In 2016, 4 year old Liseth Lares died just days after visiting the same Yuma, AZ Kool Smiles clinic as 2 year old Zion Gastelum

YUMA, Arizona --

Two children, one dentist's office, each meeting the same tragic fate.
An Arizona mother is suing Kool Smiles in Yuma after her 4-year-old daughter died days after she visited the dentist's office in January 2016.

Francisca Lares said she is heartbroken, because she was only trying to do the right thing in getting care for her daughter, KNXV reports.

But when little Liseth Lares developed a fever, family attorney Marco Mercaldo said the dentist sent the girl home after a "relatively cursory exam."

"Told the mom essentially there is nothing to worry about, she'll be fine," Mercaldo said. "Unfortunately, the infection spread and she died of the infection."

Mercaldo argues Liseth could have survived the infection if Kool Smiles had given her the proper treatment.

Read full report here.

TEXAS: 10.45% Reduction in Medicaid Reimbursement to Ambulatory Surgery Centers Likley To Be Catastrophic for Pediatric Dental Patients

On Wednesday of this week (November 16, 2016) at 1:30 there is to be a public hearing held by Texas Health and Human Services (THHSC) in the Brown-Heady Building, 4900 North Lamar Blvd, Austin, TX. The purpose of the public hearing is to receive comments related to a 10.45% reduction in reimbursement to Ambulatory Surgical Centers for Dental Rehabilitation and Restoration. My sourse says this reduction is spear headed by the Dental Service Organizations (DSO') whose target patients are children on Medicaid and is to take effect January 1, 2017.

(Why aren’t these “hearing” held at a time when the actual public or interested parties are available? It shall be interesting to see who is there to offer “public comments”.  THHSC website indicatged the hearing will be webcast and available to watch here: http://legacy-hhsc.hhsc.state.tx.us/news/webcasting.asp.)

The source states the long term plan is to reduce the number of licensed pediatric dentists and oral surgeons from accepting children who currently require sedation for treatment, whereby those dentists will drop out of the program thereby limiting the access to quality care for the children. This is outrageous!

I’m told the DSO's plan to hire young new graduates carrying loads of student debt general dentists to perform these procedures, The source hinted a system is already in place to make sure all children meet the qualifications to require sedation.

As it was told to me, it is planned to be much like the orthodontic scam that took place in Texas just a couple of years ago whereby nearly all children suddenly qualified for braces and the per-authorization process was to rubber stamp and approve every child!

(Let’s not forget how dentists were trained on how to scam the system by Dr. James (Jim) Orr and attorney Robert (Bob) Anderton, in Anderton’s private office.  Orr, at the time was Dental Director of the claims agent for Texas. In sworn testimony before the State Office of Administrative Hearings (SOAH) witnesses stated Orr and Anderton taught them how to “utilize” the HDL scoring system in place to qualify children for orthodontic braces. In addition the processors, who worked from home, were paid $50 for each approved application! For more on there click here.)

No doubt the Ambulatory Surgical Center’s are not going to complain too much about a reimbursement rate reduction when they expect their patient volume to skyrocket. Win, Win for everyone, right?  Well except the children who are needlessly sedated for what is likley to be unnecessary dental procedures, like 4 year old Navaeh Hall who was left brain damaged or Daisy Lynn Torres or 3 year old Marvelena Rady who both died this year.

For the public who would like to make comments by mail:

Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
P.O. Box 149030
Austin, TX 78714-9030

Overnight mail, special delivery mail, or hand delivery:
Health and Human Services Commission
Attention: Rate Analysis, Mail Code H-400
Brown-Heatly Building
4900 North Lamar Blvd.
Austin, TX 78751
Phone number for package delivery: 512-730-7401
Fax: Attention:  Rate Analysis at 512-730-7475

 

Related Links:

November 16, 2016 Hearing Briefing Package
Link to Webcast page

14 Month Old Daisy Lynn Torres dies after visit to Austin Children’s Dentisry

Austin, Texas – 14 month old toddler, Daisy Lynn Torres, died March 29, 2016 after visiting Austin Children’s Dentistry in what spokesperson, Sarah Marshall, says was a “fairly routine” procedure that required anesthetics.

As pale and frightened as Marshall looked on camera, I suspect she was scared to death to actuall “speak”. Marshall also said, they have been in business for 40 years! Really? She also  told KVUE-TV “these types of procedures are done all the time”. Really?

I wonder if the routine part actually means that their office routinely sedates children unnecessarily for unnecessary procedures in order to bilk Medicaid or other insurance.  Let’s face it, we are talking Texas here, right?

According to Daisy’s mom—as reported in a follow-up report by KVUE-TV—Daisy was only supposed to have two cavities fixed, then about 15 minutes into the procedure, they came and told Daisy’s mom they were going to go ahead and do 6—4 stainless steel crowns on top, and 2 on the bottom.

Daisy’s mom told KVUE reporter Kris Betts, about 10 minutes later, the dentist returned saying Daisy was having a “difficult time”. After taking her mom back to see her, they assured her mom that she was fine. Shortly thereafter, an ambulance was called. The ambulance took Daisy to North Austin Medical Center. Her mother followed the ambulance to the hospital. Upon arriving she was told Daisy was already brain dead.

So what happened?

3 year old Finley Boyle has died after careless sedation by dentist and staff in Hawaii dental office.

This is the saddest picture I think I’ve seen in many years and should be the one that comes to mind the next time ANY dentists want to sedate a child.  Sadly these deaths are more common than you may think.  In 2011 there were 8 that were reported, who knows how many were not.

On December 3, 2013 baby Finley was sedated at Island Dentistry for Children. Dr. Lilly Geyer was the dentist in charge, but who actually administered the deadly cocktail 5 different drugs?  According to court documents a “technician” gave Finley the lethal cocktail. Not surprising to those of us who watch this sort of news, questions have arisen as to the whether Finely actually needed the extensive treatment recommended at her November check-up by Dr. Geyer.

Court documents say when Dr. Lilly Geyer discovered Finley had gone into cardiac arrest, the doctor ran down the hall to a pediatrician’s office in the building to get him to come and perform CPR.

