment, witnesses said.

Stomach-Pumping Suggested

Other testimony indicated that the boy might have been saved at almost

any time during the four hours and 40 minutes before he died by having

had his stomach pumped or by having him drink some milk or lime water,

which would have changed the fatal fluoride compound he had been given

into a nontoxic calcium fluoride. The defendants in the case were New

York City, its Health and Hospitals Corporation and one of its clinics,

the Brownsville Dental Health Center; Brookdale Hospital and its

Brookdale Ambulatory Pediatric Care Unit; Dr. Bradford , a dentist;

Roslyn Cohen, a dental technician, and Dr. Pretti Bathia, a Brookdale

pediatric clinic physician.

After more than a day of testimony by Mrs. Kennerly and medical and

toxicological experts, and what were described as a thorough

investigation by the city and Brookdale Hospital, lawyers for the

defendants on Thursday conceded liability, and the jury of five women and

one man was instructed by Justice A. Monteleone to return a verdict

for the plaintiffs and to decide the damages to be assessed.

After the jury’s verdict at 2:30 P.M., the defendants’ lawyers, W.

Weiler for the city and for Brookdale Hospital, moved to set

the award aside as excessive. Justice Monteleone denied the motion, but

said he would consider written motions for a retrial .... would resist

efforts to cut the $150,000 awarded for that.

The story of the boy’s death was related by his mother during the trial.

She recalled that she took , born on Feb. 7, 1971, for his first

dental checkup on May 24, 1974, to the Brownsville Dental Health Center,

a city clinic at 259 Bristol St.

There, he was examined by Dr. , who found no dental caries and

turned the boy over to Miss Cohen, a dental hygienist, for a routine

teeth cleaning procedure. After cleaning, witnesses explained, Miss

Cohen, using a swab, spread a stannous fluoride solution in the form of a

jell over the boy’s teeth as a decay preventive measure.

Fluoride in small amounts is mixed into various brands of toothpaste and

the drinking water of some communities to prevent tooth decay. When used

by a dentist or dental hygienist after a teeth cleaning, the fluoride

jell is in a relatively strong solution, and a patient is told not to

swallow it.

Instead, after the solution is allowed to remain on the teeth briefly,

the patient is given water and told to wash his mouth out and

expectorate.

Fatal Solution Swallowed

According to Mrs. Kennerly, Miss Cohen was engrossed in conversation with

a co-worker while working on and, after handing him a cup of

water, failed to instruct him to wash his mouth out with it and spit out

the solution. Mrs. Kennerly said that Miss Cohen was not paying attention

when drank the water about 9:30 A.M.

In drinking the water, according to a Nassau County toxicologist, Dr.

Bidanset, ingested 45 cubic centimeters of 2 percent

stannous fluoride solution, triple an amount sufficient to have been

fatal.

Upon leaving the dentists chair, began vomiting, sweating and

complaining of headache and dizziness.

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Facts: Atomic weight of Sn 118, of F 19.

-------------------------------------------------------------------------

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Questions

Calculate within 5% the dose of F- ingested by the child (show all

calculations).

List the negligent actions taken by the dentist and hygienist that led to

this child’s demise.

How does the amount ingested by the child compare with the toxic dosage

reported for fluoride? If different, how can you explain the outcome for

this patient?

How do you convert a toxic dosage calculated for an adult to a toxic

dosage for a child?

The Case Studies In Dentistry Web site is sponsored by the University at

Buffalo School of Dental Medicine's Department of Oral Biology and the

University at Buffalo Infectious and Chronic Disease Center of Discovery.

http://research.sdm.buffalo.edu/case/9803.asp

A Case of Fatal Fluoride ToxicitySubmitted by Dr. Scannapieco, University at Buffalo School of Dental Medicine

(This article was published in the NY times. Please read the article and address the questions that follow)

$750,000 Given In Child’s Death In Fluoride Case.

By D. McFadden

(reprinted from The New York Times© Sat. January 20, 1979)

A State Supreme Court jury awarded $750,000 yesterday to the parents of a 3-year-old Brooklyn boy who, on his first trip to the dentist in 1974, was given a lethal dose of fluoride at a city dental clinic and then ignored for nearly five hours in the waiting rooms of a pediatric clinic and Brookdale Hospital while his mother pleaded for help, and he lapsed into a coma and died.

