AN anaesthetist has admitted he failed on a number of occasions to call off risky dental surgery on a two-year-old boy who later died.
Leonard Crowe did not regain consciousness after having 13 decayed teeth removed and six others repaired under general anaesthetic at Broken Hill Base Hospital on July 11, 2008.
The toddler had numerous medical issues, including club feet, a retreating jaw and a historical breathing problem known as apnoea.
An autopsy also showed he had a respiratory tract infection on the day of surgery, the inquest into his death was told on Tuesday.
Giving evidence at Sydney's Glebe Coroners Court, the boy's principal anaesthetist Dr George Waters said he spent a few minutes carrying out a visual assessment of Leonard before surgery.
Aside from a "yucky nose", he said the boy was happily running around the waiting room.
But he agreed with counsel assisting the coroner Ian Bourke that it was not "thorough", adding there was no physical examination nor any questions asked of the boy or his mother.
Dr Waters said he "omitted parts of his normal practice" because he was so distracted by Leonard's abnormal facial features, which posed potential problems for intubation.
He agreed with Mr Bourke that he should have been more particular in his assessment.
"If I had known that Leonard Crowe had a cough, I am sure that I would've cancelled the case," he told the court on Tuesday.
"I made, in hindsight, the wrong assumption that all was well and this was a perfectly normal child."
Dr Waters said he distinctly remembered considering calling off the procedure after observing the boy but couldn't say why he decided not to.
He again thought about stopping the surgery while administering the fourth dose of a muscle relaxant to help intubate the boy in the operating room.
"I believe that with hindsight I should've stopped before that last dose," Dr Waters said.
"Yes, there were risks and yes, during the intubation I believe that I was about to call it off and (assisting anaesthetist) Dr (Philip) Rosewarne got the tube in and we proceeded."
Dr Waters said he doesn't remember seeing a more detailed record of Leonard's medical history, which some nurses claim was in a second file in the theatre suite.
Asked by Mr Bourke what he would have done if he'd been aware of such a record, Dr Waters said: "I would've immediately recommended to (the dentist) we cancel the case".
The inquest before Deputy State Coroner Paul MacMahon continues on Wednesday.
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