The AAPD Guidelines recommends vital signs should be monitored and documented at least every five minutes for patients who are sedated.  However, as was learned in the dental malpractice case in Syracuse, NY the AAPD guidelines are “options”.  Dentists on the stand testified under oath, the AAPD guidelines have little influence in the decisions many dentists make in treatment. (sorry, I tried not to do there)

According to the Boyle’s attorney, Rick Fried, only 3 notations were made as to Finley's vital signs and they went unchecked for 26 minutes after the technician sedated her.

I can only conclude Dr. Geyer and staff as careless idiots.

As promoted by the Raven Marie Blanco Foundation, every dentist office should be prepared to handle a medical emergency and recommends The Six Links of Survival. 

See the RMBF Public Service Announcement

However, dentists are fighting this “tooth and nail”.  State dental boards are doing little to protect the public and everything to make it easier for dentists to increase their income stream by offering sedation.

Below are several links to various stories, don’t miss out on the comments.  As you will see in the comments, the first thing people do is blame the victim or in this case the victim’s parents.  What is usually not stressed in the stories is that the child probably did NOT need such extensive treatment, if at all.

The Medicaid gravy train continues

If you read this blog, then you know profits with Medicaid dentistry is made on high volume, gross excessive treatment, all at a single visit. The prime example is Small Smiles and their Production Per Patient (PPP) mantra handed out to their employed dentists. As testimony revealed in a New York malpractice case, "PPP is the Golden Goose", said one Small Smile executive. As was put another way by one of Small Smiles managers, “you eat what you kill”. 

It’s undeniable, years ago, Small Smiles Dental set the gold standard of excessive treatment by restraining children with use of the papoose board. 

As heat from press, parents and few state dental board followed some Medicaid accepting dentists and dental chains decided sedation would be the key even more profits, leaving the least amount of yuk in everyone's mouth—the children, the parents and especially the public.

Weekend "get-a-way" sedation courses were developed, lobbyist hired and representatives of the dental community were sent on press junkets stressing the need for higher reimbursements from insurers and Medicaid; all to accomplish the same thing—Production Per Patient. Now, as ABC news has reported in 2012, we have children being overdosed, brain damaged and dying at an alarming rate.

All the while, government regulators appear to be hiding under their desks. It is understandable that the bulk of the dental profession has given up. It’s been proven over and over there is no money to be made in Medicaid dentistry, if provided ethically. Add government corruption and ineptitude to the mix and it’s like the sadistic relationship between the addict, and their co-dependent enabler; life and death danger to both.

Family says 3 year old Finley Boyles was given too much anesthesia.

 

December 11, 2013

KAILUA, OAHU (HawaiiNewsNow) -

A three-year-old girl is in critical condition following a procedure at a local dentist in Kailua, Oahu.

Three year old Finley Boyle is at Kapiolani Medical Center.  It's unknown if she had any pre-existing medical conditions but we do know a lot of lives have been changed forever.

Photos show three year old Finley Boyle's bright smile.  Family friends say on December 3 she was brought in for a dental procedure at Island Dentistry in the Kailua Professional Center when something went horribly wrong.

The friends say Finley was given too much anesthesia and sedatives.  She then went into cardiac arrest and now has severe brain damage and will never be the same.

Friends say the dentist is Dr. Lilly Geyer.  Her office, called Island Dentistry for Children, has a sign up saying it is currently closed.  Not even the delivery man was let in. There were people in the office but they weren't talking.

"We have no comment," said an unidentified man inside the office.

The Island Dentistry website has also been taken down, but a screen grab from the archived website says the practice opened in 2006 and has 2,000 patients.

The "about us" section of the site also says Dr. Geyer "is certified in Basic Life Support, Advanced Cardiac Life Support, as well as Pediatric Advanced Life Support."  However friends say when Finley began having complications the staff ran to the pediatrician's office down the hall and that doctor came to help with CPR.

Children at risk of disease after needle sharing with dentist who committed suicide?

Anyone realizing the “patients” are little children?  Anyone realizing the intravenous sedated patients are at risk because the needle was probably in the dentist’s arm then in child’s?  Or are people realizing it, just not saying it?  Anyone asking why this has been known for so long and patients are just now being alerted?  Someone besides me should be asking.  I’m getting tired of being the only one asking the hard questions! I’ve been asking for well over 5 years!!

 

Watch More News Videos at ABC | Technology News | Celebrity News

 

ABC News(NEW YORK) -- The Arkansas Department of Health announced this week that it would contact the 100 patients of the late Dr. William Jarrod Stewart as they may have been exposed to "infectious material," but the state dentistry board says it's not clear the dentist did anything wrong.

Patients were treated with the intravenous painkiller meperidine -- known as Demoral -- between Nov. 20, 2011 and Feb. 20, 2012.  Stewart committed suicide on Feb. 29, 2012 at age 40 shortly after he lost his job, according to his father.
"Anybody around him would tell you he was a great dentist," Stewart's father, Larry, told ABC News.  "He just had a problem with drugs. That's mainly what caused all this."
Stewart had issues with substance abuse in the 1990s when he was living and practicing dentistry in Louisiana, and he eventually surrendered his dentistry license there, said Arkansas Board of Dentistry attorney Bill Trice. 
After completing a rehabilitation program in 2000, Stewart asked for a dentistry license in Arkansas.  It was granted on the condition that he complete a five-year program with daily drug testing.
Stewart was drug-free for the full five years, but he relapsed and had to complete the five-year program again, Trice said.  In 2010, Stewart completed the program a second time.  For the next two years, the dentistry board didn't hear about any problems.
Ocean Dental, which owned several clinics where Stewart worked, asked Stewart to take a drug test on Monday, Feb. 20, 2012, after he appeared to be impaired during Sunday communications with Ocean Dental employees.  He was told he would be fired immediately if he refused, but he refused anyway, according to a statement from Ocean Dental.
The dental board did not know why Stewart was fired, Trice said.
Then, Stewart committed suicide by overdosing on drugs on Feb. 29, 2012, according to Pulaski County Coroner Gerone Hobbs.
Six months later, in August, the Drug Enforcement Agency got a complaint from a former employee of the dental clinic where Stewart worked, prompting the agency to visit the clinic, Trice said.  Investigators found evidence that two vials were tampered with, but they didn't find evidence of any disease.
Trice, who has been a prosecutor on behalf of the dentistry board since the early 1980s, said he's not convinced Stewart contaminated any drugs.
"They've got all these isolated facts out there, but I'm not sure the dots connect," Trice said.
DEA spokesman William Bryant said two separate sources called to say the single doses of these drugs were compromised.  The second call came in as late as last week, he said.
Stewart's former patients were advised to seek tests for blood borne diseases like HIV and hepatitis b, but Larry Stewart said his son was tested and the results were negative.  Given the length of time between the death and the announcement, he said he felt his son's name was "truly smeared."
"We feel like we've been violated," Larry Stewart said.  "These things would have already come to light if there had been any diseases, yet they took it upon themselves to put it out to the public nationwide 13 months after the fact."
The Arkansas Department of Health was notified eight days ago, but it needed the time to determine how best to inform patients and convey the low level of risk, according to state epidemiologist Dr. Dirk Haselow.
"We definitely believe that people needed to be notified," Haselow said.  "No one else in those facilities had sedation privileges, therefore no one else had access to those medications."

