The state health department is alleging unprofessional conduct by the doctor who administered anesthesia to a 4-year-old Vancouver boy who died after a dental procedure in March.
Dr. Chester C. Hu — a licensed physician and surgeon who is board certified in anesthesiology — administered anesthesia to Mykel Wayne Peterson during a March 10 visit to Must Love Kids Pediatric Dentistry. Hu, therefore, was responsible for Mykel’s recovery, according to charging documents by the health department’s Medical Quality Assurance Commission.
But state health officials say Hu failed to meet the standard of care by not using monitoring equipment or having an appropriately credentialed and trained person monitoring the boy as he emerged from sedation, according to the documents.
“(Hu’s) failure to meet the standard of care put (Mykel) at grievous risk of harm and contributed to (Mykel’s) death,” according to the documents.
Hu has 20 days to respond to the charges, which were filed Wednesday. The medical commission has the authority to level disciplinary action against Hu’s licenses, which could include additional training, suspension or license revocation, among other options.
Hu has been licensed to practice in Washington since November 2000. He could not be reached for comment on Monday.
The Dental Quality Assurance Commission investigation into Mykel’s death is ongoing.
Slow, shallow breathing
Mykel, who had developmental delays, had been a patient at Must Love Children, 601 S.E. 117th Ave., for about two years. His dental records indicated he was anxious and uncooperative; treatment with general anesthesia was recommended, according to charging documents.
Mykel received anesthesia for two dental procedures in November 2014 and July 2015. During those visits, the owner of a mobile anesthesiology company administered the anesthesia with no complications. Hu worked as an independent contractor for the company, according to the documents.
Mykel’s dentist scheduled a March 10 appointment with general anesthesia to determine what type of treatment was needed and to obtain X-rays. Mykel was seen March 1 by his primary care provider and cleared for general anesthesia, according to the documents.
When Mykel and his mother arrived at the dental office on March 10, Hu checked Mykel’s vitals and listened to his heart. Hu injected Mykel in the arm with two sedation drugs, ketamine and Versed, according to the documents.
In the operatory room, propofol and nitrous oxide were used for ongoing anesthesia; Mykel also received fentanyl. After the procedure, the boy was taken to a recovery room. Hu initially monitored the boy before turning his care over to a medical assistant so he could initiate anesthesia on another patient. No vitals were recorded in Mykel’s medical records during his recovery, according to the documents.
The medical assistant checked on Mykel every 10 to 15 minutes. She noticed he was not awake and placed wet towels on the boy’s face and back of his neck to stimulate him, but it didn’t work. Then she noticed Mykel’s slowed and shallow breathing and notified Hu, according to the documents.
Hu confirmed Mykel’s breathing was slow and shallow, before leaving the room to “briefly check on his other patient.” When he returned, Hu found the boy’s breathing was “significantly depressed and his lip color had darkened,” according to the documents.
Hu performed a maneuver to prevent the boy’s tongue from obstructing his airway and checked for chest rise. He retrieved a pulse oximeter — used to measure oxygen saturation — from the cupboard and found only faint pulses. When the boy’s breathing sounds stopped and the pulse oximeter stopped picking up a pulse, Hu called for the medical assistant, according to the documents.
Hu then tried bag-valve mask ventilation, followed by compressions, but Mykel’s breathing had stopped. Hu started an IV and administered epinephrine. He continued resuscitative efforts while 911 was called, according to the documents.
Paramedics continued resuscitative efforts while transporting Mykel to the hospital, and emergency department performed resuscitative efforts for 30 minutes. Mykel was pronounced dead at the hospital, according to the documents.
The Clark County Medical Examiner’s office in June announced the boy died of multiple drug intoxication from anesthesia.
There was no criminal investigation into this incident by the Vancouver Police Department, spokeswoman Kim Kapp said.
