Coroner calls for action after man dies of bug following trip to dentist

HE CONTRACTED HEART INFECTION AS A RESULT OF EXTRACTIONS

A CORONER has called for action after a man died following a trip to the dentist.

Michael Briggs died in January 2023 due to complications arising from a dental extraction procedure.

The 79-year-old had three teeth taken out because they were causing him pain. The procedure, which took place on November 26, 2022, was described as “uneventful”.

Mr Briggs, from Ilkeston, returned home but was admitted to hospital a week later with a fever and reported bleeding following the dental procedure.

Tests on Mr Briggs’ blood showed the presence of staphylococcus aureus, a bacteria that causes infections. As he had a prosthetic valve in his heart, further tests were run which confirmed he had developed infective endocarditis – a rare infection of the inner lining of the heart.

Despite treatment, his condition continued to worsen before he died at the Royal Derby Hospital on January 11, 2023.

During Mr Briggs’ inquest, Derby Coroner’s Court heard evidence that infective endocarditis is a recognised complication of invasive dental procedures for those who have certain underlying health conditions such as valve replacements

Patients who are a high risk of developing infective endocarditis are sometimes provided with antibiotic prophylaxis before a procedure. Antibiotic prophylaxis is used before contamination by surgical incision has occurred and is given with the intention of preventing infection.

Assistant Coroner Sophie Lomas ruled that on the evidence provided it was not possible to determine whether the antibiotics would have made a difference to the outcome in Mr Brigg’s case. However, she did note that there is limited guidance available for dentists in England on handling patients who are at increased risk of infective endocarditis and whether such patients should be given antibiotic prophylaxis.

The guidelines dentists in England and Wales follow (NICE GC64) state that antibiotic prophylaxis against infective endocarditis is not recommended routinely for people undergoing dental procedures. The guidelines do not provide any implementation advice for dentists on how they should manage patients who are at an increased risk of infective endocarditis.

Filing a Prevention of Future Deaths Report to be sent to the National Institute for Health and Care Excellence, Ms Lomas said: “During the course of the investigation my inquiries revealed matters giving rise to concern. In my opinion, there is a risk that future deaths could occur unless action is taken.

“You are under a duty to respond to this report within 56 days of the date of this report, by May 31, 2024. I, the coroner, may extend the period. Your response must contain details of action taken or proposed to be taken, setting out the timetable for action. Otherwise, you must explain why no action is proposed.”

Michael Briggs died on January 11, 2023. His medical cause of death was listed as infective endocarditis within the context of chronic obstructive pulmonary disease, acute kidney injury and heart failure.

Mr Briggs’ inquest, held on March 21 this year, concluded that he “died due to recognised complications arising from a dental extraction procedure.”