Civil trial begins for Dr. Brain Seastrunk - accused in child death. Dr. Seastrunk is blaming nurse, Cynthia Jones.

Civil trial begins for doc accused in child death

By Craig Kapitan

Updated 10:57 p.m., Thursday, September 20, 2012

Read more: http://www.mysanantonio.com/news/local_news/article/Civil-trial-begins-for-doc-accused-in-child-death-3882118.php#ixzz27R8SKe00

When 22-month-old Maddoux Cordova woke up from a routine outpatient dental procedure three years ago crying, thrashing and trying to remove his intravenous line, Dr. Brian Seastrunk approved two doses of morphine instead of Advil.

The anesthesiologist's decision, along with his failure to closely monitor the boy after the narcotic was administered, led to the child's death, attorneys for Cordova's parents told a civil court jury Thursday as testimony began in a malpractice trial.

Seastrunk's attorneys have countered that the nurse who requested and administered the drug — and therefore the hospital that hired her — instead is to blame. The hospital also has been sued but is not a party in the trial.

“As a doctor, the rule is you don't expose your patient to needless risk,” plaintiff's attorney Beth Janicek said during an opening statement in 37th state District Court. “That's what they live by. It was needless to order such a powerful drug.”

Cordova was found not breathing by his grandmother the afternoon of Dec. 11, 2009, about five hours after he was discharged from Village Specialty Surgical Center, according to court documents. He was revived by emergency responders but was brain dead, and on the day after Christmas the decision was made to take him off life support.

MetLife, IMEP and the Raven Maria Blanco Foundation Working Together to Make Dental Offices Safer

Want to hear a real crock? …

By Jim Cross
PHOENIX -- An ABC News investigative report found some states require very little for dentists to be certified to administer sedatives to children and that 12 children have died nationally after being sedated by dentists.

Arizona dentists face some of the toughest standards in the nation. Kevin Earle is executive director of Arizona Dental Association and said if parents have fears make sure their dentist is board certified.

"If you go to a board-certified pediatric dentist you can be certain the individual has had proper training. Where the concern lies is with individuals who have not had that extensive training.

"The use of oral sedatives have become much more common in the past 10 years so if you have a general dentist who graduated more than 10 years ago, there is an obligation to have more extensive training before they proceed with using oral sedatives."

Earle said board-certified dentists are trained to deal with any emergency.

"There's a rigorous permitting process that includes having proper equipment on site in case there is an incident and having proper medication in case there's a reaction. The assistants are trained to react quickly in the case of an incident."

"We're lucky here in Arizona that those have been in place for more than 10 years."

Earle said to the best of his knowledge there has never been an incident involving the administering of oral sedation.

Jim Cross, Reporter

HIV, Hep A, B or Death.. no line not crossed in dentistry out of pure greed.

This blog has spent the last four years trying to drive home the fact that dentistry in the 21st Century is based on greed with little sign of healthcare considered before treatment.  (no, not everyone) but it is becoming the norm. So much so that madness as reported here has become acceptable.  The ADA and most of its members has remained silent.  This is yet another black mark on what was once a noble profession.

There are over 1100 blog posts here about the corners that are being cut and those who are cutting them.  Yet, today I continue to have to report crap like this!  Why? Why does everything lead back to Colorado? This time, Stein's Oral and Facial Surgery and Dr. Stephen Stein.

July 12, 2012
DENVER -- Patients of a Highlands Ranch and Cherry Creek dentist were advised Thursday to be tested for HIV, hepatitis B and/or hepatitis C.

CALL7 Investigator John Ferrugia began asking questions of the state health department early Thursday and the department made its investigation public Thursday afternoon.

The Colorado Department of Public Health and Environment issued the advisory urging anyone who was a patient of Dr. Stephen Stein, who practiced oral surgery at his practice in Highlands Ranch and Cherry Creek, may have been exposed if they received intravenous medications, including sedation, under Stein’s care between September 1999 through June 2011.

The health department said patients may be at risk if they were seen by Stein during the 12-year period and at these locations:

- September 1999 to June 2011 at Stein Oral and Facial Surgery, 8671 S. Quebec St., #230, Highlands Ranch, Colo. 80130

- August 2010 to June 2011 at Stein Oral and Facial Surgery, 3737 E.1st Ave., Suite B, Denver, Colo., 80206. Patients were also seen at this location by Stein under another name, New Image Dental Implant Center.

The health department said there have been no specific infections linked to these offices, so far.

Investigation Found That Injection Needles Were Reused

The department began its investigation following a report of unsafe injection practices. Upon investigation, it was determined syringes and needles used to inject medications through patients’ IV lines were saved and used again to inject medications through other patients’ IV lines. This practice has been shown to transmit infections.

The investigation continues. State health officials are working with health officials at Tri-County Health Department and Denver Public Health due to the locations of Stein’s practices in those counties.

Practice Closed, Stein Not Practicing

Stein Oral and Facial Surgery is closed. Stein entered into an Interim Cessation of Practice Agreement with the Colorado State Board of Dental Examiners at the Department of Regulatory Agencies on June 24, 2011, and currently is not practicing.

