Closing arguments set in manslaughter case against Kailua dentist

Closing arguments are scheduled for Monday in the Circuit Court trial of Lilly Geyer, the former Kailua dentist who is charged with recklessly causing the death of her patient 3-year-old Finley Boyle.

Geyer is accused of reckless manslaughter, second- degree assault and “manslaughter by omission” for failing to obtain medical aid when Finley stopped breathing in the dental chair and went into cardiac arrest on Dec. 3, 2013.

The state contends the three sedatives the girl received were too strong in combination and that the dentist didn’t do enough to save the child. The defense argues that a muscle spasm in her larynx blocked her airway, likely due to an upper respiratory infection diagnosed Nov. 7, 2013.

Geyer acknowledged that the drugs get more powerful when used together but said the dosages the child received took that into account. Deputy Attorney General Michael Parrish questioned how Geyer could be sure, since she wasn’t there to supervise when an assistant administered the chloral hydrate, hydroxyzine and meperidine.

Parrish focused on a delay of roughly 13 minutes before anyone called 911 after Finley’s oxygen levels plummeted. Geyer said she had directed an assistant, Nicole Martin, to call 911, although she discovered later that had not happened.

“I don’t think she intentionally disobeyed my order,” Geyer said. “Both my staff members were crying. My emotion was to be alert.”

Geyer’s other assistant, Kathleen Cacal, had previously testified that Geyer had said “no” when Cacal asked whether she should summon a pediatrician who worked across the hall.

Ultimately, Cacal alerted the pediatrician. Dr. Brit Reis and her assistant rushed over and began chest compressions and rescue breathing.

“I would have done the same, those things, if I had just entered the room,” Geyer said. “There’s a series of things you have to try first.”

Geyer said she had first used suction to try to remove any obstruction in the child’s airway and then focused on “trying to pump oxygen into Finley” using a mask. She denied there was any delay in summoning Reis.

The former dentist also dismissed suggestions from Parrish that she could have inserted a suction tube or oxygen tube down Finley’s throat to open the airway, saying that would have been impossible.

Reis directed Cacal to call 911 and gave Finley an antidote to reverse the effects of one of the sedatives. Parrish noted that the antidote takes time to kick in when injected into the muscle.

Finley started breathing spontaneously about 20 minutes later in the ambulance. But the child had suffered massive brain damage and never regained consciousness. She died Jan. 3, 2014.