A team of the Executive Agency "Medical Supervision" is checking the private clinic in Plovdiv following the tragic death of a 6-year-old boy after a dental procedure. The child died shortly after undergoing an operation under general anesthesia. The Regional Health Inspection (RHI) has already requested written explanations from all medical professionals who participated in the surgery and the subsequent resuscitation efforts.
The medical supervision agency will follow the entire path from the child's treatment to the fatal outcome. The Regional Prosecutor's Office is conducting a pretrial investigation into the possibility of medical malpractice, and the documentation collected by the Regional Health Inspection has already been handed over.
Dr. Argir Argirov, Director of RHI Plovdiv, stated: "At the moment, we do not have the full documentation, as the child passed away at the Children's Clinic of the University Hospital 'St. George'. The documentation from there was seized by the Second District Police and the Prosecutor’s Office."
The private hospital where the procedure took place has fully cooperated with the inspectors from the Regional Health Inspectorate.
Dr. Argir Argirov Director of the Regional Health Inspectorate - Plovdiv: "The child had a more serious dental condition, but I personally categorically reject the allegations that this was a medical error."
The boy's mother gave written consent for the surgery under general anesthesia. An anesthesiologist was present during the procedure, and two resuscitators participated in the emergency resuscitation that followed, according to the initial results of the RHI inspection. 
Dr. Borislav Milanov, Secretary-General of the Bulgarian Dental Association, commented, "A deteriorated dental status doesn’t happen overnight. What happened is unacceptable, and responsibility must be shouldered by all of us. In the 21st century, to come to this situation where the procedure is conducted under general anesthesia is irresponsible to say the least. It is a method without which no treatment can be performed, but there are indications and contraindications."
General practitioners point out that there is no unified test for allergic reactions to anesthetics, and anesthesiologists are not obligated to conduct such tests.
Dr. Kostadin Sotirov, Chairman of the Association of General Practitioners, added, "It is impossible to be tested for everything beforehand. Preoperative testing is done for the specific anesthetic that will be injected, especially for certain antibiotics, which are more commonly associated with allergies."
Besides, there is no uniform standard of anaesthesiology in our country, neither for children nor for adults. Therefore, according to medical law specialists, regulatory changes are needed.
Dr. Maria Sharkova, a medical law lawyer, said, "The lack of a standard does not mean there is lawlessness or that doctors do not know how to do their job. The duration of anesthesia cannot be considered the cause of the subsequent deterioration of the child's condition. There are much longer surgeries with prolonged anesthesia. However, what is mandatory before any surgery is an assessment of the operational risks and the necessary preoperative consultations, including with a pediatrician and an anesthesiologist."
But until the cause of the child's death is established, everything said is in the realm of speculation - clarifies Maria Sharkova. The medical supervision do not have a deadline for completing their inspection.
In the next two weeks, a triple forensic medical examination is expected to be completed.
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