The doctor whose string of blunders ended in the death of a ten-year-old boy in the dentist's chair faces being struck off the medical register on Monday. The General Medical Council yesterday found anaesthetist Dr John Evans-Appiah guilty of failures in his treatment of West Lothian schoolboy Darren Denholm.
The GMC's professional conduct committee also said the doctor had botched the anaesthetic on a woman undergoing a Caesarean section, just three weeks after Darren's death at an Edinburgh dental clinic.
Hazel Woolger, 33, of Barming, Kent, told the committee she warned the anaesthetist that she still had feeling in her abdomen but that he told the surgeon to proceed.
She went on to describe the operation as "A Nightmare on Elm Street" and said she suffered 45 minutes of intense pain as the baby was removed.
The GMC committee will begin considering on Monday if the 17 charges proved against 58-year-old Dr Evans-Appiah amount to serious professional misconduct, in which case he is likely to be struck off.
But last night there was a question mark over why Dr Evans-Appiah was allowed to work in 43 hospitals in Britain during his 27-year career, despite concerns being raised over his performance.
He left at least two posts, including one at Borders General Hospital, under a cloud, but despite complaints to the GMC, was allowed to continue to practise.
The three-week GMC hearing was told of a catalogue of errors made by Dr Evans-Appiah when he treated Darren at Edinburgh's Peffermill Dental Clinic on October 9, 1998.
The schoolboy, attending for a routine extraction, had a natural surge of adrenaline and suffered a cardiac arrest after Dr Evans-Appiah gave him inadequate sedation, the committee heard.
The problem was then compounded when the doctor gave the boy an injection containing adrenaline.
The doctor then tried to get his colleagues to lie for him and invented pulse and blood pressure readings which had never in fact been taken.
Dr Evans-Appiah, of Leyton, East London, admitted that he failed to ensure that a blood pressure cuff was attached to Darren either before or after the anaesthetic was administered, and that he entered false details of pulse rate and blood pressure on an anaesthetic record form after the boy was taken to hospital.
He did not issue clear instructions or co-ordinate his team of surgeons and later tried to persuade the dentist, Hallgeir Pedersen, and dental nurse Kirsty Thompson to say that a blood pressure reading had been taken, the GMC's professional conduct committee found.
He also admitted failing to ensure that an electrocardiogram was attached to Darren before or after he administered the anaesthetic.
The hearing ruled that Dr Evans-Appiah wrongly advised Mr Pedersen to give Darren a local anaesthetic during the course of surgery.
Yesterday, Darren's mother, Isla, from Armadale, West Lothian, said: "I feel absolutely delighted at how the case has progressed. I've been waiting two years. It's been a long haul."
Dr Evans-Appiah was also found to have made a series of grave mistakes in treating Mrs Woolger as she gave birth by Caesarean section at Maidstone Hospital, Kent, on 30 October, 1998. At one point during the surgery the anaesthetist dropped a piece of equipment on the floor, picked it up, wiped it in his mouth and put it in Mrs Woolger's windpipe.
The committee also found he had failed to pay attention when Mrs Woolger said she could still feel through the nerves in her abdomen and therefore failed to give her an adequate anaesthetic. Dr Evans-Appiah failed to act speedily to deal with her pain following the operation.
Dr Evans-Appiah, 58, from Ghana, trained in the Ukraine, graduating in 1970 with a degree recognised by the World Health Organisation. He moved to the UK three years later and was given temporary registration by the GMC, which did not at the time require references.
Since 1979, overseas doctors in the UK have had to pass the PLAB (Professional and Linguistic Assessment Board) or enter an approved training course.