YUMA, AZ - An Arizona family is left confused, devastated and looking for answers about just what happened during a young boy's dental appointment.
The family of Zion Jay Gastelum said the 2-year-old died after a dentist appointment in Yuma last month. Zion's uncle told ABC15 the child's parents took him to Kool Smiles Dentist on December 16 for a crown and filling, and somehow either during or after the process, it appears Zion stopped breathing.
According to family, Zion was transported to Yuma Regional Medical Center and then flown to Maricopa County, where he died several days later.
The family of the 14-month-old girl who died after a visit to the dentist has filed a wrongful-death lawsuit against Austin Children's Dentistry.
The toddler died while under anesthesia for multiple baby root canals and crowns on four of her teeth.
Her parents believe it was part of a Medicaid scam and are suing the dentist and the anesthesiologist who worked on her. The cause of death of Daisy Lynn Torres, who died on March 29, 2016, was determined to be the result of anesthesia administered for the treatment of tooth decay, according to the Medical Examiner's Office.
"We haven't heard much, so we are kind of just taking action here, getting some answers so we can get some justice going on," said Elizandro Torres, Daisy Lynn's father. "We want this to be heard so that it doesn't happen again." …
…The lawsuit claims the girl's death was part of a corporate scheme to bill Medicaid for unnecessary dental procedures. Her parents are now suing for $1 million. Their attorney, Sean Breen, told us Tuesday night they hope this lawsuit will protect other children from the dangers of pediatric predators and their money-making schemes.
"A big component of people that use Medicaid happens to be people who are low income and sometimes not as formally educated as others and they make for very good targets because they are trusting," said Breen, with Howry Breen & Herman.
Breen says other families have come forward saying their children were also underwent unnecessary dental work at Austin Children's Dentistry…
Dr. Melanson was the fake owner dentist for non-dentist Brian Lynne Walker who owns North End Healthcare, LLC. North End owns and operates 3 ambulatory surgery centers (ASC): Houston Children’s Dental Center, San Antonio Children’s Surgical, and DFW Children’s Surgery Center. All designed exclusively for sedation dental procedures. In fact the website of these clinics list their “privileged” providers and they are only dentists, oral surgeons and endodontists. April 29, 2016, exactly 30 days of the death of Daisy Torres, North End Healthcare began to change its name to Blue Cloud Pediatric Surgery Centers and scrub Dr. Michael Melanson’s name from their website;, replacing Melanson with Dr. Ketan Sukkawala as “owner”.
Being Melanson works for a group that owns surgery centers one must wonder why he didn’t use one of those facilities. Or at the very least understand the need to sedate babies somewhere other than his office!
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
Dr. Michael W. Davis maintains a general dental practice in Santa Fe, NM. He serves as chairperson for Santa Fe District Dental Society Peer-Review. Dr. Davis also provides a fair amount of dental expert legal work for attorneys. He may be contacted via email: MWDavisDDS@comcast.net Economic Turf Wars over Dental Sedation and Public Safety
By: Michael W. Davis, DDS
Introduction
One can’t evaluate the different parties fighting over dental sedation privileges and the vast sums of money involved, without examination in the context of our toxic dental Medicaid program. Medicaid is a social safety net program jointly funded by the federal government and each individual state. However, administration of dental Medicaid is left to the particular state. Each state handles dental Medicaid very different with a complex variety of outcomes.
Florida
For example, the state of Florida refuses to authorize hospital-based sedation for dental Medicaid cases. Therefore, many of the most severe dental cases go untreated. Institutionalized patients for severe developmental disorders often go untreated. The potentials for ensuing major medical problems may go unaddressed, until the crisis stage for morbidity and mortality (illness and death).
As a result, numbers of Florida dental Medicaid providers deliver in-office sedation upon patients, who truly should only be seen in a hospital setting. Children, who have a much greater compromised airway than adults, are treated en masse with cocktails of different sedation medications, and in risky dose levels. In order to maximize dollar production under a flawed Medicaid fee schedule, these doctors are notorious for a dangerous lack of patient monitoring.
Authorities rarely deliver more than wrist-slap regulation upon these violators, as their removal from the Medicaid system could hasten the collapse of this broken government program. The poor and disadvantaged are left between a rock and a hard place. They can elect to eat a $hit sandwich or go hungry.
Other providers of Florida dental Medicaid pursue a different scheme. They simply place any “uncooperative” child in restraints (euphemistically called “protective stabilization”). Again because the dental Medicaid fee schedule is so abysmal, these doctors feel justified in maximization of dollar production regardless of a child’s stamina, understandings, and limited abilities. All treatment possible is completed in a single visit. In order not to overdose a child for local anesthesia (generically termed “Novocain”) for their diminutive body weight, these doctors frequently deliver inadequate anesthetic, which generates excruciating patient pain. However, with the child adequately restrained, dental services of extractions, steel crowns and pulpotomies (baby root canals) continue, regardless of a child’s discomfort. Obviously, many of these patients will be in need of extensive psychological counseling for posttraumatic stress. Unfortunately under our programs for the disadvantaged, it’s doubtful this brutal problem of which government bares great responsibility, will ever be addressed. Medicaid dentists too often choose between “juice ‘em (sedate) or papoose ’em (physical restraints)”.
