Latest news with #SilvannaMoreno
Time of India
17-06-2025
- Health
- Time of India
9-year-old dies after undergoing anesthesia for a dental procedure: What went wrong?
Representational image In a tragic case, a nine year old girl has died after undergoing anesthesia. She was supposed to have a dental procedure. According to the San Diego County Medical Examiner's office, Silvanna Moreno, "underwent dental surgery under anesthesia in Vista and transitioned to a recovery room afterwards. She was later discharged from the facility. She fell asleep during her ride home. Upon arrival, she stayed sleeping and was transitioned into her bed at home. Family checked on her throughout the day to later find her unresponsive in bed and called 911 for emergency services assistance. Responding paramedics contacted the decedent and provided lifesaving measures while transporting her to the Rady Children's Hospital Emergency Department. Upon her arrival, medical staff assumed the provision of lifesaving measures to no avail with death being pronounced." She died on March 18. The report mentions her cause of death to be "Methemoglobinemia in the setting of recent nitrous oxide administration." What is Methemoglobinemia? Methemoglobinemia is a rare but serious blood disorder where your red blood cells can't carry oxygen. Normally, hemoglobin works like a delivery agent, bringing oxygen to all the tissues in your body. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Play Chess on Your PC, Free Play Classic Chess Install Now Undo But when someone has methemoglobinemia, a form of hemoglobin called methemoglobin starts to build up. This version can't carry oxygen like it's supposed to. It's like your oxygen delivery system broke down halfway through the job. Now here's where it gets tricky: this condition can be genetic (you're born with it), or it can happen because of exposure to certain drugs, chemicals, or even foods high in nitrates (like well water or too much spinach in babies). People with methemoglobinemia might look blue or gray-ish (a condition called cyanosis), feel short of breath, dizzy, or super tired all the time. In severe cases, it can cause seizures or even death if left untreated. Yes, anesthesia can sometimes cause methemoglobinemia, especially certain types of local anesthetics like benzocaine, prilocaine, or even lidocaine in high doses. These drugs can trigger the formation of methemoglobin in the blood, making it harder for red blood cells to carry oxygen. This risk is higher in babies, people with genetic susceptibility, or those getting large doses during surgery or dental work. Symptoms might show up shortly after exposure—like bluish skin, shortness of breath, or fatigue. She was administered anesthesia by Dr. Ryan Watkins. "The patient was referred to our office for dental treatment under general anesthesia due to her young age and acute situational anxiety," he told PEOPLE. "Throughout the procedure, she was continuously monitored by our dentist anesthesiologist ... with no complications observed." New reports say Dr Watkins had faced disciplinary action before. One step to a healthier you—join Times Health+ Yoga and feel the change
Daily Mail
16-06-2025
- Health
- Daily Mail
My daughter, 9, died after a routine trip to the dentist triggered deadly blood condition
A nine-year-old was left dead after a freak accident occurred while she was at a routine dentist appointment. Silvanna Moreno, 9, from San Diego, California, was at the dentist getting a root canal and several cavities filled. There were no complications and afterward Moreno was moved to the recovery room in a wheelchair before being taken to her mother's car. On the drive home she was described as 'out of it', and fell asleep snoring loudly. She was taken to her bedroom, but then her snoring slowed and began to quieten — prompting her mother to call 911. She was rushed to the hospital after her heart stopped, reports said, where doctors tried to resuscitate her without success. The San Diego Medical Examiner's Office has now discovered in a report, viewed by that she was suffering from methemoglobinemia — a condition in which blood cannot carry adequate oxygen through the body. The condition can be genetic, but can also be triggered by prolonged exposure to nitrous oxide, known as laughing gas, which is often used in dental procedures for mild sedation and to reduce anxiety. Nitrous oxide normally diffuses directly into the brain after being breathed in through the nose, but can also enter the blood where it can bind to hemoglobin, the protein that carries oxygen, and leave it unable to carry out its function. Moreno was receiving nitrous oxide during her appointment but it's not known if she had been previously diagnosed methemoglobinemia — which estimates suggest may affect up to one in 3,000 Americans. Warning signs of methemoglobinemia caused by nitrous oxide exposure can appear in minutes to hours later, and include a bluish tinge to the lips, difficulty breathing and struggling to stay awake. No foul play is suspected in the girl's death, which was stated as methemoglobinemia in the setting of recent nitrous oxide administration and ruled an accident by the medical examiner. There is no suspicion that anyone at the dentist's office acted improperly. In methemoglobinemia, blood