German ATI doctor on the case of the little girl who died in the dental clinic: “It happens all over the world” / “I would never do pediatric anesthesia outside the hospital”

Iuliu Torje, honorary advisor to the Minister of Health, says that tragedies like the one on Thursday in a dental clinic in the center of Bucharest, where a 2-year-old girl died after a general anesthesia, also happen “in very developed countries, in solid medical systems”.

Torje, ATI primary doctor in Germany, believes that “tragedies occur everywhere”, and they are “similar in mechanism, not in the culprits”.

“I was asked what I think about the tragedy in Romania. My answer is difficult, but honest. First of all, such events are not “Romanian accidents”. Unfortunately, they happen all over the world… in highly developed countries, in solid medical systems”, said Iuliu Torje, on Friday, in a post on Facebook.

He believes that such tragic events “have a common framework:

• it is a small child, an age with extremely high physiological risk;

• sedation or anesthesia is done outside the fully equipped environment;

• a sudden complication occurs.. laryngospasm, apnea, aspiration;

• the local infrastructure does not allow a fast enough response, and the child does not have time to “wait” for the missing resources;

• and in many such situations, the anesthetist is either out of the pediatric clinical routine, or does not have real skills in the anesthesia of the young child, a major factor in the context of the rapid reactions specific to this age”.

Why he says he would 'never do pediatric anesthesia outside the hospital'

Iuliu Torje claims that “these tragedies resemble each other in the mechanism, not in the culprits”.

“If you ask me, personally, as a physician and as a parent, my position is categorical. I personally would never do pediatric anesthesia outside of the hospital. Never. And I say this as a superspecialized intensive care physician who had the professional misfortune of cannulating ECMO in children as young as 2 years old,” the doctor added.

He said that, “in pediatrics, the environment is part of the treatment.”

“It's not a detail. It's not a preference. It's a vital element. And as a parent, my position is even more decisive: I would never accept that my own child be sedated or anesthetized outside a hospital, outside a pediatric anesthesia department, outside immediate access to pediatric intensive care,” continued Iuliu Torje.

The doctor said that he knows, “from practice, that the physiology of a small child does not forgive delays”, and that, “when the complication arises, the difference between a hospital and an office is not an 'administrative' one, but 'it is one of life and death.'

“Tragedies happen everywhere. They are all similar. They all have the same red thread: a child too young, a procedure outside the necessary infrastructure, a sudden complication. But what I can say, with all sincerity and professional responsibility, is: I as a specialist doctor, out of deep respect for my profession, would never undertake a pediatric anesthesia outside a hospital. And I would never accept my own child to be anesthetized like this. Because when we are talking about a small child, “almost certainly” is not enough”, concluded Iuliu Torje.

A 2-year-old girl died on Thursday, following a cardio-respiratory arrest, while she was in a dental office in Sector 3 of the Capital. The police opened an investigation. The Minister of Health, Alexandru Rogobete, stated that the girl was subjected to a general anesthesia, performed intravenously, and that he ordered checks at the said dental clinic to check if the medical protocols were followed.

On Friday, Minister Rogobete said that the girl was treated in a second location of the clinic, opposite the main building, and the anesthesia office “does not comply with the regulations and legislation in force”.

Also on Friday, the Prosecutor's Office of the Bucharest Court declared that the girl had a “complex pre-existing chronic pathology”, according to the preliminary conclusions after the medico-legal autopsy.

PHOTO: Curtain | Dreamstime.com