May 2004 -
KUSA - In May of 2004 9NEWS Investigative Reporter Deborah Sherman began a series of reports on the treatment of children at a chain of dental clinics in Colorado and across the country. These reports have lead to changes in Colorado state law and prompted investigations in a half-a-dozen states.
In the first part of her investigation called "Papoose Boards" that aired on April 29, 2004, Investigative Reporter Deborah Sherman reported that some parents filed police reports after their children left dentist offices with scrapes and bruises.
These are the same clinics that 9NEWS reported had been hiring dentists not licensed in Colorado to work on some of the state's poorest children.
Children like Adrian and his brother Daniel, Dakota and her brother Chris, Cecilia , Alexis and Angelica.
All of their parents say the children were traumatized by a trip to the dentist.
"She actually threw up on me," said Tamera Elliott, mother of 2-year-old Cecilia. "She was just terrified of going back there."
Lucia Nevarez said her son Alexis, "went in crying and came out crying."
The moms took their kids to the "Medicaid Dental Clinic" in Aurora or "Children's Dental Clinic" in Thornton. That's where Catherine Richardson says both of her kids left with bruises. "It was about the size of a half dollar," Richardson said as she pointed to the spot above her 2-year-old daughter's eye.
Richardson says Dakota was bruised on her head. She says her five-year-old son Chris had a bruise on his wrist when his arms were tied down in the dentist's chair.
9NEWS learned the children were put in restraint devices called papoose boards; unable to move their arms, legs and heads while dentists worked on or cleaned their teeth.
Some of the children were restrained for more than an hour.
Beatrice Ponce says her two boys came out very scared. "Their mouths were swollen from all the work and full of blisters. Their foreheads blistered up and peeled."
The moms say they were told the clinic might use restraints on their kids and they might get red marks. But the moms say they didn't realize the extent of what was going on because they weren't allowed in the exam room.
"What goes on back there?" asked Catherine Richardson.
"It scares me, you know? These are my babies and nobody can go back there with them."
The Aurora and Thornton clinics were co-owned by Drs. William Mueller of Denver and Michael Derose and Ed Derose of Pueblo.
The Deroses also owned three other dental clinics in Colorado: Smile High Dentistry in Denver, Small Smiles Dentistry in Colorado Springs and Derose Children's Dental Clinic in Pueblo.
Nationwide, the Deroses owned 22 clinics. Dr. Mueller is part-owner in 12 of them. All of the clinics cater to kids on Medicaid.
The Executive Director of Colorado's Medicaid office, the Colorado Deptartment of Health Care Policy and Financing, was astonished at the police photographs of the children that 9NEWS showed her.
"This is really extreme," said Karen Reinerston. "If these injuries were caused by the papoose board, it is not a nice little blanket that you wrap around them and make them feel like a papoose."
Drs. Michael and Ed Derose and Dr. William Mueller would not talk to 9NEWS on camera. But in an audio-taped interview, Mueller says they use papoose boards to protect children. "They're used so the children won't make a movement in an inopportune time and hurt themselves or cut themselves," said Mueller.
But at a clinic in Phoenix, Arizona, which is co-owned by Dr. Mueller and the Deroses, 4-year-old Jonathan Barrera died from an overdose of anesthetic while strapped to a papoose board.
The Arizona Dental Examiners Board investigated the dentist responsible, Dr. Matthew C. Nolen, saying the restraints "could have masked the signs of respiratory distress...or signs of the child going into convulsions."
Before he began working at the Arizona clinic, Nolen trained at the Medicaid Dental Clinic in Aurora, Colorado.
Nolen testified before the Arizona Dental Examiner's Board. He admitted that most parents did not know about an unwritten policy at the Arizona clinic to restrain every child under the age of 5.
A Board member asked Dr. Nolen "Is the papoose board common in your practice?" Dr. Nolen replied, "Very common."
"Routine?" the Board member asked. "Pretty routine for children," said Dr. Nolen, "under the age of five."
Last April, the Arizona Dental Board revoked Nolen's license. One of its findings: that Nolen had used the papoose board on Jonathan because it was convenient; not because he had been misbehaving.
9NEWS has also learned Dr. Mueller was charged two months ago with gross malpractice at his clinic in Tennessee for "routinely and arbitrarily immobilizing kids up to 3-years-old on papoose boards, without justification, for longer than an hour for routine dental work".
Dr. Mueller denies his clinics have a blanket policy to use restraints.
Still, Colorado Dental Examiners Board is now investigating why they were used on these kids.
Jason Hopfer, of the Colorado Dept. of Regulatory agencies said, "If they're doing it simply because it's convenient, that is a concern."
9NEWS talked to an expert, Pediatric Dentist Dr. Bradley Smith, spokesman for the American Academy of Pediatric Dentistry in Colorado.
Smith says he rarely uses papoose boards in emergencies. "If a child comes in and they've fallen or broken their tooth or cut their lip or had some major oral trauma and we have to do treatment that day and we have no choice at all," said Smith.
Smith also prefers to have parents in the exam room with him while he works. "I want to be able to talk to the parent, I want them to see what I'm doing," said Smith.
The American Academy of Pediatric Dentistry and the Colorado Dental Examiners Board have policies that say restraints should be used only when absolutely necessary, for uncooperative kids, and should not injure them.
But 9NEWS learned that Medicaid in some states pays extra each time a dentist puts a child in a papoose board.
Drs. Ed and Michael Derose and William Mueller would not tell 9NEWS how often they use papoose boards in each of their respective clinics.
So 9NEWS used open records laws to obtain and analyze state Medicaid bills.
9NEWS learned in all other clinics across the state, dentists use papoose boards, on average, 4 percent of the time.
But at Mueller's 'Medicaid Dental Center' and the Deroses' 'Smile High Dentistry', their dentists put 21 percent of kids in restraints. In the year 2001-2002, those two clinics used papoose boards more than 2,500 times.
The cost to taxpayers for those papoose boards at four of their clinics; $106,473.
Karen Reinerston of the Colorado Department of Health Care Policy and Financing, thinks that is excessive.
"You shouldn't have to have a kid restrained all the time," she said. "I think it's very scary for the child."
Last year, Reinerston stopped Colorado dentists from charging Medicaid for restraints.
Dr. Mueller sent 9NEWS an e-mail saying he did not personally treat any of the children in the story.
Mueller also said he is not responsible for the care provided by other dentists in his clinics, because they work under contract and practice under their own licenses.
Mueller would not allow 9NEWS inside his clinic to show the actual papoose boards that his clinics use for children.
All three sold their ownership in the company in 2007 but continued to Manage them for the new FORBA Holding, based in Nashville for handsome sum.