In the original action from 2011, the state found “the public health, safety or welfare imperatively requires emergency action.” Because of privacy issues, the state won’t release details about the complaint to Call7.

Maulid Miskell, DORA Program Director, says that the agency continued to investigate Stein’s practice. In April 2012, the agency notified Colorado Public Health about the Stein possibly reusing needles on patients.

"It’s related but unrelated. It’s hard to talk about. I can’t go into detail, but the information provided to them, as soon as we found out about that information, it was timely reported to them," Miskell said.

Under this agreement, Stein can hold a dentistry license, but he cannot practice because no final action has been taken in the 2011 complaint.

The Highlands Ranch office was purchased by another oral surgeon in September 2011. State health officials have determined that the reuse of needles and syringes on multiple patients in Dr. Stein’s offices did not continue past June 2011.

8,000 Letters Sent Out To Former Patients

CALL7 Investigator John Ferrugia reported that 8,000 letters have been sent out to former patients of Dr. Stein. The letters should be received within the next few days, the health department said.

However, records may be incomplete, so any patients who remember receiving IV medications, including sedation, at one of Stein’s offices between the dates listed contact their health care provider to be tested as a precaution.

Patients who are uncertain if they received IV medications should also be tested.

Patients who did not receive IV medications do not need to be tested. Members of the public can call 1-877-462-2911 or visit http://www.cdphe.state.co.us/ for more information.

People infected with viruses such as HIV, hepatitis B and hepatitis C may not have symptoms for many years, so it is possible patients might have been infected and not know it. Even though patients who may have been exposed may not feel ill or remember getting sick, they should get tested. Although testing cannot determine where or how someone was infected (at Stein’s offices or from another exposure), it is important to know so treatment can begin.

Health providers who test Stein’s former patients are being asked to report any tests positive for HIV, hepatitis B or hepatitis C to their county health department or the state health department and to specify the patient was tested as a result of unsafe injection practices at Stein Oral and Facial Surgery. HIV, hepatitis B and hepatitis C are reportable conditions in Colorado, meaning they must be reported to public health authorities.

Former Patient "Angry," Felt "Instant Denial"

Shannon Stamey saw Stein for a dental implant in 2008. She found out about the potential health scare when she read it first on the 7NEWS Facebook page.

"I got on Facebook and saw on 7NEWS that Dr. Stephen Stein's patients should be tested for HIV and Hepatitis," said Stamey. "I immediately, actually, began shaking. I was with my young son. I talked with my husband on the phone. But definitely, instant denial."

Stamey has a weakened immune system and because she receives blood transfusions every three weeks, she already gets tested for HIV and Hepatitis.

"They just tested me in May and said I'm in the clear, most likely, because this was four years ago," said Stamey. "I'm just very angry for everyone else who has to go through this. I definitely can't imagine waiting to go into a doctor's office and get tested and waiting for those results. That would be very stressful."

She also doesn't understand how this could have been going on for 12 years with no one coming forward.

"How could people working in the office not say anything? And I just don't understand why. I mean, I don't know if it was a money thing? I don't think syringes cost that much," said Stamey. "I don't really understand how someone could do that or why you would do that and why no one would speak up for 12 years."

More Info: http://www.cdphe.state.co.us/dc/Epidemiology/dentistFAQs.pdf or call 1-877-462-2911.

ABC News - Death, Greed at the Dentist: American Children at Risk

By MEGAN CHUCHMACH (@megcourtney) and BRIAN ROSS (@brianross)

July 12, 2012

Death, Greed at the Dentist: American Children at Risk

American children are being put at risk by inadequately trained dentists who often seek to enhance profits by sedating their young patients for even routine tooth cleaning and cavity treatments, an ABC News investigation has found.

In many cases, even well-trained dentists have been unable or ill-equipped to handle emergencies with young patients.

More than a dozen children have died after being sedated by dentists, according to the Raven Maria Blanco Foundation, which seeks to alert parents to the potential dangers of the increasingly widespread use of oral sedatives on patients as young as 18-months old.

Dr. Jian-Fu Zhu, loose cannon!

Someone needs to stop this dentist before he kills someone. Other’s have come forward with similar stories, none willing to speak out of course.

Detroit Free Press - Ashton's story: Michigan Child Nearly Dies

26  Comments

Ashton Adler is the subject of "Ashton's story: Michigan Child Nearly Dies," in which his mother describes complications he had with dental sedation. / Photos by JARRAD HENDERSON/Detroit Free Press

 

Rebekah and Jason Adler and their sons Gabe, 5, and Ashton, 7, at their Royal Oak home.

The case of a 6-year-old Royal Oak boy whose family charges he was unresponsive for nearly six unsettling hours after a dental sedation procedure last year is under investigation by Michigan health care regulators.

The allegations by the family of Ashton Adler, now 7, involves one of Michigan's few known cases involving a child experiencing complications from dental sedation. The incident is the subject of a new video by a national nonprofit organization that monitors deaths and serious complications of children undergoing such procedures.

"Ashton's story: Michigan Child Nearly Dies," is a video interview with Rebekah Adler, the mother of the boy interviewed by the Raven Maria Blanco Foundation. The Virginia-based foundation, which has tracked 45 pediatric sedation deaths around the country, recently led its website with the Adlers' story to show parents and caregivers to "trust their instincts" and "walk away" if they question sedation procedures, Executive Director Nicole Cunha said.

The Adlers contacted the foundation after reading a February report in the Free Press on controversies over state regulation of dental sedation. The article described the national controversy over pediatric sedation deaths and regulatory measures under debate by Michigan and other states to increase training and safety in the field.

Michigan has had no known sedation deaths, according to a spokesman for the Michigan Dental Association. And there have been very few complaints involving sedation dentistry practices, said Rae Ramsdell, chief of the Bureau of Health Professions with the Michigan Department of Licensing and Regulatory Affairs.

The foundation's video does not name the dentist, but the couple's complaint to Michigan regulators lists him as Troy pediatric dentist Dr. Jian-Fu Zhu. The complaint, which the Alders filed June 8, 2011, with Michigan's licensing department, is under investigation, Ramsdell said. No formal charges have been filed.

