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THE ORANGE COUNTY REGISTER
Thursday, August 21,
1997
MICHELLE NICOLOSI Dentists caring for a 4-year-old Santa Ana boy before he
died gave "incompetent and grossly negligent" care and then destroyed his
dental record showing how much sedative he had been given, according to
witness statements in an affidavit filed by Santa Ana police in Orange
County Municipal Court.
Javier Villa died Aug. 4 at Megdal Dental Care in Santa Ana during a
routine visit to have cavities filled. State and county officials and
seized boxes of records during a search last week. Investigators would not
comment. Clinic spokesmen have denied any wrongdoing. Orange County
coroner's investigators said "the preliminary finding is that the death
was due to positional asphyxiation," or inability to breathe because of
position, the affidavit said.
Dental assistant Claudia Briseno told investigators that dentist
Gabriella Pham had filled three of Javier's cavities and worked on a
fourth when they noticed mucus coming from the boy's nose.
"While (dental assistant) Alejandra (Juarez) was wiping the nose, she
noticed that the chest was not rising. ... Alejandra put the mouth mirror
up to his nose and it did not fog up. She checked for a pulse and could
not locate one," Briseno said.
Pham, according to one of the assistants, "froze in her chair" and the
two assistants "took over."
Briseno ran from the room to get oxygen, telling managing dentist
Miguel Garcia that the boy was in trouble. He rushed in and started CPR.
"Javier's stomach was ballooning up," Pham said, according to the
report. "He did not seem to be responding."
Javier was whisked away by paramedics to UCI Medical Center, where he
was pronounced dead.
In the frantic minutes after the trouble, Garcia gathered clinic
workers around him and told them that "the story was that 6 ccs of chloral
hydrate was given to him," Juarez told investigators, according to the
affidavit.
Pham told investigators that Alejandra Juarez said 16 ccs were given.
"Dr. Garcia then told her (Juarez) to throw away the chart. She ripped
up the treatment chart and then threw it away in the trash," according to
accounts in the affidavit.
Juarez told investigators that "after the incident, both Dr. Garcia and
Dr. Pham were running behind her and asking her if she was OK and if she
had the story down. She was scared and did not know what to do," the
affidavit says.
Falsifying dental records is a felony offense; dentists found guilty of
the crime can lose their licenses.
Later, Pham said she told Juarez "that she was going to tell the police
the truth about what had transpired and she should do the same."
Garcia did not return calls for comment; Pham's attorney said she has
no comment.
Witnesses said Javier was confined in a papoose board _ used to keep
children from moving during procedures _ and the workers did not follow
manufacturer recommendations to keep his airway open by putting a
rolled-up towel under his head and neck.
They said Javier was not monitored with machines to check that his
breathing was normal, as recommended by professional dental societies,
according to the affidavit.
Dr. Richard Mungo, the state Board of Dental Examiners' expert on the
case, said "positioning and monitoring" might be key to the child's death.
He said the care Javier received was negligent and incompetent.
"If their head was down and there wasn't anything supporting the neck,
it might mean that air was blocked" and Javier was unable to breathe.
Mungo said the 16 ccs of chloral hydrate given to Javier "might be at
the upper limits if not beyond the upper limits" of the recommended dose
for Javier, a 39-pound child.
"There's a lot of questions," Mungo said. "We don't have all the facts
yet." |