Woman aged 44 dies three days after getting her tooth repaired

Mandy Parish, 44, of Crag Hill Avenue, Leeds, died on June 30 last year in Bradford Royal Infirmary after doctors were forced to withdraw treatment in the face of overwhelming odds.

Bradford Coroner’s Court heard that Miss Parish had gone to Rawdon Dental Practice on Leeds Road, Rawdon, on June 27, found for her by her partner Mark Huckerby.

He said that the bottom part of her front tooth had fallen away and she wanted it rectified for aesthetic reasons. In a statement read by Coroner Prof Paul Marks, he said: “She was pleased and showed me her tooth which had been repaired. She was overjoyed with the treatment.”

But later he said she told him that she had swallowed something while at the surgery and felt sick though expert medical witnesses told the court they could find no evidence to support this.

On June 29 he said: “She was clearly unwell and I became aware that her breathing was becoming erratic.”

That evening she was taken to the A&E department at the infirmary where medics initially suspected they were dealing with a case of severe pneumonia.

Dr Paul Cramp who was involved in treating her said on admittance she was found to be suffering from severe respiratory problems and extreme agitation.

He said: “It was difficult to take a history because she was so agitated. She required a high level of oxygen.

“Unfortunately, her systems continued to fail and it became clear that continuing treatment was not going to succeed in reversing the condition.

“A decision was made to withdraw treatment.”

John Clark who had seen Ms Parish at Rawdon Surgery said no anaesthetic had been used and he had undertaken only a very small amount of drilling.

He said: “The procedure was carried out, I didn’t even touch the gum. There was no extraction, just a simple repair.” When he was asked by the coroner if he had known that she had cirrhosis of the liver would it have altered how he had treated her, he replied: “No, not at all.”

Consultant pathologist Alan Padwell said that his post mortem examination had revealed Miss Parish had several serious health problems.

These included abscesses in her heart – an uncommon phenomenon – pneumonia in her lungs, abscesses in her kidneys and cirrhosis of the liver.

Asked by the coroner where the infection came from he replied: “Two days previously she had dental work done and therefore it implies that there was an element of infection in the tooth. I can neither prove it nor disprove that. Her illness occurred so soon after this and there was no other source of infection.

“I can only postulate that at the time of the dental procedure some infection got into the blood stream and set off this chain of events.

“I can’t think of any other explanation. She was susceptible to problems because of the liver.”

Mr Huckerby of Albion Road, Bradford, interjected: “She had been perfectly well and a very happy person.

“My partner would not have been ill if she had not been to the dentist.”

He said that Miss Parish had at one time drunk white wine and vodka on a daily basis but had not had a drink since 2008 when she fell ill and attended Bradford Royal Infirmary.

However, Dr Padwell explained that once cirrhosis became established abstaining from drink would not automatically of itself improve the condition.

Prof Marks recorded a narrative verdict. He said: “Mandy Parish died on June 30 2011 two days after a dental procedure.

“Her pre-existing cirrhosis of the liver would have made her more vulnerable to infection and in the absence of other competing sources of infection ... it is likely that the procedure resulted in a bacterium which progressed to septicaemia and multi-organ failure.”

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