Zhu declined to comment. He referred a call from the Free Press to Lynda Farnen, a Roseville attorney.

"We're involved in an ongoing investigation," she said. "Under those circumstances, there's very little I'm going to say. Dr. Zhu believes that all the care and treatment he rendered was appropriate and within the standard of care." She declined to answer other questions.

The state website lists no violations on Zhu's record.

Credentials seemed fine

The Adlers say a brochure they picked up in his office on the day of the visit gave them confidence they made the right choice.

Zhu also came on good recommendations from their family dentist, the Adlers said.

The brochure identified Zhu as a board-certified pediatric dentist and clinical assistant professor of pediatrics at the Wayne State University School of Medicine, as well as a previous co-director of the pediatric residency program at Children's Hospital of Michigan in Detroit.

WSU medical school records show that Zhu has not worked there since 2005.

He left Children's Hospital several years ago, a spokeswoman said.

He remains a board-certified dentist, a credential that indicates he passed a tough national exam.

Pediatric dentists undergo at least one month of hospital or office training with an oral surgeon or dental anesthesiologist that allows them to perform light or moderate sedation techniques -- drugs that help people rest during a procedure but that allow them to respond to voice commands easily.

In their complaint to the state, the Adlers say they were told to give two different sedation drugs to their son, a skinny 47-pounder at the time, before undergoing a root canal and five fillings.

The Adlers claim that:

• They were left to give the drugs to their son on their own. When Zhu returned and found Ashton apparently had spit out some of the medicine, Zhu gave them a third cup of medicine to give to their son and then left them alone again. The Adlers say they don't know which medicine and how much of it was in the third cup, requiring emergency room doctors at Beaumont Hospital in Royal Oak to monitor Ashton for more than four hours to observe his breathing and vital signs because he was so listless when they arrived.

• Their son was unmonitored for long stretches throughout the dental visit and was sent home asleep. A staffer for Zhu told them, "We can't be with our patients from start to finish of a sedation process," Rebekah Adler said.

• Zhu didn't awaken the boy before sending him home, did not check his vital signs and gave the parents no reason to think there was a problem.

The allegations, if true, would violate standards of the American Dental Association and the American Society of Pediatric Dentistry, of which Zhu is a member.

The guidelines require "no administration of sedating medication without the safety net of medical supervision." They also say that children must recover to pre-sedation levels of consciousness before discharge; that dentists must document the name and dosages of medications given, and if children receive different sedative drugs simultaneously, they might need more monitoring before discharge. The guidelines say a child should be able to remain awake for "at least 20 minutes when placed in a quiet environment."

Before Jason Adler left Zhu's office the day of the visit, he said he asked for his son's X-rays and medical records. He received only a bill, marked "statement for services rendered." Scribbled on it were references to two sedative drugs: "hydroxyzine 50 milligrams and chloral hydrate 1,700 milligrams."

The statement did not mention that Ashton also received laughing gas, or nitrous oxide, the Adlers say.

Dr. Norbert Kaminski, a Roseville dental anesthesiologist and president of the Michigan Dental Society of Anesthesiology, said the dosages exceed guidelines from the federal Food and Drug Administration and standard reference manuals for dentists, such as the "Drug Information Handbook for Dentistry" from Delta Dental and LexiComp's Dental Reference Library.

Kaminski computed dosages for the boy and said Ashton was given five times the dose of hydroxyzine and two to three times the dose of chloral hydrate, and that even lower doses are recommended when the drugs are used together. Combined with the laughing gas, Ashton was pushed into a level of sedation that Zhu, as a pediatric dentist, was not licensed to perform, Kaminski said.

Kaminski has campaigned statewide to toughen Michigan's sedation regulations.

Michigan is one of only two states that do not require permits for dental professionals performing sedation, Kaminski said. Permits help consumers readily identify what level of sedation a dental practitioner can offer, Kaminski said.

The state Board of Dentistry is reviewing whether to toughen standards in the field. So far it has balked at requiring permits, which would tell consumers whether a dentist has the right training to do either awake sedation or deeper sedation. The board had planned to take up the changes at its April meeting but postponed the discussion, possibly until its next meeting June 14.

'I just want justice'

The Adlers say more parents, even people like them who are familiar with sedation, need to ask more questions before and during a visit. The couple has watched a younger child with a brain injury undergo sedation for brain tests. But now they have to relive their fears -- something will go wrong every time he has another sedation procedure, Rebekah Adler said.

"I just want justice," she said. "I want the people of Michigan to know this can happen to them."

Contact Patricia Anstett: 313-222-5021 or panstett@freepress.com

More Details: Questions parents should ask before pediatric dental sedation

• How much training have you had?

• How do you monitor children to see whether they stay properly sedated?

• Does the office have rescue equipment in the room where the procedure is done, and how often does the staff practice using it?

• How long do you monitor a child before discharge?

• Will I receive a pretreatment report describing what is being done and what drugs will be used in the procedure?

By Patricia Anstett
Detroit Free Press Medical Writer

How prepared is your dentist?

How prepared is your dentist?

One local family's mission to keep children safe

How prepared is your dentist?: wavy.com

 

Updated: Monday, 14 May 2012, 6:30 PM EDT
Published : Monday, 14 May 2012, 4:49 PM EDT

• David Culver

CHESAPEAKE, Va. (WAVY) - A trip to the dentist can evoke pain, anxiety or fear. Those feelings generally subside once your appointment is over. But for one Chesapeake family the pain will never end. It's been five years since their traumatic visit.

Today, they want to challenge parents; they want them to question their child's dentist.

On March 9, 2007, the Blanco family took their 8-year-old daughter Raven in for a simple procedure. She would be sedated, worked on, then awakened from her sleep.

But Raven never woke up.

Raven's father, Mario Blanco, often visits Norfolk's Forest Lawn Cemetery ; that's where Raven is buried. He brings a chair and sits a few steps from her headstone. It's time alone with his eldest daughter. He opens up to her.

"I don't hear her talk back, but I feel her presence," Mario said.

There is a picture of her at the burial site and Mario meditates on her sweet smile. The same smile still fills the Blanco's Chesapeake home. There are family pictures in every room.

