Court Refuses to Overturn Conviction of Protopappas : Dentist’s Methods That Killed Three Posed ‘Grave Risk’

The 4th District Court of Appeal, describing Costa Mesa dentist Tony Protopappas’ anesthesia for patients as “lethal cocktails,” refused Wednesday to overturn his 1984 murder conviction for the deaths of three patients.

“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,” wrote Justice Edward J. Wallin in the Santa Ana appellate court’s unanimous opinion.

Protopappas was convicted on July 31, 1984, of second-degree murder in the deaths of three women who had received general anesthesia at his clinic. All three had gone to Protopappas for routine dental work.

Protopappas, 41, was the first dentist in the United States, to the prosecutors’ knowledge, to be convicted of murder in a patient’s death. He was sentenced to 15 years in prison.

Nationwide Attention

The case gained national attention and led to changes in California’s supervision of dentists. Under tightened training requirements, more than 140 dentists lost their right to give general anesthesia.

Protopappas’ three victims were Kim Andreassen, 23, of Huntington Beach, who died Sept. 30, 1982; Patricia Craven, 13, of Sacramento, who saw the dentist on Feb. 8, 1983, and died 11 days later, and Cathryn Jones, 31, of Costa Mesa, who saw the dentist on Feb. 11, 1983, and died two days later.

Andreassen, who weighed just 88 pounds, suffered from kidney failure, anemia and high blood pressure. When she refused to undergo treatment with only a local anesthetic, Protopappas warned her that she was a bad risk for general anesthesia.

The dentist was told before he performed the anesthesia anyway that her doctor had sent instructions she was not to be given general anesthesia. She was pronounced dead on arrival at a hospital.

After Protopappas administered general anesthesia to Patricia Craven, he left her in the care of others and did not return to monitor her. When he learned that she was coming out of the anesthesia, he ordered more doses.

Still in a Coma

When Cathryn Jones came to Protopappas’ office, Patricia Craven was still in a coma in a hospital. Complications developed after Jones’ general anesthesia, but Protopappas’ assistants had to ask three times before he allowed them to call paramedics.

Protopappas’ appellate attorney, Handy Horiye of San Diego, argued that the dentist’s conviction should be reduced at least to involuntary manslaughter.

Protopappas, he argued, would not have consciously jeopardized his successful dental practice.

The dentist’s lawyer further argued that Protopappas had anesthetized hundreds of other patients and none of them had died.

But Justice Wallin pointed to prosecution experts who said Protopappas should have “tailored” the dosage of anesthesia to the patient. Wallin added that Protopappas’ conduct after complications developed showed a lack of care.

‘Slow to React’

“He was habitually slow to react to the resulting overdoses; in the case of Craven, (he) simply abandoned her,” Wallin wrote.

“This is more than gross negligence. These are the acts of a person who knows that his conduct endangers the life of another.”

Prosecutors sought a murder conviction on the ground that Protopappas’ administration of overly large doses and lack of care demonstrated “implied malice.”

His attorney, Horiye, said Wednesday that he does not dispute that Protopappas “was guilty of some kind of criminal negligence.”

“I just don’t think what he did reached the level of murder. It’s possible the (state) Supreme Court might review this case, so we can get a better definition of what implied malice really is. I don’t think there is an attorney in this state who really knows.”

One of Horiye’s arguments on appeal was that the jury was not given a clear explanation of the distinction between second-degree murder and involuntary manslaughter.

But Justice Wallin emphatically disagreed.

‘Anything but Vague’

“The instructions read to the jury were anything but vague,” Wallin stated in his 43-page opinion. “The distinctions between the crimes were clearly explained.”

Protopappas now works as a clerk at Soledad State Prison, according to a spokeswoman there. Protopappas declined, through the spokeswoman, to be interviewed Wednesday.

A UCLA graduate, Protopappas had a million-dollar-a-year, high-volume practice in which he specialized in oral surgery. In one ad, he was pictured surrounded by 18 staff members. The ad read: “Dr. Protopappas and Company--general dentistry, all phases.”

Deputy Dist. Atty. James P. Cloninger, who prosecuted Protopappas, had told jurors during the four-month trial that Protopappas was motivated by greed, which caused him to rush patients through without giving them proper care.

Horiye said there was some truth to that: “I think his problems began when he became a high-volume operation. It became hard for him to give the time he needed to each patient. But that doesn’t mean Tony was a murderer.”

More Than 12 Lawsuits

Since the deaths, more than a dozen lawsuits have been filed against Protopappas by former patients. The families of the three victims have also sued.

The parents of Andreassen were awarded $450,000 in a jury trial a year ago. On Tuesday, Sandra Caron, 27, of Buena Park accepted a $170,000 settlement, becoming the first of Protopappas’ other patients to settle out of court. All other lawsuits are pending.

A question remains of how much malpractice insurance money Protopappas has available to pay claims. He was known to have at least $500,000 in malpractice insurance. Protopappas declared bankruptcy shortly before his trial.