Atlanta Child, 5, Dies From Local Anesthesia

PHOTO: Lidocaine, a local anesthetic, was responsible for the death a 5-year-old Atlanta girl who was being treated at a local urgent care center with a broken arm.
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Five-year-old Kensley Kirby was taken to an Atlanta urgent care center to get treated for a broken arm, but died from a lethal dose of local anesthesia given to her at the clinic, an Atlanta coroner confirmed.

In June, Kensley's parents brought her to Family Medical Clinic in Atlanta, Ga. after she fell. When doctors administered the local anesthesia lidocaine while setting Kensley's arm, her parents "went from picking the color of the cast with their daughter to basically being with her as she died," Pete Law, the Kirby family's attorney, told ABC News' Atlanta local affiliate, WSB-TV.

A hospital spokesperson refused to comment on the case, and the family's attorney did not return several requests for comment.

"Dying from a local anesthesia is extremely rare," said Dr. Elliot Krane, professor of pediatrics and anesthesia at Stanford University. "But there is a maximum allowable dose of lidocaine, and as with any drug, it has toxicity associations with it."

Lidocaine is a common local anesthesia used topically to relieve itching and burning from skin irritations; it is injected during dental work and other minor surgeries. The drug blocks nerves and in turn, numbs pain, during surgical procedures.

Allergic reactions to the drug are rare, but excessive doses of the anesthesia can cause unconsciousness, seizures, low blood pressure and even cardiac arrest. Drug dosage is determined by a patient's weight and whether it will be injected into tissue mass or directly into the bloodstream.

"If they're getting it intravenously, the maximum dose is much smaller," said Krane.

It is unclear which way Kensley received the anesthesia after breaking her arm.

"It's possible that the doctor might have been accustomed to taking care of adults all the time, which would have been a larger dose than necessary," said Krane, who was quick to note that he did not know the details of the case. "And with broken bones, there's an opening of vascular channels, so it's possible that it absorbed very rapidly into the bloodstream."

If parents are concerned, Dr. Mark Singleton, chair of the committee of pediatric anesthesia at the American Society of Anesthesiologists, encouraged them to speak with their child's anesthesiologist prior to surgery to discuss their child's medical history and the type of anesthesia that will be administered. Krane also noted that doctors have been collecting information on anesthesia cases across the country over the past five years in a database known as the Pediatric Regional Anesthesia Network.

"It's our sense that nerve blocks are extremely safe," said Krane. "Complications are extraordinarily low."

"Parents should be aware that local anesthetics can be toxic," said Singleton. "This applies to the dental office, as well as other surgeries. It is important to recognize that anesthesiologists take very special precautions to minimize the complications of toxicity from local anesthetics."

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