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Ashley Puleo choked back tears as she recalled how her 3-year-old daughter, Finley Puleo Boyle, dutifully swallowed a cocktail of drugs prepared by a dental assistant in the office of former Kailua dentist Lilly Geyer. Read more

Ashley Puleo choked back tears as she recalled how her 3-year-old daughter, Finley Puleo Boyle, dutifully swallowed a cocktail of drugs prepared by a dental assistant in the office of former Kailua dentist Lilly Geyer.

“Fin kind of tasted it, and she actually took it like a champ — she swallowed it,” Puleo said Friday in Circuit Court as the leadoff witness in the manslaughter case against Geyer. The little girl played and cuddled with her mom in the chilly waiting room until the sedatives began to take effect.

“At that point she said her last words, which were …” Puleo paused as emotion over came her, “‘Auntie, can I have my prize?’”

Boyle was carried to the dentist’s chair for fillings and root canals, but parents were not allowed into the treatment room. Puleo didn’t know things had gone horribly wrong until more than half an hour later when several emergency medical technicians from the Fire Department arrived.

Geyer is charged with manslaughter for recklessly causing Boyle’s death and failing to get medical help after the youngster stopped breathing and her heart stopped beating in the dentist’s chair on Dec. 3, 2013. Boyle suffered severe brain damage and never regained full consciousness. She died Jan. 3, 2014.

An autopsy determined that the cause of death was cardiac arrest, likely caused by the drugs given to sedate her. Geyer is also charged with second-degree assault for causing serious bodily injury as well as prohibited actions involving the sedatives.

On Nov. 7, 2013, Puleo, who was then married and known as Ashley Boyle, had brought in the youngster for her first-ever dental visit because she thought it was about time to check for cavities. Puleo said she was surprised and upset when the dentist told her Boyle had 10 cavities and needed four “baby root canals,” because the little girl had not complained of any pain. They made an appointment for the procedure on Dec. 3.

Defense attorney Michael Green pressed Puleo about a form she had filled out at the initial dental visit Nov. 7, indicating her daughter was healthy.

Although Puleo said she couldn’t remember what she had done before going to the dentist, Green produced a medical record showing she had taken Boyle to a clinic on a military base that morning for a runny nose and cough that had persisted five days. The doctor diagnosed it as an upper respiratory infection that should resolve within another week.

“Do you think the dentist had a right to know this information?” Green asked. “You were concealing the fact that your daughter had an upper respiratory infection.” Pointing to the form, he added, “It looks like this kid’s in perfect health.”

Puleo said they had gone to the beach the day before and that “she was in good enough, perfect health to have her mouth examined.”

Prosecutor Michael Parrish pointed out that the Nov. 7 clinic record showed that Boyle had no symptoms: She had no fever, no sore throat, no nasal discharge or blockage, no headache, no wheezing, her lungs were clear and neither her throat nor lymph nodes were inflamed.

Puleo testified that she filled out the form truthfully at Geyer’s office that afternoon because Boyle did not suffer from serious, chronic diseases such as those listed on the form, including asthma and AIDS, and because she was in no discomfort.

But Green said that she should have alerted the dentist. He described a medical condition, laryngospasm, that he said “four to six weeks after an upper respiratory infection, it can make your vocal cords close up when you have anesthesia.”

Puleo said she wasn’t familiar with it. And in any case, she said, “I think that’s a judgment you make on the day of the sedation, not a month before.”

The defense attorney also stressed that Puleo had told a doctor at Kapiolani Medical Center, where Boyle was transferred later that day, that her daughter had a “upper respiratory infection two weeks ago.” Puleo said she was in a state of shock, and the evidence shows it was nearly a month previous.

Green and Puleo often sparred during cross-examination, and Circuit Judge Paul Wong repeatedly intervened to keep them from interrupting each other.

Puleo rode with her daughter in the ambulance to Castle Medical Center, where she worked as a nurse. At the request of Castle staff, she called Geyer to find out exactly what medications had been given to her daughter, she testified.

“The next night, I did the drug calculations and found that she was grossly overdosed,” Puleo said. “That’s why I didn’t call her back: because she killed my daughter.”