It has been determined what caused the death of a little girl who was nine years old and had undergone dental surgery earlier this year while under the influence of anesthetic.
According to a new autopsy report acquired by PEOPLE from the San Diego County Medical Examiner’s Office (SDCME), Silvanna Moreno, a third-grader from Southern California, passed away on March 18 hours after undergoing surgery at Dreamtime Dentistry in Vista, California.
It was determined that methemoglobinemia was the cause of death for Silvanna, within the context of the injection of nitrous oxide not too long ago.
The condition known as methemoglobinemia may be brought on by the introduction of an excessive quantity of nitrous oxide into a person’s hemoglobin, which is the protein found in red blood cells that transports oxygen to the tissues. This can lead to hypoxia, which is when the tissues do not get sufficient oxygen.
The findings of the autopsy indicates that nitrous oxide was one of the anesthetics that were delivered to Silvanna during the surgery that she underwent.
Following her complaint of tooth discomfort in October 2024, Silvanna had surgery, according to the autopsy report. She was directed to Dreamtime Dentistry, which scheduled her for an operation in March.
In accordance with the findings of the autopsy report, she had a fever the day before, but her symptoms went away when she was given Tylenol for children.
According to the report, she said that she was experiencing a headache on the day of her operation, but she did not seem to be in any discomfort. In preparation for a three-hour surgery, she was given anesthetic at ten o’clock in the morning.
It is stated in the autopsy that once she regained consciousness, she was transferred to a recovery room and subsequently released. She was characterized as being “out of it” on the trip home, and later on she was snoring excessively. However, she was initially able to open her eyes and stand up.
According to the autopsy, once Silvanna arrived at her residence, she was carried inside and stayed sleeping for around ninety minutes. once that, her snoring became substantially quieter and slower.
Following that, her grandma took two independent measurements of her heart rate while she was awake. Following the second reading, she continued to be unconscious, and at 4:46 p.m. local time, a call was placed to 911. This was almost six hours after she had received anesthetic.
During the time that they were waiting for emergency professionals to come, the grandmother was given instructions by a dispatcher to do chest compressions.
She was sent to the Emergency Department at Rady Children’s Hospital, where she was found to be in asystole. Asystole is a condition in which the electrical system of the heart malfunctions, causing the heart to cease pumping blood throughout the body, as stated by the Cleveland Clinic.
However, at 5:44 p.m., Silvanna was proclaimed dead despite the fact that various life-saving techniques were provided to her.
A board-certified dental anesthesiologist at Dreamtime Dentistry with over 20 years of experience in pediatric anesthesia, Dr. Ryan Watkins, said in a new statement that methemoglobinemia is a “extremely rare condition that can occur with nitrous oxide administration,” and that when patients experience this condition, their “pulse oximetry readings will show abnormally low levels in the 80s.” Methemoglobinemia is a condition that can occur with the administration of nitrous oxide.
Throughout the treatment, Silvanna “never exhibited” any warning symptoms, according to Watkins, and her oxygen saturation levels remained to stay normal throughout her recuperation. Watkins insists that Silvanna did not exhibit any warning indications.
They conducted a “thorough review of her medical and dental history” before to the treatment, and Watkins said that they “maintained our standard of care with continuous monitoring by me” while the procedure was being performed.
In addition, Watkins said that Dreamtime Dentistry is now undertaking an in-depth internal investigation, despite the fact that the manner in which Silvanna passed away was determined to be unintentional.
“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,” Watkins said in addition. “We extend our deepest condolences to Silvanna’s family and ask for continued respect for their privacy during this time of grief.”