Protopappas Loses Bid for Hearing in Triple Murders

SAN FRANCISCO — The California Supreme Court on Wednesday let stand the second-degree murder convictions of an Orange County dentist for the deaths of three patients from lethal doses of anesthesia during treatment.

Tony Protopappas, who had operated a Costa Mesa dental clinic since 1974, was convicted in Orange County Superior Court in the deaths of two young women and a teen-aged girl between September, 1982, and March, 1983.

He was not accused of deliberately killing the patients but of using procedures that he knew endangered their lives.

None of the justices voted to grant a hearing on his appeal of a lower-court ruling upholding his convictions and prison sentence of 15 years to life.

According to appeals court records, the first patient, Kim Andreassen, 24, suffered from diseases that caused her regular doctor to forbid general anesthesia.

Protopappas ordered only a local anesthetic for a root canal and other dental work in September, 1982. But she quickly went to sleep and began breathing irregularly. She did not respond to other drugs or oxygen, and was dead when she reached a hospital. Medical witnesses said she had been given massive amounts of drugs, and also said Protopappas had failed to recognize life-threatening conditions and had delayed in calling paramedics.

Patricia Craven, 13, had swollen tonsils but otherwise was in normal health when she went to Protopappas for extractions and fillings in February, 1983.

Protopappas gave her the first dose of anesthetic and then turned the work over to a second dentist, who was not licensed to give anesthetics, with instructions to give the girl drugs whenever she started waking up, the court said.

Both Protopappas and the second dentist gave the girl periodic shots while completing the operations during the day. She was still under anesthesia when Protopappas sent her home with her mother. She never regained consciousness and died in a hospital 11 days later.

While the girl was in a coma, the third patient, Cathryn Jones, 31, came to the office to have her teeth removed. Protopappas administered anesthesia, which Jones’ doctor later said consisted of different drugs and in far higher dosages than he would have approved.

Soon afterward, a dental assistant told Protopappas the woman’s lips were turning purple and her fingernails were blue, but Protopappas denied it, the court said. The assistant said Jones soon appeared not to be breathing, but Protopappas delayed giving her oxygen or calling paramedics. She died at a hospital two days later.

In appealing his convictions, Protopappas said the evidence supported no more than a finding of ineptitude or gross negligence, rather than a conscious disregard of his patients’ safety. But the 4th District Court of Appeal disagreed on a 3-0 vote.

“The entire thrust of the prosecution’s case was that Protopappas knew his procedures threatened his patients’ lives,” said the opinion by Justice Edward J. Wallin. “The case was tried and argued on the crucial element . . . (that) Protopappas knew his patients might die, but he treated them with lethal doses of anesthetics anyway.”

Summarizing the three cases, Wallin said: “Protopappas did not supply proper general anesthesia or tailor the dosage to the patient. Without the patient’s authorization, he substituted surrogate dentists who were neither licensed nor qualified to administer general anesthesia.

“He instructed them to give improperly preset dosages for extended periods with little or no personal supervision. . . . He was also habitually slow in reacting to the resulting overdoses and, in the case of Craven, simply abandoned her.

“This is more than gross negligence. . . . No reasonable person, much less a dentist trained in the use of anesthesia, could have failed to appreciate the grave risk of death posed by the procedures he utilized. It was not a question of whether a fatality would occur, only a question of when.”