San Diego police are investigating after a 9-year-old girl died hours after she had undergone dental surgery, officials said.
Silvanna Moreno was found unresponsive in her bed hours after being placed under anesthesia at a Vista dental office March 18, according to the San Diego Medical Examiner’s Office.
Her family called 911, and paramedics provided life-saving measures and took her to Rady Children’s Hospital. Emergency room medical staff took over “to no avail,” and she died just before 5:45 p.m., the Medical Examiner’s Office said.
Silvanna, a third-grader at Sherman Elementary School in the Sherman Heights neighborhood, had undergone surgery earlier that day.
After her recovery, she was sent home. The Medical Examiner’s Office said she slept in the car and remained asleep as she was placed in her bed. Her family checked on her throughout the day and called 911 when they discovered she was unresponsive.
The surgery was at Dreamtime Dentistry, which released a statement saying it was “deeply saddened by the tragic passing of our young patient, which occurred several hours after her completed dental procedure.”
“The patient was referred to our office for dental treatment under general anesthesia due to her young age and acute situational anxiety,” the office said.
It said Silvanna was “continuously monitored” by our dentist anesthesiologist throughout the procedure and that no complications were seen.
The dentist anesthesiologist was Dr. Ryan Watkins, who the office said has more than 20 years of experience administering general anesthesia to children. Watkins, 48, owns Dreamtime Dentistry.
Marisa Vallbona, who is answering press inquires for Watkins, said the doctor handled the anesthesia as a second dentist performed the surgery.
Afterward, the girl was moved to a recovery room and later discharged.
“Following the procedure, (Silvanna) 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,” reads the statement from Dreamtime.
Vallbona said the girl was awake and in a wheelchair before she left the office. “She stood up with her mother’s help. She was clearly awake,” Vallbona said.
Vallbona said they could not discuss specific details, citing privacy laws and the ongoing investigation.
“At this time, the cause of death has not been determined,” the office said in its statement. “The medical examiner is conducting a thorough investigation, with which we are fully cooperating. We are committed to ensuring all facts come to light.”
Silvanna’s family members could not be reached for comment. A verified GoFundMe account to raise funeral funds says the girl, who had three siblings, was “bright and loving.”
“She was the sunshine in every room she entered, always greeting staff and classmates with a big smile and an even bigger hug,” the GoFundMe page reads. “Her friends describe her as kind, caring, and always happy, a true friend to everyone she met.”
San Diego police Lt. Jo Makwana confirmed that the department’s child abuse unit is investigating.
Vallbona said Watkins is continuing to work, that his practice remains busy and he “remains focused on patient care.”
According to his practice, Watkins is a Diplomate of the National Dental Board of Anesthesiology and a Fellow in Anesthesiology from the American Dental Society of Anesthesiology. He is also a member of the American Society of Dentist Anesthesiologists.
Online records with the Dental Board of California indicate Watkins faced discipline after a patient’s heart stopped beating while under anesthesia under Watkins’ care during surgery in 2016. Watkins began administering life-saving measures, and paramedics took the patient to a hospital, where he spent two days before his release.
According to the accusation, the patient was a 54-year-old triathlete. During dental surgery, his blood pressure and heart rate were low. Watkins was accused of administering a drug that raised both, then a second drug that caused the patient’s heart to stop, according to a finding by a doctor. The accusation states that the patient continued to suffer from mild neurocognitive disorder a year after the incident.
In 2020, Watkins and the board reached a settlement in which Watkins was placed on probation for 35 months.
Putting a child under some level of anesthesia for dental procedures is common and done when necessary, said Dr. Mitchell Poiset, a board certified pediatric dentist in San Diego who is also the president of the California Society of Pediatric Dentistry.
“Tragedies like this are extremely rare,” Poiset said.
He suggested parents go to the American Academy of Pediatric Dentistry if they have questions about sedation and anesthesia for their child. The website includes guidelines for sedation.