Inept dentist led to Krisha’s death

Doctors say five-year-old died, not because of wrongly-administered anaesthesia, but because dentist was not qualified

The death of five-year-old Krisha Joshi, who died during a dental procedure on Friday, could not have been caused by medical neglect, doctors say. It has been alleged that the dentist who carried out the root canal operation, was not qualified enough. Dr Mrunal Kende, who carried out the six root canal procedures on Krisha on the same day - the child was scheduled for 14 root canal operations, but her family requested for only six initially - is a Bachelor of Dental Science (BDS), not a periodontist or an endodontist. This was confirmed by Dr Uday Tamhankar, head of Cremaco Clinic, who was earlier supposed to operate on Krisha. It was when Dr Tamhankar went abroad that Dr Kende took over the case. According to the police, Dr  Kende is absconding.

A BDS may have only five years experience, compared with a periodontist or an endodontist, who must have at least seven years. Dentists say without these qualifications, no doctor should perform multiple root canal procedures in a single sitting.

“Handling multiple root canals in a single sitting, that too for a five-year old, requires the skills of at least a periodontist or endodontist,” a well-known city dentist says. “If the dentist who conducted the surgery does not have these qualifications, she should not have even attempted such a complex, multiple surgery.”

Ashok Dhoble, secretary general of the Indian Dental Association, adds, “It is not uncommon for children to be treated for 14 root canals, and that too in a single sitting. Since the cost of anesthesia alone is about Rs2,500-3,000, some people opt for just one sitting. In fact the fewer sittings you put a child through, the better. But such surgeries must be handled only by qualified doctors.”

Doctors add that had Krisha been administered general rather than local anaesthesia, she might have survived the operation. An Indian Dental Association member, requesting anonymity, says “Reports state that the anaesthetist had not met the child before the procedure. In such cases, you have to bring the child over to the clinic several times before the operation, and help her get accustomed to the surroundings. This would have relaxed her before the procedure.”

Doctors have also raised questions about the 14 root canals being suggested. “Most children lose their milk teeth by the time they are eight,” says dentist E Bhatnagar. “The back teeth come out only when the child turns 11. Since only the back teeth needed to be treated, Krisha would have required less than 14 root canal procedures in any case.”
Krisha’s uncle Amit Trivedi says that they had no idea who would treat her until an hour before the surgery. “We thought it was Dr Tamhankar, and had cancelled a previous appointment because he was not available. It was at the last minute that some junior doctors convinced us to go ahead with the surgery, since Dr Tamhankar was in Japan. They kept reassuring us, saying that since they had trained under Dr Tamhankar, they would do a good job.”

He adds that the family was not informed even when Krisha was in a critical condition. “It was around 12.15pm, when the doctors began to panic, that we got to know of her situation,” Trivedi said. Around 1.15pm, the doctors declared Krisha dead. The family was going to pay Rs25,000 for the treatment.

Inspector Annasaheb Rajmane of Borivli police station says, “We are trying to get information about Dr Kende and also waiting for the autopsy results. It’s too early to say whether this was a case of medical neglect. We will know once the reports are in.” Hospital authorities, however, refused to comment on the incident.
a_anita@dnaindia.net