cells contain a higher level of methemoglobin — a form of hemoglobin that cannot carry oxygen. Normally, the blood contains about zero to two percent methemoglobin, but in methemoglobinemia these levels rise to anywhere between 15 and 70 percent. Doctors say that levels below 20 percent generally trigger no symptoms, while levels above 70 percent can prove fatal if someone is exposed to a gas like nitrous oxide. A 2024 study from Toxicology Reports estimates that exposure to nitrous oxide as a medical therapy is the second most common cause of methemoglobinemia — accounting for about 18 percent of cases in children and 13 percent of cases in adults among the nearly 300 cases surveyed. The genetic form of methemoglobinemia is rare, doctors say, with there being few reliable estimates on how many people have the condition. In Moreno's autopsy, carried out a day after her death, examiners found her blood's methemoglobin levels were 75 percent. They cautioned, however, that this may have been a significantly higher figure than that when she died, saying these levels can rise significantly in the hours after death. The report also notes that she received other drugs while at the dental office, which they said could also have contributed to the death. Moreno had received a root canal, placement of crowns and fillings and extraction of teeth at Dreamtime Dentistry in Vista, run by Dr Ryan Watkins, who has 20 years of experience in the field. In a previous incident in 2016, however — revealed by online records with the Dental Board of California — he faced disciplinary action after a patient's heart stopped beating while under anesthetic. The individual, who has not been named, was hospitalized for two days and allegedly continued to suffer from a mild cognitive disorder for a year afterward. Dr Watkins was placed on probation for 35 months by state dental regulators over the issue in 2020, meaning he could continue to practice — but only with enhanced observations. In a statement, Dr Watkins told People that methemoglobinemia is 'an extremely rare condition that can occur with nitrous oxide administration'. He insisted that Moreno 'never exhibited' any warning signs and that her oxygen saturation levels remained normal. He said he also undertook a 'thorough review' of her medical records before the procedure, which raised no concerns. He added: 'We are committed to learning from this tragic event and will implement any additional safety measures that may help prevent such occurrences in the future. 'We extend our deepest condolences to Silvanna's family and ask for continued respect for their privacy during this time of grief.' The day before the procedure Moreno had a fever and received Tylenol, but her symptoms resolved afterward — the Medical Examiner's report also noted. On the day of the surgery, she also complained of a headache 'without appearing distressed', her mother said. The dental office said if staff were aware of this they would not have carried out the procedure.
Yahoo
07-06-2025
- Health
- Yahoo
A 9-year-old girl died after a dental surgery. Now we know why
The death of a 9-year-old girl who became unresponsive after dental surgery in San Diego County has been ruled an accident resulting from a rare blood disorder, according to autopsy report by the San Diego County Medical Examiner's Office. Silvanna Moreno died from a disorder called methemoglobinemia that could have been triggered by the administration of nitrous oxide and other commonly used anesthetic medications during her dental surgery on March 18, the medical examiner said. Methemoglobinemia is a rare blood disorder which disrupts how iron in the hemoglobin can deliver oxygen to cells and tissue in the body. It's extremely rare for a person to be born with the disorder — there isn't an exact number of affected people due to its rarity. Experts who have studied the condition say it can, more commonly, be developed by an unusual confluence of events involving the exposure to medication, which may have happened in the case of Moreno. It's not clear if Moreno had the congenital form of methemoglobinemia, meaning present at birth, or a form triggered by exposure to certain medications. The disorder leads to symptoms such as shortness of breath, fatigue and cyanosis, or bluish discoloration of the skin, said Dr. Michael Levine of UCLA Health. Read more: Pope meets with child protection advisory board as survivors call for zero tolerance of abuse "Sometimes people have a defect in that system and they get congenital methemoglobinemian as a result," said Dr. Gentry Wilkerson, associate professor at the University of Maryland School of Medicine who has authored a study on the condition and ways to treat it. "I's so rare, I would be shocked if I ever saw it in my career." The San Diego Police Department's child abuse unit announced in April that it was investigating the girl's death but the department said Friday it has ceased its investigation and closed the case, said Lt. Travis Easter. Dreamtime Dentistry, the Vista, Calif., facility where Moreno underwent surgery, responded to the medical examiner's report by saying the death was "not due to dosage but instead due to her rare but undiagnosed/undetected medical condition." The dentistry office also said there were no clear signs before the