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I would wager that this was an HCM death


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  • I would wager that this was an HCM death


    Breathing tube linked to boy's dental-clinic death

    Jacobi Hill died at VCU Medical Center after having caps put on several of his teeth at the VCU Dental Faculty Practice.
    Published: June 29, 2010
    » Richmond, Va. --
    A 6-year-old boy who died after he underwent anesthesia for dental treatment suffered an abnormal heartbeat when his breathing tube was removed, according to the state medical examiner's office.

    Jacobi Hill of Henrico County died May 11 after undergoing dental treatment at the Virginia Commonwealth University Dental Faculty Practice in Richmond.

    Steve Murman, a spokesman for the medical examiner's office, said yesterday that the manner of Jacobi's death was ruled natural, and that the cause was "cardiac dysrhythmia due to endotracheal extubation."

    Murman declined to elaborate beyond the official cause and manner of death.

    Dr. Robert Campbell, a pediatric oral surgeon at Virginia Dental and Anesthesia Associates, said it is not clear whether Jacobi's irregular heartbeat was the result of the heart slowing down or speeding up.

    Generally, a heart that is beating too quickly can be controlled using a defibrillator, Campbell said.

    He said nerves that accelerate or slow down the heart branch off to the trachea. As a patient awakens from anesthesia, a stimulation of the vagus nerve in the trachea can cause the same nerve in the heart to slow down or stop, Campbell said.

    "That's pretty rare, because during the process of waking up, your heart rate generally speeds up, and we try to do something to slow it down," he said.

    "I've probably done 5,000 cases of children with breathing tubes, and I have yet to a see a heart rate slow down because the breathing tube was pulled."

    Campbell said the medical examiner's ruling appears to be "a diagnosis of exclusion -- you've ruled out everything else."

    VCU spokeswoman Pamela Lepley said yesterday that she would not comment because she has not received a report from the medical examiner. "Our thoughts remain with the family," she said.

    Jacobi's mother, Crystal Lewis, also declined to comment on the cause and manner of death. She added that the family has not decided whether it will pursue a lawsuit and that they have not hired an attorney.

    Lewis has said Jacobi was at the dental practice to have caps, also known as crowns, put on several teeth. He was given anesthesia.

    She said her son went into cardiac arrest as soon as the procedure ended and a breathing tube was removed. Jacobi was taken to VCU Medical Center, where he was pronounced dead.

    Lewis has said her son had asthma but no other known health problems.


    Contact Reed Williams at (804) 649-6332 or [email protected].
    Daughter of Father with HCM
    Diagnosed with HCM 1999.
    Full term pregnancy - Son born 11/01
    ICD implanted 2/03; generator replaced 2/2005 and 2/2012
    Myectomy 8/11/06 - Joe Dearani - Mayo Clinic.

  • #2
    Re: I would wager that this was an HCM death

    That's horrible. But it makes me wonder...

    Why would a 6 year old boy be going for caps?
    36 yr old w/ HCM,l novel variant in TNNT2 gene
    2004 diagnosed
    2004 ICD implant
    DX with Low Cardiac Output - Heart transplant in discussion.
    2009 changed to new wireless Medtronic after battery died
    Father passed away 8/2000
    Oldest sister passed age 44 11/2000
    8/21/09 Son born, showing novel variant in TNNT2 gene


    • #3
      Re: I would wager that this was an HCM death

      Originally posted by jenn2112 View Post
      Why would a 6 year old boy be going for caps?
      I've heard of it in cases where the child has no enamel on their teeth and thus need to be capped in order to save them. There's a medical name for it though the name escapes me at the moment.

      Very sad story.
      "Some days you're the dog... some days you're the hydrant."


      • #4
        Re: I would wager that this was an HCM death

        Caps or crowns are becoming more apparent in young kids - and dentists push it for cavaties that may be between teeth. They explain that without treatment it will affect the permanent teeth under the gums - not really sure if this is 100 percent true but it scared us enough to go ahead with the crown. Gavin was put under in March for a crown and was only four. We know several other kids that have had them done as well - although not under anesthesia. Because of Gavin's HCM diagnosis we had the dentist do the dental work at a hospital and under the care of pediatric anesthesiologist who requested an echo within a 30 day window of the dental surgery. He also spoke with his HCM specialist who felt this was the safest route to go with a child with HCM. He had been under before when we did a cardiac MRI so we knew he handled anesthesia well. I, as a parent, would never allow my child to go under anesthesia anywhere other than a full up medical hospital with trained staff (especially a pediatric anesthesiologist - which was a requirement per our HCM specialist) and the equipment necessary to handle any situation that arises. You never know what underlying medical issues a child may have . . . just a little insight since I have been through this with my son who has HCM.

        My thoughts are with this family during this very difficult time.
        Angie & my boys
        Gavin diagnosed at 3 1/2 yrs old - Mar 2009 w/HCM, Gene mutation identified 7/09
        Younger brother (Cullen) - born 7/08, gene negative but still being screened on occasion due to his brother's "unique presentation" - meaning there could be another gene involved
        Husband (Chad) - clear
        Myself - Positive for gene mutation (identified 10/09), echo negative but diagnosed with mild regurgitation of the mitral, tricuspid & pulmonary valves


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