The award - $600,000 for the wrongful death of the boy, Kennerly, and $150,000 for the pain and suffering he endured in the hours before his death - was by far the largest ever made in New York State for the death of a 3-year-old, according to the lawyers for the parents, Clay Kennerly, 48, an $8,000-a-year city exterminator, and his wife, Inez, 42, of 300 Dumont Avenue in the Brownsville section.

The child, according to testimony at a four-day trial in State Supreme Court in Brooklyn, suffered spasms of vomiting and nausea, headaches and dizziness, and had to be revived from a coma by an injection of adrenaline into his heart several hours after his ordeal began.

The boy was then made to wait - in shock, another coma and finally in a state of cardiac arrest - for more than an hour before getting further treatment, witnesses said.

Stomach-Pumping Suggested

Other testimony indicated that the boy might have been saved at almost any time during the four hours and 40 minutes before he died by having had his stomach pumped or by having him drink some milk or lime water, which would have changed the fatal fluoride compound he had been given into a nontoxic calcium fluoride. The defendants in the case were New York City, its Health and Hospitals Corporation and one of its clinics, the Brownsville Dental Health Center; Brookdale Hospital and its Brookdale Ambulatory Pediatric Care Unit; Dr. Bradford , a dentist; Roslyn Cohen, a dental technician, and Dr. Pretti Bathia, a Brookdale pediatric clinic physician.

After more than a day of testimony by Mrs. Kennerly and medical and toxicological experts, and what were described as a thorough investigation by the city and Brookdale Hospital, lawyers for the defendants on Thursday conceded liability, and the jury of five women and one man was instructed by Justice A. Monteleone to return a verdict for the plaintiffs and to decide the damages to be assessed.

After the jury’s verdict at 2:30 P.M., the defendants’ lawyers, W. Weiler for the city and for Brookdale Hospital, moved to set the award aside as excessive. Justice Monteleone denied the motion, but said he would consider written motions for a retrial .... would resist efforts to cut the $150,000 awarded for that.

The story of the boy’s death was related by his mother during the trial. She recalled that she took , born on Feb. 7, 1971, for his first dental checkup on May 24, 1974, to the Brownsville Dental Health Center, a city clinic at 259 Bristol St.

There, he was examined by Dr. , who found no dental caries and turned the boy over to Miss Cohen, a dental hygienist, for a routine teeth cleaning procedure. After cleaning, witnesses explained, Miss Cohen, using a swab, spread a stannous fluoride solution in the form of a jell over the boy’s teeth as a decay preventive measure.

Fluoride in small amounts is mixed into various brands of toothpaste and the drinking water of some communities to prevent tooth decay. When used by a dentist or dental hygienist after a teeth cleaning, the fluoride jell is in a relatively strong solution, and a patient is told not to swallow it.

Instead, after the solution is allowed to remain on the teeth briefly, the patient is given water and told to wash his mouth out and expectorate.

Fatal Solution SwallowedAccording to Mrs. Kennerly, Miss Cohen was engrossed in conversation with a co-worker while working on and, after handing him a cup of water, failed to instruct him to wash his mouth out with it and spit out the solution. Mrs. Kennerly said that Miss Cohen was not paying attention when drank the water about 9:30 A.M.

In drinking the water, according to a Nassau County toxicologist, Dr. Bidanset, ingested 45 cubic centimeters of 2 percent stannous fluoride solution, triple an amount sufficient to have been fatal.

Upon leaving the dentists chair, began vomiting, sweating and complaining of headache and dizziness.

Facts: Atomic weight of Sn 118, of F 19.

Questions

Calculate within 5% the dose of F- ingested by the child (show all calculations). List the negligent actions taken by the dentist and hygienist that led to this child’s demise. How does the amount ingested by the child compare with the toxic dosage reported for fluoride? If different, how can you explain the outcome for this patient? How do you convert a toxic dosage calculated for an adult to a toxic dosage for a child?

The Case Studies In Dentistry Web site is sponsored by the University at Buffalo School of Dental Medicine's Department of Oral Biology and the University at Buffalo Infectious and Chronic Disease Center of Discovery.

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