The San Diego County Department of the Medical Examiner has ruled that the death of a 9-year-old girl in California who passed away hours after she was administered anesthesia and underwent dental surgery was accidental.
The cause of death of Silvanna Moreno, who was pronounced dead at a children's hospital in San Diego on March 18, was ruled as “methemoglobinemia in the setting of recent nitrous oxide administration,” according to an update from the county medical examiner. Methemoglobinemia is a rare blood disorder that affects how red blood cells transport oxygen to cells and tissues and the condition can be inherited or occur when given certain medications.
Contributing conditions to the child’s death were the administration of dexamethasone, glycopyrrolate, hydromorphone, isoflurane, ketorolac, midazolam, ondansetron, propofol, and sevoflurane, according to the medical examiner.
After Moreno underwent her procedure at Dreamtime Dentistry in Vista, CA, on March 18, the third grader was taken to a recovery room at the practice before she was discharged.
Initially, authorities stated that she remained asleep during her car ride home and stayed asleep when she was transported to her bed at her home. It was later reported that she was not asleep when she was discharged from the practice, but that Moreno fell asleep in the car while traveling home.
The family reportedly checked on the girl throughout the day of the procedure. During one check, Moreno was found unresponsive, so they called 911. Lifesaving measures were provided, but she could not be revived.
On March 30, Dreamtime Dentistry released a statement from Dr. Ryan Watkins, a licensed dentist who is trained in anesthesiology, regarding Moreno's death, saying the girl “was discharged in stable condition -- awake, with stable vital signs and protective reflexes intact -- into her mother's care, following our standard post-anesthesia protocols.”
In the statement, Watkins said he had been fully cooperating with the medical examiner's investigation.
