Doctor 'cleaned surgical appliance with his mouth'

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A consultant anaesthetist who dropped a piece of equipment on the floor of an operating theatre, picked it up and wiped it in his mouth before replacing it in a patient's windpipe, a disciplinary hearing was told yesterday.

A consultant anaesthetist who dropped a piece of equipment on the floor of an operating theatre, picked it up and wiped it in his mouth before replacing it in a patient's windpipe, a disciplinary hearing was told yesterday.

Dr John Evans Appiah rejected the offer of a sterilised replacement during a caesarean operation on Mrs Hazel Woolger in October, 1998, that left her in acute pain because he had given insufficient anaesthetic. She told her husband the experience had been "like Nightmare on Elm Street".

Dr Evans-Appiah, 58, of Leyton, east London, is appearing before the General Medical Council charged with serious professional misconduct. The doctor was also responsible for administering a general anaesthetic to 10-year-old Darren Denholm, who died the same month while having a tooth out.

His mother, Isla Denholm, of Armadale, West Lothian, wept as she told how dentists at the Peffermill dental clinic in Edinburgh had locked her out of the room while they made desperate attempts to revive Darren after his heart stopped.

Mrs Denholm said: "I heard a bleeping noise coming from the surgery and I said, 'What is that noise?' I was screaming, saying this was my son and I had a right to know what was going on. The receptionist phoned the surgery and told them I was coming through, so they locked the door."

Eventually Mrs Denholm was taken to a neighbouring surgery and told Darren had suffered a cardiac arrest. An ambulance was called but he could not be revived. "If I'd been told there was even the slightest risk, I wouldn't have done it [agreed to a general anaesthetic] and Darren would have understood," she added. "If it had been heart surgery or something life-threatening, then I would have said okay, but not for a tooth out."

Dr Evans-Appiah is charged with failing to keep a check on Darren's physiological state and of falsifying records. He is also charged with instructing the dentist, Hallgeir Pedersen, to give Darren a local anaesthetic containing adrenalin, although he should have known it could interact with the anaesthetic halothane to cause cardiac arrhythmia, a disturbed rhythm of the heart.

The case, due to last a month, is likely to focus attention on the lack of support for overseas-trained doctors. Ghana-born Dr Evans-Appiah, who was trained in the Ukraine, came to Britain in 1973 and spent more than two decades in temporary jobs as a locum. He had failed part of his exams in anaesthesia although he was practising legally at the time of the incidents.

The hearing continues.

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