Dental death inquest
The daughter of a Perth woman who bled to death after having two teeth removed says she hopes the findings of a coronial inquest will prevent similar tragedies.
Myo Moriarty, 68, died in December 2010, two days after the teeth were extracted by Patrick Colgan, a veteran Perth dentist of nearly 50 years.
Her daughter, Fiona, found her lying unconscious on her bed with her mobile phone in her hand.
She was pronounced dead an hour later.
A post-mortem revealed the grandmother-of-three died of a combination of acute gastrointestinal haemorrhage and her existing valvular heart disease.
Mrs Moriarty had been taking the blood thinner warfarin because of a heart condition which stemmed from a previous horror dental procedure.
She had an infected heart valve replaced in 1987 after that procedure was completed without antibiotics.
Her death in 2010 is the subject of a coronial inquest examining what Dr Colgan could have done to prevent complications given her high-risk presentation.
The inquest is probing Dr Colgan's awareness of his patient's ‘international normalised ratio' - a measure of the anticoagulant effect of warfarin - and the precautions he took against excessive bleeding.
Yesterday, Coroner Barry King was told the dentist never independently verified Mrs Moriarty's INR, instead choosing to take her word that the INR was within the acceptable range six days before the extractions.
The Coroner's Court was also told Dr Colgan did not adhere to several recommendations in the therapeutic guidelines, such as applying sutures and tranexamic acid to the wounds, and organising a follow-up appointment.
Expert witness Gareth Davies, an associate professor at the UWA Dental School, said the INR should have been independently verified and ideally measured within 24 hours of the extractions.
"I would want to see evidence of the most recent INR,” Assoc. Prof. Davies said.
"If it hasn't been done within the last few days it should be redone."
Dr Colgan said although he believed he had made a sound clinical judgment, he has since reviewed his methods.
He told the court Mrs Moriarty underwent tooth restorations immediately before the extractions, and given the lack of bleeding, he deemed it safe to proceed.
He said the 68-year-old was intelligent and acutely aware of her health, and he had trusted what she told him about her medical history.
But he said he could have been more thorough with regards to "local measures" such as sutures and tranexamic acid.
"(Now), I tend to view the local measures as more intrinsic to the process than as back-ups if there are difficulties," he said.
Outside the court, Fiona said her family wanted the issue brought to light.
“It's too late for our beautiful for mother but it's not too late for your father or your sister,” Fiona said.