Raven's mother, Robin Blanco, still finds her young daughter's death hard to accept.

"For me, the longer the time goes by, you learn to cope with it. But the longer the time goes by, I miss her more," Robin said, her voice cracking.

Raven was sedated for a routine dental procedure. While getting the work done, complications arose and her heart stopped. Robin watched as staff members performed CPR on her little girl. Crews rushed the child from the dental office to the hospital emergency room.

"I remember a doctor coming out and telling... you know, that they've done all that they can do," Robin continued tearfully. "And did I want to see her - you know I just couldn't believe it. And I said, 'Yes I want to see her. I want to see her.' I just couldn't believe it. And she was gone."

In Raven’s memory, the family started The Raven Maria Blanco Foundation, Inc. They follow and share the stories of other children who’ve died following complications at the dentist.

By their count, 11 have lost their lives in the past year.

Today they're on a mission to educate parents and they want dentists to be prepared. Raven's cousin, Nicole Cunha, is spearheading those efforts.

"People have to go to the dentist, people have to have these things done, there are children with anxiety that have to be sedated, they have to have the work done on them, so no you can't take that away, you have to know what to do if something goes wrong," Cunha said.

Virginia Beach Oral Surgeon Dr. Scott Goodove puts into practice what Raven’s foundation wants in every dental office. He told us, "If we have an emergency, our assistants are prepared. They have stations to take if we have an emergency from the back to the front."

Each morning he holds a staff meeting and goes through the patient list. They discuss any medical complications that could arise.

Dr. Goodove sedates hundreds of patients each year. That's far more than a general dentist. But he points out that oral surgeons also undergo years of specialty training. His advice for any dental office, whether they sedate or not, be ready for a worst-case scenario.

"What we have here is sort of a more organized central emergency station.... (Our) patients walk in, they feel comfortable, 'Hey ... these guys are prepared.'"

In a corner of his office he has an automated external defibrillator (AED), a tank of oxygen, a range of medications and drugs. There's also an emergency response guide.

CLICK HERE FOR THE RAVEN MARIA BLANCO FOUNDATION'S SIX LINKS OF SURVIVAL

"It's as simple as picking the emergency - someone passes out - and it will give you the step-by-step guide. But you don't want someone reading this for the first time during the emergency itself, so you run through these drills."

And Dr. Goodove holds mock drills every month. For general dentists, not doing deep sedation procedures Virginia dental regulations don’t go nearly that far. That’s where the Blanco’s want the public to help.

"If we get a group of the whole country coming together, and demanding these things, you'll see a big change," Mario said. Mario eventually wants to see these preparedness practices become law - Raven’s law - as he sees it.

Meantime, much of his time is spent sitting across from Raven burial site, as they keep each other company. Her epitaph reads: "'The most beautiful girl in the world a beloved daughter and sister who is missed and loved so much. One day we will all be together again....' And we will."

Raven's parents want you to ask certain questions before you make a dentist appointment for your child. Click here for a list of those six questions.

Click here to watch the portion of our interview in which the Blanco's discuss taking their other children to the dentist for the first time, following Raven's death.

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After this story aired, I received the following:

 

Kimberly Asercion

Hello,
After going to the link that showed all the children that had lost their lives due to "complications" at the dental office, I felt like I just needed to tell someone briefly what I have experienced as someone "in the field". I live in Va. Beach and was a dental assistant for almost thirteen years. (I left the field in 2004 after working in an adult practice, and since that time I actually work in the cemetery industry as a General Manager at a cemetery in Va. Beach) I worked five of my thirteen years in a pediatric office. (Drs Sundin and Bullock) and about two months after that at Drs Hechtkopf and Cox. (1998) I did not work long at the last office because the unsafe practices that they undertook actually scared me.

When a child had to have a lengthy procedure they were given Chloral Hydrate for the procedure as well as Nitrous Oxide. (and Lidocaine of course) The dental assistant would come out to the waiting room and get their patient and bring them back. Then the assistant would mix the Chloral Hydrate based on the dose prescribed by the Dr. and give it to the child. Within about ten minutes the children would literally just start getting drowsy and then basically pass out. We would then have to hold them until it was time for them to have their work done...if the office was busy that day then sometimes that could be up to 45 minutes. During that time (and this happened A LOT) the children would begin vomiting...while unconscious and we would have to try to hold them upright while this was happening.

When the procedure would start, the child (who was already completely unconscious) was given Nitrous. It was jacked up way over the necessary level (about 70%) and to the point that it would induce nausea and vomiting even in an adult...but especially on a child that was already sedated. While the child was being worked on (with the papoose board) they had a heart monitor on...when their heartbeat would start to increase the Dr. would say, "Okay...get ready...here we go!" (Because the heart rate would increase when they were getting ready to vomit.) They would not reduce the Nitrous strength and we would just have to keep suctioning as they were getting sick.

After the procedure was finished, they would turn on the straight oxygen and start to try to wake the child up. They would still be very groggy when we would carry them back out to their parents, however we were not allowed to tell them that their little child had just spent the last two hours vomiting while unconscious. We did give them precautions for them to eat lightly and to watch them while their mouth was still numb so that they wouldn't bite the inside of their mouth, etc. They never had any idea what had happened back in the office though. That is the part that was so upsetting to me.

I happened to be CPR certified, however this was not a requirement for the job. I was never asked before I was hired if I was. That I know of, none of the assistants were ever shown emergency procedures. I know I was not. This happened on an almost every day basis. Now, when I started the job, I did have eight years of experience and five of those had been in a pediatric office...however the requirements to get a job in Dr. Hechtkopf and Cox's office were very minimal.

I am saddened to hear these stories...I can very easily see how these tragedies could take place. The dentist most of the time very heavily relied on their assistant to have already checked the child's health history without every looking at it themselves. (This was the story in every office I worked at unfortunately.)
I'm truly sorry that this happened and I hope that you sharing these stories will help to regulate the requirements of dentists and their assistants in the future. I just felt like I needed to tell what it was like behind the scenes because I can easily see how this could have happened.
Sincerely,
Kim

WAVY TV to air “Deadly Dangers at the Dentist Office”–May 14, 2012

David Culver of WAVY 10 TV reports on the deadly dangers at the dentist office. Full piece to air on Monday, May 14, 2012 starting at 5:00 PM. Please watch and share.

