A California dentist who gave anesthesia to a 9-year-old girl before she died had previously been disciplined, according to documents.
Silvanna Moreno died on March 18, hours after undergoing surgery at Dreamtime Dentistry in Vista, Calif., according to an autopsy report from the San Diego County Medical Examiner’s Office (SDCME), as previously reported by PEOPLE.
Authorities attributed her death to methemoglobinemia following recent nitrous oxide administration. Her death was accidental.
Dr. Ryan Watkins, a dentist trained in anesthesiology who treated her that day, said in a statement obtained by PEOPLE that Silvanna “never exhibited” warning signs of methemoglobinemia, a “extremely rare condition that can occur with nitrous oxide administration,” during the procedure or afterward.
Watkins has treated thousands of patients, according to the Dreamtime Dentistry website, but records show that this was not the first time a patient in his care experienced a serious complication.
In 2020, the dentist faced disciplinary action over a 2016 incident in which a 54-year-old man’s heart stopped after Watkins administered anesthesia during a dental procedure. According to a copy of the complaint, the incident occurred while Watkins was practicing in Carlsbad, California.
The man, known only as “MK,” was said to be in “excellent health” and a triathlete. However, he had a low resting heart rate, a dental phobia, and a history of fainting, which officials claim Watkins did not investigate or document.
According to records, “MK” survived the ordeal but suffered fractured ribs as a result of chest compressions. He was later diagnosed with a mild neurocognitive disorder caused by cardiac arrest.
“A doctor concluded that the administration of ephedrine likely caused MK’s tachycardia (increased heart rate above 100 bpm) that would have subsided and that the use of adenosine was unnecessary and caused MK’s heart to stop (asystole),” according to the records.
The Dental Board placed Watkins on probation for 35 months, allowing him to continue working as long as he met additional requirements and underwent oversight. He was also ordered to pay more than $19,000 in investigative and prosecution costs.
“Upon successful compliance with the conditions of probation, and completion of the probation term, Respondent’s license shall be fully restored,” stated the decision’s officials.
Following Moreno’s death, Watkins told PEOPLE in a statement that Dreamtime Dentistry would conduct an extensive internal review.
“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,” a spokesperson said. “We extend our deepest condolences to Silvanna’s family and ask for continued respect for their privacy during this time of grief.”
