Saturday, July 17, 2021

Young Child Dies While Sedated in Dentist Office

 A 3 year-old child died while under general sedation in a Kansas dentist office.  KSNW (Wichita, KS) reported: 


 Nancy Valenzuela, a mother of three from Scott City, said she took her son, Abiel Valenzuela Zapata, into Tiny Teeth Pediatrics Dentistry because he needed teeth pulled after a gum infection. She said she thought it would be a simple procedure....

Abiel, who was only a month away from turning 4, died Tuesday after being transported to a Wichita hospital.

Valenzuela said after visiting two dental offices in southwest Kansas, she was told her son needed some teeth removed. She said he was fine before he went into surgery. She said he cried when he had to get a shot, but she reassured him...

According to the report, the anesthesiologist said Abiel was doing fine for about 30 minutes under sedation. As the doctor was working on the boy’s lower jawline, the document said, his cheek swelled and his pulse slowed down.

CPR was started, and shortly afterward, the boy was taken to the hospital, where he later died....

 According to the report, the doctor said in his career, he had never seen anything like this, especially in someone without any known allergies. Valenzuela, who said she’d been asking the front desk for details, said she didn’t know the medical emergency at the office was for her son until he was brought out to the ambulance. ... Article.

Fox8 News provided some more crucial info: 

Although the police incident report listed the individual who administered IV medications for the sedation as an anesthesiologist, the website for the dental office does not list an anesthesiologist on staff. Instead it says “IV sedation at Tiny Teeth Pediatric Dentistry is administered by Special Anesthesia Services, a group of Nurse Anesthetists (CRNAs) who specialize in caring for patients needing sedation in the dental office setting. Your child’s sedation will be performed solely by the CRNA, and they will not perform any other component of the dental procedure.” The website also has a section explaining sedation procedures with children.

Cases such as this one are why there has been a fierce debate among dentists in Mississippi over the use of general anesthesia in the dentist office.  Several offices (usually corporate-owned) float so-called dental anesthesiologists from office to office as they fully sedate children for extractions and other treatments. The pediatric dentists advocate putting children either in a hospital, ambulatory setting, or in the office of an oral surgeon.  The Dental Board of Examiners tightened the regulation but the fight continues.  Opponents of sedating children in the dentist office will surely point to this case. .  


Anonymous said...

Did she sign a paper saying she would not hold the dentist accountable if something went wrong, i had too ,now the bastard is hiding behind it.

Anonymous said...

Sometimes a freak, tragic incident is just that.

Anonymous said...

You can't sign away you rights, 2:58. Just like you dumbasses who thought you could get your neighbors to sign a trampoline release. You might sign an arbitration (or similar) agreement, but not a 'hold harmless' agreement when a medical procedure is involved. Don't get your advice down to the gas station.

Anonymous said...

@ 2:58, why is the dentist "a bastard?" Why vilify a professional with zero evidence of negligence or wrongdoing?

Are you that sensitive about others' success?

I don't know what happened but I bet if negligence is involved there is a lawyer out there who will find a way to sue -- not that it would bring the child back to life.

While on the subject, the training process for CRNAs is, if anything, more selective than to be an MD. True, in many settings, CRNAs only work under supervision of an MD anesthesiologist. I believe in terms of raw numbers it is easier to get into med school than a CRNA program.

In other words, there are, arguably, more experienced RNs and RNPs applying to CRNA schools than med school applicants relative to available slots. And, if it matters, newly trained CRNA degrees are doctorates (DNAP).

Putting a person under general anesthesia, literally to the edge of death, and bringing them back to life is what CRNAs do every day. Like flying a jet fighter, or practicing law, or dentistry, it always looks easier and more foolproof than it is. Particularly, to folks with zero understanding of the process and little respect for education and training.

From experience said...

My heart goes out to this family. It is a terrible pain to lose a child. A pain that doesn't go away, you learn to live with it.

Anonymous said...

There is no such thing as signing a paper to hold harmless a physician. That would be as worthless as having neighbors sign a statement absolving you if their child is injured on your property (common with trampolines).

I'm no malpractice attorney but I play one at Buffalo Wild Wings.

Anonymous said...

Having lost a three year old grandson in an accident, prayers to the family. The tragedy of losing a child or grandchild is an enormous burden on those trying to navigate grief.

Anonymous said...

By the time the Internet and our enemies rewrite this story, it will be a liberal dentist who refused to see obvious signs and the popular assumption that policy should be made to cover all exceptions and mistakes, no matter how small, will be reinforced.

The debate among dentists should continue until sufficient data exists ( which should drive the debate and be the focus BEFORE the debate causes dentists to choose up sides).

There are human events/experiences that are so atypical and so far off the probabilities as NOT to drive changes in policies and certainly not laws.