CBS Atlanta Exclusive - Three Georgia boys die unexpectedly after dental procedure

ATLANTA (CBS ATLANTA) -

CBS Atlanta News is breaking an exclusive investigation into what caused three Georgia boys to lose their lives following what should have been routine medical procedures.

All three boys, ages 14 to 21, died within a month of each other in a string of tragic and bizarre deaths. They all had their wisdom teeth extracted 16 to 72 hours before they died.

"You take your kids to doctors and dentists, and you don't expect this. You don't expect to lose them," said Bobbie Ellis, the father of Ben Ellis, one of the victims.

The grieving families are speaking out for the first time, only to CBS Atlanta Chief Investigative Reporter Wendy Saltzman.  They're sharing their emotional stories as a warning to other parents.

"He was the baby, I miss him terribly," Karan Ellis said about the loss of Ben.

The pain is still extremely raw for the Bobbie and Karan Ellis and the other families, who all lost their sons just four months ago.

"A family should be informed that there is a possibility that your child may not wake up," Lisa Robinson said.

The Robinsons and the Ellis family agreed to speak with CBS Atlanta News to warn others of the dangers they say they were never told about.

"You don't want to go through what we've went through. There are too many kids dying out there. Something needs to be done," Bobbie Ellis said.

The Ellis' son was just 14 years old when they say their oral surgeon recommended that he have all four of his wisdom teeth removed.

"That's my baby, and his beautiful smile" Karan Ellis said.  "That's all I've got now is his pictures."

"We have pictures, but we don't have our son," Bobbie Ellis cried.

Ben's wisdom teeth were removed on Dec. 7, 2011.

Scary–On the one year anniversary of Jenny Olenick’s death, anesthesia dentistry is on the rise.

On the one year anniversary of Jenny Olenick’s death, Medscape posted, what I refer to as “Anesthesia Media Blitz II”. Since early March, the AAPD and other associations have released various press releases promoting putting children to sleep to perform dental procedures. The Medscape article is the second round. Medscape could have posted a story on the hazards of such practices, but didn’t. I’m not saying it was on purposely, however, I’ve learned seldom are stories published without reason.

Visit msnbc.com for breaking news, world news, and news about the economy

   

MedScape

April 6, 2012 — Pediatric dentists cannot find enough dentist anesthesiologists to meet the needs of their patients, according to a survey of pediatric dentists published in the spring 2012 issue of Anesthesia Progress.

The survey responses differed somewhat by region, sex, and years in the specialty, with 20% to 40% of participants saying they currently use a dental anesthesiologist and 60% to 70% saying they would use one if one were available.

The demand for dentist anesthesiologists has been increasing in recent years in pediatric dentistry, according to a separate survey of dental anesthesiology program directors published in the same journal.

"The trend in the past has been that many dentists provided [both] anesthesia and dental care," coauthor James Jones, DDS, chair of pediatric dentistry at Indiana University in Indianapolis, told Medscape Medical News.

Now, many pediatric dentists would prefer to concentrate on the dentistry while someone else focuses on anesthesia, he said. "We're realizing that it's a safety issue."

Dr. Jones said researchers at the university had become aware of the need for anesthesia in their patients because they provide service to a lot of low-income patients who need extensive dental work of the type that often requires general anesthesia.

To see what other pedodontists were experiencing, they sent out emails to all 2586 active board-certified pediatric dentists who are members of the American Academy of Pediatric Dentistry and who made their email addresses available, asking them to participate in an online survey.

The messages bounced back from 659 of these, leaving 1927, of whom 494 completed the survey.

Participants disclosed their sex, age, years in practice, region, number of years as a diplomate of the American Board of Pediatric Dentistry, use of in-office sedation, and use of intravenous (IV) sedation. They also commented on their use of a dentist anesthesiologist.

The respondents differed in their use of anesthesiology by demographics. Thirty-nine percent of women answered "yes" to the question, "Do you use the services of a dentist anesthesiologist?" compared with 23% of men, which is a statistically significant difference (P < .01).

Only 12% of those in practice for longer than 21 years used IV sedation in their office, and only 25% of this group used dentist anesthesiologists (P < .01). Although only 53% of this group answered "yes" to the question, "Would you use the services of a dentist anesthesiologist, if available?" this percentage was not statistically significant compared with dentists who have been in practice for fewer years.

In contrast, 30% of those in practice for 5 years or fewer used in-office IV sedation, 38% used dentist anesthesiologists, and 74% would use dentist anesthesiologists if they could (P < .01).

Group practices were least likely to administer in-office sedation; solo practices were the most likely.

Practices in the Southwest were most likely to use in-office sedation. Westerners were most likely to administer in-office IV, employ dentist anesthesiologists, and use dentist anesthesiologists if they could.

Dental Anesthesiologists Address Many Needs

Dr. Jones said the finding points to a need for more training programs for dentist anesthesiologists. "I think the demand is going to increase over time," he said.

He pointed out that bringing an anesthesiologist into the office is half as expensive as taking the patient to a hospital or day-surgery center for anesthesia.

American Academy of Pediatric Dentistry Spokesman John Liu, DDS, agreed, noting that hospitals and surgery centers charge for the use of their facilities.

Dr. Liu, a clinical assistant professor of dentistry at the University of Washington in Seattle, told Medscape Medical News that pediatric dentists are in greater need of help from dentist anesthesiologists for several reasons.

First, more children are being diagnosed with behavior-related conditions such as autism and attention deficit disorder, he said.

Second, fewer parents are comfortable with having their children physically restrained through frightening and sometimes painful treatments. "The reality is that it's not an easy thing to sit through something like that," Dr. Liu, who has a private practice in Issaquah, Washington, told Medscape Medical News.

Dr. Liu also said that some state dental boards prohibit dentists from providing general anesthesia or deep sedation, even if they have completed residency programs in anesthesiology, and he thinks these regulations should be changed.