surgery that she had this condition. "A common cause of exposure that can lead to methemoglobinemia is dental procedures because one of the medicines that they'll give for patients that have dental pain is benzocaine," Wilkerson said. Benzocaine was not listed in the medical examiner's report as one of the medications administered to Moreno. Wilkerson said dental procedures are generally very safe. But in other cases, "it's a medication dose dependent effect where a person can take an excess of quantity or an excess amount of the drug and then subsequently develop methemoglobinemia," Levine said. Moreno was referred to Dreamtime Dentistry after complaining about a toothache four months prior, according to the autopsy reviewed by The Times. The dental office accepted the referral because it offered Moreno "treatment under general anesthesia due to her young age and acute situational anxiety," the facility stated. A day before her March 18 surgery, Moreno's autopsy said that she had a fever but her symptoms resolved after being given children's Tylenol. Representatives for Dreamtime Dentistry told The Times they were not aware of her fever and noted that Moreno's mother, "completed and signed a pre-operative check-in form indicating 'No' when asked if the patient was sick." The pre-op evaluation included a thorough review of Moreno's medical and dental history, assessment of vital signs, a physical examination including heart, lung sounds and airway evaluation, among other procedures, according to a statement from Dreamtime Dentistry. Read more: Commentary: A mother's plea to Trump: If you want to encourage a baby boom, give families a break "All medications were administered according to manufacturer guidelines based on Moreno's age and weight," according to the statement from the facility. Throughout the procedure, anesthesiologist Dr. Ryan Watkins observed Moreno and noted no complications, the dental office stated. Once the procedure was completed, the child was monitored in the facility's recovery area until she awoke with stable vital signs. After the procedure, she was discharged into the care of her mother and sent home, according to the County of San Diego Medical Examiner's Office. Moreno fell asleep on the car ride home, and when she arrived home she stayed asleep and was transitioned into her bed, according to the medical examiner's office. Her family checked on her throughout the day and called 911 when it was discovered later that she was unresponsive. First responders transported Moreno to Rady Children's Hospital while performing life saving measures. When the child arrived at the hospital medical staff assumed life saving measures to no avail and she was pronounced dead, according to the medical examiner. Sign up for Essential California for news, features and recommendations from the L.A. Times and beyond in your inbox six days a week. This story originally appeared in Los Angeles Times.
Yahoo
30-05-2025
- General
- Yahoo
9-year-old San Diego girl's death after dental procedure ruled an accident
More than two months after a 9-year-old San Diego girl died following a dental procedure, officials have released new details on her death. The San Diego County Medical Examiner's Office ruled the death of Silvanna Moreno an accident, according to an updated summary report. The girl died after she underwent anesthesia. The medical examiner listed her cause of death as "methemoglobinemia in the setting of recent nitrous oxide administration." Contributing conditions included the administration of multiple anesthetic medications. Methemoglobinemia is a very rare blood disorder that affects how red blood cells deliver oxygen, according to the Cleveland Clinic. Not everyone experiences symptoms, but nearly all people with the disorder have skin, lips or nails that are blue or purple. In some cases, it can be life-threatening. People can inherit the disorder, but it usually happens "when people use certain medications or recreational drugs or exposure to certain chemicals," according to the Cleveland Clinic. The dental procedure took place on March 18 at Dreamtime Dentistry in Vista. Dr. Ryan Watkins, the office's trained anesthesiologist, said methemoglobinemia can occur with the administration of nitrous oxide, commonly known as laughing gas. He said Silvanna never exhibited signs that something was wrong during the procedure. "If we had observed any indication of methemoglobinemia, we would have immediately discontinued the procedure and transported her to the hospital for emergency treatment," he said in a statement. The day before the procedure, Silvanna had a fever and was given children's Tylenol, People magazine reported, citing an autopsy report. The day of, she complained of a headache but did not appear to be distressed, it said. The dental procedure was three hours long, People reported. The dentist's office said Silvanna was a new patient and had been referred to them for a root canal on a molar. Doctors completed the root canal and restored the tooth with a crown. Some decayed "baby teeth" were extracted, as well as some decayed permanent teeth. One permanent tooth needed a crown, the office said, noting that three hours is normal for these procedures. Watkins said Silvanna was "a healthy 9-year-old with a history of regular medical checkups" and