8-year-old's sedation death spurs dad's effort to change laws
Article Thumbnail ImageJune 17, 2010 -- A Virginia man whose 8-year-old daughter died under conscious sedation during a routine dental procedure is trying to get a law passed that would require all dental offices to have and maintain defibrillators.
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Raven Blanco died in March 2007 after receiving three drugs by Virginia Beach dentist Michael Hechtkopf, D.D.S. The drugs were used to calm the child while she had her teeth cleaned and calcium deposits removed, according to her aunt, Maria Blanco.

Raven Blanco.

But the girl became unresponsive and went into cardiac arrest while under sedation in Dr. Hechtkopf's office. She died about 90 minutes after being taken to a hospital.

Now Raven's father, Mario Blanco, said he's found a purpose: to push lawmakers to require defibrillators in dentists' offices and to inspect those offices more often to ensure the machines are functioning properly. He has contacted several state legislators urging them to develop such legislation, his sister told DrBicuspid.com.

Virginia does not currently require dental offices to have defibrillators, and inspections are done only after a complaint has been filed, according to Diane Powers, spokeswoman for the Virginia Department of Health Professions, which regulates the Virginia Board of Dentistry. Only the Legislature can pass laws requiring defibrillators, she noted.

Mario Blanco is also urging parents to closely question dentists to ensure they have working defibrillators and someone trained to do emergency resuscitation if problems arise.

"Do research before you bring your child in," he said during an interview with TV station WVEC. "Make sure the dentist has all the right equipment. If their equipment had worked, I think she'd still be here."

'Dental sedation complications'

Dr. Hechtkopf had given the child 1300 mg of chloral hydrate and 30 mg of hydroxyzine, according to dental board hearings on the matter. The autopsy showed Raven had a blood concentration of 24 mg/L of chloral hydrate -- three times the average range -- which the medical examiner considered lethal.

“She was very afraid about going to the dentist.”
— Maria Blanco, Raven Blanco's aunt

"She was very afraid about going to the dentist," Maria Blanco told DrBicuspid.com. "She was even afraid to brush her teeth."

"So he [Mario] thought it would make it less stressful for her," she said. The girl had not eaten prior to the procedure, as Dr. Hechtkopf had instructed, Maria Blanco recalled.

The girl died from "complications of dental sedation," the medical examiner said. In addition to chloral hydrate and hydroxyzine, nitrous oxide was also administered.

The dental board cited Dr. Hechtkopf for failing to have adequate clinical documentation of the girl's sedation record, specifically noting that her "vital signs and pulse oximetry readings were absent or poorly documented prior to the onset of the emergency event."

He was also ordered to complete record-keeping and risk-management classes. The dental board initially restricted Dr. Hechtkopf from administering any form of general anesthesia, sedation, or analgesia, but the restriction was later rescinded.

Dr. Hechtkopf agreed to a confidential settlement in a lawsuit filed by the family. He declined to comment for this story.

Sad trend

Recently, Mario Blanco attended memorial services in Richmond, VA, for Jacobi Hill, a 6-year-old boy who died in May following a dental procedure at Virginia Commonwealth University dental clinic, according to his sister.

The boy is one of four pediatric patients who have died in the past 15 months in the U.S. after undergoing sedation prior to dental treatment.

Sedation is becoming more common in pediatric dental procedures because so many children are coming into dentist offices at younger ages with caries, and they sometimes need extensive work, according to Indru Punwani, D.D.S., M.S.D., a spokesperson for the American Academy of Pediatric Dentistry (AAPD) and head of the pediatric dentistry department at the University of Illinois at Chicago.

Pediatric sedation is safe if done correctly, said Dr. Punwani, noting that it is routinely used without problems. "Sedation is used thousands of times every day in medical and dental procedures," he said. "It's an extremely common and safe procedure."

Mario Blanco has now started the Raven Maria Blanco Foundation in memory of his daughter. The foundation raises money to provide children all over the world with food, shoes, soccer balls, and school supplies.

He personally gave away more than 100 soccer balls while working on a construction project in South Africa, Maria Blanco said.

"He's doing better since starting the foundation," she said. "Before that he was just lost. So it's given him a motive to go on."

Copyright © 2010 DrBicuspid.com


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