二歲兒童於牙醫診所接受局部麻醉後猝死案【寰宇醫事裁判】 試閱
Sudden Death of a 2-year-old Child after Receiving local Anesthesia at a Dental Clinic
被告Y本身為牙醫及A兒童牙醫診所的院長，而C為其診所之兼職醫師。C醫師在對死者B進行蛀牙治療時，使用以利多卡因（Lidocaine）為主要成分的局部麻醉劑。因注射時不慎血管破裂，導致藥劑流入血液中而使濃度過高，令B急性利多卡因中毒。B雙親雖察覺B有不明反應，然經Y二度確認僅為兒童麻醉後常見疲憊現象；惟B中毒狀況未減，其雙親仍送往H醫院才發現B病情危篤，最終死亡。法院認為使用利多卡因於兒童的情況下，要十分注意預後狀況，B症狀為典型的急性利多卡因中毒症狀，應能合理懷疑症狀與局部麻醉劑有關；且Y有能力進行適當措施，避免B死亡。復又考量兒童麻醉後通常疲憊嗜睡，且該注射劑量通常不致中毒，因此判Y業務過失致死罪2年有期徒刑並緩刑。
Defendant Y was a dentist and director of a Children’s Dental Clinic A, and C was an adjunct dentist in his clinic. C used Lidocaine as the main ingredient of a local anesthetic during giving the treatment of Decedent B’s decayed teeth. Due to inadvertent rupture of blood vessel during the injection, the concentration of the anesthesia was too high as it flowed into the bloodstream, resulting in acute Lidocaine intoxication. Although B’s parents noticed that B had an unknown reaction, Y confirmed that it was only a common phenomenon of exhaustion after anesthesia in children; however, B’s condition did not decrease and his parents sent him to Hospital H. It was be found that B was in a critical condition and eventually died. According to the court’s opinion, great attention should be paid to the prognosis in the case of using lidocaine on children. B’s symptoms were typical of acute lidocaine intoxication, and there should be a reasonable suspicion that the symptoms were related to the local anesthetic. Furthermore, Y was capable of taking appropriate measures to prevent B’s death. Taking into account that children are usually tired and sleepy after being given anesthesia, and that the injected dose is not usually toxic, Y was sentenced to two years’ imprisonment with probation for the offence of causing death by vocational negligence.
092-098