underwent the office's standard preoperative evaluation. He said he evaluated her as "an appropriate candidate for outpatient general anesthesia" and continuously monitored Silvanna throughout the procedure. Afterward, she was monitored in a recovery area "until she was awake with stable vital signs," he said. She was evaluated before she was released into her mother's care, he said. Silvanna's family could not be reached for comment on Friday. According to the medical examiner's summary report, Silvanna fell asleep during the car ride home and stayed sleeping upon her arrival. Family members put her in bed and checked on her throughout the day. Her family later found her unresponsive and called 911, according to the summary report. She was rushed to the hospital, where she was pronounced dead. Watkins said the office is conducting an internal review of the case and will consult with experts "to ensure we continue to provide the safest possible care for our patients." "We are profoundly saddened by the tragic loss of Silvanna Moreno, and our hearts continue to go out to her family during this incredibly difficult time," he said. Watkins was previously investigated by the Dental Board of California after a 54-year-old patient nearly died in 2016, according to NBC San Diego. State investigators said the man was put under anesthesia and was given two drugs, which led to his heart stopping. Investigators had said that one of the drugs should never have been given to the man. Watkins was put on probation from 2020 to 2023, according to a decision order. The man ended up filing a lawsuit against Watkins, which was later settled, NBC San Diego reported. This article was originally published on
NBC News
30-05-2025
- Health
- NBC News
9-year-old San Diego girl's death after dental procedure ruled an accident
More than two months after a 9-year-old San Diego girl died after she underwent anesthesia for a dental procedure, officials have released new details in her death. The San Diego County Medical Examiner's Office ruled the March 18 death of Silvanna Moreno an accident, according to an updated summary report. It listed her cause of death as "methemoglobinemia in the setting of recent nitrous oxide administration." Contributing conditions included the administration of multiple anesthetic medications. Methemoglobinemia is a very rare blood disorder that affects how red blood cells deliver oxygen, according to the Cleveland Clinic. Not everyone experiences symptoms, but nearly all people with the disorder have skin, lips or nails that are blue or purple. In some cases, it can be life-threatening. People can inherit the disorder, but it usually happens "when people use certain medications or recreational drugs or exposure to certain chemicals," according to the Cleveland Clinic. The dental procedure took place on March 18 at Dreamtime Dentistry in Vista. Dr. Ryan Watkins, the office's trained anesthesiologist, said methemoglobinemia can occur with the administration of nitrous oxide. He said Silvanna never exhibited signs that something was wrong during the procedure. "If we had observed any indication of methemoglobinemia, we would have immediately discontinued the procedure and transported her to the hospital for emergency treatment," he said in a statement. The day before the procedure, Silvanna had a fever and was given children's Tylenol, People magazine reported, citing an autopsy report. The day of, she complained of a headache but did not appear to be distressed, it said. The dental procedure was three hours long. Watkins said Silvanna was "a healthy nine-year-old with a history of regular medical checkups" and underwent the office's standard preoperative evaluation. He said he evaluated her as "an appropriate candidate for outpatient general anesthesia" and continuously monitored Silvanna throughout the procedure. Afterwards, she was monitored in a recovery area "until she was awake with stable vital signs," he said. She was evaluated before she was released into her mother's care, he said. Silvanna's family could not be reached for comment on Friday. According to the medical examiner's summary report, Silvanna fell asleep during the car ride home and stayed sleeping upon her arrival. Family members put her in bed and checked on her throughout the day. Her family later found her unresponsive and called 911, according to the summary report. She was rushed to the hospital, where she was pronounced dead. Watkins said the office is conducting an internal review of the case and will consult with experts "to ensure we continue to provide the safest possible care for our patients." "We are profoundly saddened by the tragic loss of Silvanna Moreno, and our hearts continue to go out to her family during this incredibly difficult time," he said. Watkins was previously investigated by the Dental Board of California after a 54-year-old patient nearly died in 2016, according to NBC San Diego. State investigators said the man was put under anesthesia and was given two drugs, which led to his heart stopping. Investigators had said that one of the drugs should never have been given to the man. Watkins was put on probation from 2020 to 2023, according to a decision order. The man ended up filing a lawsuit against Watkins, which was later settled, NBC San Diego reported.
