$95M awarded in case of girl left with brain damage from dental care

A jury in Texas awarded $95.5 million to the family of a 4-year-old girl left with irreversible brain damage following a 2016 dental visit, according to a press release issued on September 22 from an attorney representing the girl's family.

Jurors in the District Court of Harris County, Texas, 269th Judicial District assessed the damages to the girl's family after finding Dr. Bethaniel Jefferson, who had her dental license revoked in 2016, negligent in her treatment of the child. The family accused Jefferson of improperly restraining and sedating the girl during treatment for decayed teeth, James R. Moriarty, the family's attorney, said in a release.

The girl, who suffered drug-induced seizures and oxygen deprivation while receiving treatment at Diamond Dental in Houston, is now 10. She is conscious but can no longer see, speak, walk, or eat on her own and requires 24-hour medical care, according to the release.

"(The family hopes) that this verdict will help prevent other families from suffering preventable tragedies like this one," Moriarty said in the release.

Backstory

On January 7, 2016, the then 4-year-old patient and her parents went to Diamond Dental to have a "baby root canal" and crown placed on a lower right tooth. To sedate the child, Jefferson administered 6 mg of meperidine and 5 mg of Atarax. After the sedatives took effect, the girl was restrained with a papoose board, according to a petition filed on behalf of the family.

To relax the child, Jefferson administered nitrous oxide, slowly increasing it to 70% nitrous oxide to 30% oxygen. Then, the child was given lidocaine/epinephrine and mepivacaine as an anesthetic. After a few minutes, the dentist reportedly used a drill to remove tooth decay when the toddler started screaming loudly and then convulsing. The dentist allegedly turned the child on her side, but the shaking persisted, the petition stated.

The girl's parents were brought back to the treatment area and asked if their daughter had a history of seizures. The parents said she didn't and asked if an ambulance should be called. Jefferson purportedly told them it was unnecessary and that she needed to stabilize the child. Jefferson sent the child's parents back to the waiting room, according to court records.

Then, Jefferson reportedly retrieved her drug kit and called a pharmacist about how the child's apparent seizures should be managed with medication. She allegedly was advised to give the girl Halcion orally.

Jefferson then gave the child 0.062 mg of Halcion in two doses. She purportedly crushed each 0.031 mg dose, mixed it with water, and squirted the solution into the 4-year-old's mouth. The medication and the way it was given aggravated the girl's condition.

Halcion is not an approved treatment for seizures, and in this case, it likely interacted with the other medications the girl was given, which resulted in a reduced ability to get oxygen to her blood and brain. Furthermore, Jefferson delivered the medication orally via a solution that was squirted into the mouth that the child aspirated on, which further reduced her ability to get oxygen to her blood and brain, the petition stated.

Soon after she was given both doses of Halcion, the girl showed very abnormal oxygen saturation readings, low blood pressure, and an elevated pulse. At some point, Jefferson's staff noticed that the child's body was very hot, so they removed her shirt, turned down the air conditioning, and began bathing her with water. Hours passed while the child's vital signs and level of consciousness swung dramatically. Eventually, the girl had another seizure and was given Valium. The child calmed but later vomited and shook violently, according to court records.

About five hours after the child had first been sedated and prepared for dental care, Jefferson reportedly told her staff to call 911. The call was made because the child was unconscious.

The girl was taken to the hospital and a chest x-ray was taken. It showed pulmonary edema. She was transferred to a children's hospital where it was determined she had experienced an extended period of hypoxia while under Jefferson's care.

Ultimately, the 4-year-old was diagnosed with aspiration pneumonitis, hypoxic ischemic encephalopathy, and irreversible global brain damage. An emergency room doctor contacted the Texas dental board about Jefferson for her failure to call 911 at the first sign of a seizure.

In January 2016, the Texas State Board of Dental Examiners suspended Jefferson's license for "dishonorable conduct" in relation to this incident. In November 2016, the board revoked her license, according to court records. Also, the dentist had previous disciplinary actions related to sedation practices that could have placed other patients at risk of serious harm.