I don't know where this falls. And neither does anyone else, but it's a great fear, increase distrust in the poplace piece.

Anonymous said...

I know some really goof-ball-ass nurse practitioners. Four come to mind. I'd hate think my doctors had an easier time getting their degrees than these clowns.

Anonymous said...

@4:34: read the post at 6:02, CRNA, not an RNP. Different. Selection process for available slots, not "easier time getting their degrees." Also different. Funny thing, different words mean different things. Being able to read and understand, even the big words, even subtle differences, even, dare I say, even abstractions.

Of course it doesn't matter, merely my opinion, but just saying. The fact of the business is, in this country, when you go in for a surgical procedure, almost always a CRNA is going to put you to sleep and wake you up again. Normally, in hospital settings, under supervision of an MD anesthesiologist, but not always. In dental offices almost never.

Historically, I believe, putting people to sleep for surgical procedures began as a nurse's duty.

No, I'm not a CRNA, but I do wonder about MD anesthesiologists. Essentially, they are "on call" while several CRNAs handle their cases. Supposedly, they are ready to hop in and save the the day if a problem develops. My last three general anesthesia procedures there was not an MD anesthesiologist in the building. Dental surgery, colonoscopy, hernia repair.

Anonymous said...

6:51, in total, counting both of us, I'm guessing my wife and I have had general anesthesia (put to sleep) at least fifteen times. Not once was there NOT a visit to the little curtained pre-surgery room by an MD Anesthesiologist who introduced himself, asked relevant questions and explained what he was going to do. Not once.

By the way, you don't know who the hell is 'in the building'. And you've never had general anesthesia in your regular dentist's chair. Also, by the way, it's harder and takes longer to get a BS than it does a masters in most fields.

And, there's a reason for the 'A' at the end of CRNA. Reckon?

Anonymous said...

544 Morgan & Morgan Thats who advised me

Anonymous said...

@9:02 You win, obviously your insurance will pay for stuff mine won't. And you got me/us beat by fifteen trips under general, but I guess we got you beat for good health (or, alternatively for not consenting to surgery). Of course, you may be lots older than I am. (76)

As for, "By the way, you don't know who the hell is 'in the building'." That is false. I knew exactly who was in the building and I didn't say anything about my "regular dentist's chair."

Good health to you!

Anonymous said...

@5 44 ,,,who the hell are you calling a dumbass.I suffer nerve damage from a quack dentist ,and NO he dosent work at a gas station. What the fuck does a trampoline have to do with any thing? I called Morgan And Morgan the person that i spoke with told me what i said,,,,, how about you go fuch yourself. Are you an attorney if not your giving advice without a licence.

Anonymous said...

Kingfish i made the comment That was posted 11:27 AM, Sorry for the language I don't like talking like that.
@6:02 with all that fancy talk< are you a dentist,I do have nerve damage quite severe i might add. If you're a dentist wheres your office? You can see for yourself.

Anonymous said...

As a pediatric anesthesiologist, there is quite the misinformation on this thread. CRNAs are great but they are not physicians, and i'm sorry but CRNA school is nowhere near the rigors, and educational challenge to medical school and a subsequent residency/fellowship (sensitive about others' success as you put it?). There is a reason physicians are in charge and give orders in a hospital and it is because we are trained to from day 1, never has the idea that I am following orders or am going to be an assistant crossed my mind--the buck stops with me and I face the consequences. You don't act like the captain of an airplane when you are the first-officer. I do believe some CRNAs need to practice independently in rural areas, simply cannot employ a physician anesthesiologist everywhere surgery is needed. It sounds like this child's airway was lost, the most common cause of bradycardic arrest is hypoxemia in a child. The details need to be uncovered, was he intubated and under general anesthesia or under sedation with nasal cannula. It is common for the cheek/tongue to swell during these cases and the child's mouth is propped open so the teeth may be worked on. And for all those comments about an anesthesiologist not being available in the hospital and a CRNA doing all your case, that is simply false. The number of changes I have to make to a CRNAs plan of care intraoperatively on a daily basis because harm is being done to a patient (without knowledge from the CRNA) is above 1. That means 1 or more patients would be suffer preventable harm every single day from an anesthesia provider if I wasn't watching from somewhere and intervening.

Heddy-Dale Matthias, MD said...

The children who die in dental offices with sedation or general anesthesia are almost always minority and/ or Medicaid patients. In this instance, there was NO MD anesthesiologist. These dentists have CRNAs give sedation only. I feel that many dental offices prey on the uninformed, especially minority patients. If you are concerned about sedation in a dental office, please ask questions!!! Why, who, under what circumstances? What are your safety requirements? Does you State Dental Board allow this? Couldn't it be done in an ambulatory surgical center or hospital with all the safeguards required by the American Board of Anesthesia? Don't be a fool! Assert your rights to know all the safe options.

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