Whistleblowers who step forward in Florida to expose these abuses to authorities are met with institutional roadblocks. These professionals with integrity are forced out of government service by superiors. The rationale is that if the crooks and abusers are severely disciplined and removed as Medicaid dental providers, there will be too few providers to keep the toxic program viable. Government enables the abuse of our most vulnerable citizens and assists in cheating taxpayers. http://media.news4jax.com/document_dev/2016/02/03/Dr.%20Mason_2048400_ver1.0.pdf
New Mexico
New Mexico (NM) allows for dental Medicaid hospitalization and sedation coverage, unlike Florida. On paper and in theory, Medicaid patients will be permitted access to hospital operating rooms and nurse anesthetists for necessary dental care. The reality is quite different. Further, the in-fighting between providers and hospitals is in anything but in the interests of patients.
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.
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.
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]
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.]
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?]
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.]
Web produced by Jennifer Matarese, Eyewitness News
IRVINGTON, N.J. (WABC) -- Two sets of parents are demanding a criminal investigation into the same dentist in New Jersey.
A child from both families suddenly died after routine visits to the dentist.
"He was my dream.. My future. The light of my life," said Jose Quiej, the patient's father.
Little Juan Quiej was just three years old and suffered cardiac arrest during a routine dental procedure. His mother watched helplessly as Juan slipped away.
"I started shaking and crying," Antonia Chajchalac-Garcia, the patient's mother said, "To this day, I don't know what happened or why."
She brought her son to Dental Health Associates in Irvington, New Jersey.
The procedure was conducted last week under local anesthesia by Patrick Bamgboye.
His dental license was suspended after a six-year-old patient died under somewhat similar circumstances in 2004.
"This is shocking, and they should have done something in the first place," said Farah Torres, the patient's mother.
Kyneicha Pagan had cerebral palsy and suffered a seizure.
But, his license was suspended for, "Failing to obtain an appropriate medical history, failing to adequately assess the patient's medical condition, and failing to ensure all emergency equipment was available."
Dr. Bamgboye, the board concluded, "Has engaged in repeated acts of negligence."
State regulations allowed the dentist to resume practicing under probation.
Joseph Ginarte is now representing both families.
The Raven Maria Blanco Foundation (RMBF)was established after 8 year old Raven Blanco died during sedation dentistry. The foundation is committed to educating parents and professional of the risks that lead to these deaths as well as safety measures that can easily be taken to reduce such risks. The Raven Maria Blanco Foundation travels as funds will allow to dental conventions across the nation where they set up their booth to promote safety and educated the dental community. They are not always met with open arms. Here is a public service announcement from 2010
Here are the names of 39 children who have died in recent years.
I met with Nicole, Raven’s cousin and Director of the RMBF, and Mario, Raven’s father, and have to say they are some of the loveliest people you will ever meet. They truly are committed to their cause. Sadly it has been falling on many a deaf ear, but that has not deterred them for one minute. They work tirelessly and are never to busy to help. I am proud to know such wonderful and selfless people.
The RMBF provides much needed support for parents who have suffered the pain of death of their child. They assist in raising money to help pay for funeral expenses, including traveling to fundraisers when time allows. Other times it’s putting these parents in contact with each other to help each other for support.
The RMBF has a facebook page at http://facebook.com/rmbfinc
RMBF, Inc. PO BOX 65581 Virginia Beach, VA 23467 1-757-449-3565
Currently, they RMBF is seeking dontation to assist the family of Jermaine Lee Harrison, Jr who died during a dental procedure in Stockton, California on November 11, 2011.
You can make a donation by clicking here. RMBF, INC. is a 501 (c) (3) non-profit organization.
.
Parents of a toddler who died in December after a dental procedure are suing the boy's anesthesiologist and a surgical center, claiming they gave him too much morphine in doses administered too closely together.
After Maddoux Cordova's teeth were capped at the Village Specialty Surgical Center on Dec. 11, Dr. Brian Seastrunk approved giving the 22-month-old two 0.5-milligram doses of morphine intravenously within 10 minutes — a time span that didn't permit medical staff to evaluate how the drug was affecting the patient, the medical malpractice lawsuit claims.
Maddoux stopped breathing at his grandmother's home after the procedure, became brain-dead, and spent two weeks at Wilford Hall Medical Center before he was taken off a ventilator.
“The total 1 milligram dose of morphine administered for pain relief was larger than the conventional recommended pediatric drug dosage range of 0.26 milligrams — 0.65 milligrams for this 13-kilogram patient,” said Dr. Sean Boynes, director of anesthesia research at the University of Pittsburgh, who provided an expert opinion as part of the lawsuit.
The suit was brought on behalf of the parents, Monica Meza and Adam Cordova. Alleged damages include monetary loss, loss of companionship and mental anguish.
Monetary damages are sought for medical and funeral expenses, pain, suffering and mental anguish, the lawsuit states. No dollar amount for damages is specified, in accordance with laws that govern medical malpractice cases.
James Veal, who represents Seastrunk, could not be reached for comment.
The center's spokeswoman, Misty Walton, said the facility has not been served.
“We are not aware of a lawsuit at this time,” Walton wrote in an e-mail. “Everyone associated with our surgery center was deeply saddened by the death of this child, and we continue to keep the family in our thoughts and prayers.”
The Texas Medical Board doesn't track medical malpractice cases but does discipline doctors of patients who died from overdoses or reactions to anesthesia or pain medication.
YUMA, AZ - An Arizona family is left confused, devastated and looking for answers about just what happened during a young boy's dental appointment. 