"I find it tremendously helpful to have a dental anesthesiologist, as opposed to an MD anesthesiologist, because he knows exactly what I'm doing and when I'm going to be done," said Dr. Liu. "I have used a dental anesthesiologist for more than 20 years, and I don't know how anybody manages without one."

Dr. Liu and Dr. Jones have disclosed no relevant financial relationships.

Anesth Prog. 2012;59:12-17. Full text

Another “sedation propaganda” piece for the American consumer.

My questions, who is pushing these stories.  A hospital?  Some association or organization? Someone is, you can bet on that.  Only common thread between this one and the one last week in the NYT is – Janine Costantini.  If I had time tonight, I’d rip this thing from stem to stern…  Grrrr

Tiny Mouths Found Filled With Rotting Teeth - Staying Healthy News Story - KMGH Denver

AURORA, Colo. -- The operating rooms at Children's Hospital Colorado are packed with preschool kids needing dental procedures.

"We're booked five months out in the OR, and that's three days a week, two rooms a day. And it just keep increasing," said Janine Costantini, ambulatory practice director at Children’s Hospital Colorado. "The more we do the more we need."

The hospital staff is seeing more tiny mouths riddled with big dental problems.

“There were over 3,000 OR visits last year just for pediatric dentistry,” said Costantini.

7NEWS was there when a 4-year old boy went under anesthesia for treatment.

“Out of 20 baby teeth we’re treating 16,” said Children’s Hospital Colorado Pediatric Dentist, Mark Koch.

The pediatric dentistry team at Children's Hospital Colorado mapped out the boy's treatment including extractions, baby root canals and crowns.

“His mouth is in very bad shape. This is not unusual. This is the fourth case today, in this room,” said Pediatric dentist, Mark Koch.

The boy ended up on the operating table for treatment nine months after pediatric dentistry staff recommended treatment.

“It is a very safe and comfortable treatment, but it is very expensive. That is the problem," said Ulrich Klein, DMD, DDS, MS Chair of the Pediatric Dentistry program at Children's Hospital Colorado.

The average cost of treatment is $3,000.

Virginia Regulatory Town Hall–Board of Dentistry is holding an open meeting today concerning a rule change requiring training in the 6 Links to Survival

March 9, 2012
Virginia Regulatory Town Hall website

First I want to say that I understand “good” reasons when someone opposes something. There are always two sides and views to everything. It’s the lame and idiotic excuses that gall me to no end.

Today is the 5 year anniversary of Raven Maria Blanco’s death. Raven died because a dental office was not prepared for a medical emergency. 19 children have died in the last five years from ill-prepared dentists and staff, when 6 common sense steps could have made the difference.

Comments from the public closed on February 19, 2012.  Below is a sample of those who sent comments opposing the rule change. 

These are copied and pasted as they were posted on the regulatory agency website. My comments are in [italics and brackets]

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Those OPPOSED

Commenter: Watchdog for Coalitions Against The Dental Profession (CADP)

Be Cautious! Don't be Fooled, Don't play into the empathy game!

This Raven Blanco Foundation may be a plublicity stunt to raise funds, that support their self created non profit slary jobs. Everything about their web site is very exploitive. They list no financial discloures, no board of directors/advisors. They are certainly following the guide for creating an issue that will bring them money and influence, and as they say power. And like all these nonprofits, they appeal to ones suffering to gain support.  They can be dangerous, just like all of our local dental nonprofits, run by non dentist, unlisenced advocates if you will, who want to be policy makers over dental matters of which they are trully ignorant. I would question the credibility and intentions of this group. Leave the emotional baggage out of any descision making. Dont treat victims as equals, they are not!

[ Apparently the group has problems with “unlicensed” citizens advocating for change in events that directly affect them. This is confusing to me. Who else would advocate for change? Those unaffected?  Financial “disclosures” are available online and Mr. Blanco, President and his Executive Director who puts in about 50 hours a week draw ZERO dollars from the foundation!  ZERO!  Rather, Mr. Blanco gave a large some to the foundation! Yes, I would question the intention of this group as well, since you will be amazed at what you find. You’ll also find out what wonderful people they are and how much they help other parents whose children are killed by ill-prepared dentists who are sedating children. They assist with emotional support, and financial support.  Helping families with funeral expenses or organize fundraising.They travel to every dental convention they possible can and promote safety in sedation dentistry. How can anyone be faulted for promoting safe sedation of children? The spokesperson for this group sounds as though they know the Blanco’s, are locals and have an ax to grind.]

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Commenter: Dr. E. Thomas Elstner, Jr.

Training for medical emergencies

There should be provisions for practitioners who do not administer local anesthetics in their office setting.  Currently there is no ACLS focusing on the dental setting.

[if this person is referring to Advanced Cardiac Life Support (ACLS), then with 8 deaths in the last 12 months, maybe ACLS should be focused on the dental setting.  Think?]

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Commenter: Dr. Paul W. Callahan

Another costly regulation that does nothing to help public welfare

It is the responsibility of ALL Virginia Regulatory Boards to protect the public.  Any death is is one too many, but statistically it is probably safer to go to the dentist that cross the street.   These proposed regulations are already the Standard of Care in most offices.  A regulation such as this would cost hundreds of thusands of dollars for most practicioners to follow; meaning the time spent documenting training, paying for training for a large staff when not everyone needs to be trained at the same level, etc.  So who pays for all this unnecessary documentation and training?   The average Virginia resident in the form of increased dental fees.   Is this what we want for our patients?

[This is just a wild guess, but I doubt your patients would mind a slight increase in your fee to know you were prepared to save their life if an emergency arose.]

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Guardian Angel "Raven's Song" has gone viral

The song was produced in honor of Raven Maria Blanco who died because of an ill-prepared dentist and staff sedating children in his office – Dr. Michael Hechtkopf.

The five year anniversary of Raven's death is Friday, March 9th 2012. The video has received nearly 400,000 hits in the last few days.  You can purchase the song on itunes.  Proceeds go to purchase AED's-Automatic External Defibrillators which are donated to dental offices across the county. Put there to save a child!  Please consider purchasing Raven's Song.

This week major news outlets have all but promoted sedation dentistry for children. Not a word was mentioned about the 19 deaths of children due to sedation complications that has taken place since Raven’s death 5 years ago.