Dentist Arrested in Death of Santa Ana Boy 1 Year Ago

A year to the day after a 4-year-old Santa Ana boy died during a routine dental appointment, one of the dentists who treated him was arrested Tuesday on suspicion of involuntary manslaughter.

Dr. Gabriella Thanh-Ngoc Pham, 35, was taken into custody in Whittier on Tuesday morning and will be charged with gross negligence in her treatment of Javier Villa. She faces four years in prison if convicted. Bail was set at $50,000.

The arrest comes a week after the California Board of Dental Examiners filed administrative charges against Pham and another dentist who treated Villa at the Santa Ana clinic, Dr. Miguel Garcia.

The board called the dentists “grossly negligent or incompetent” in their care of Villa. An administrative hearing is expected to be held before the end of the year to determine whether Pham and Garcia should lose their licenses or face other sanctions.

Santa Ana police said the district attorney’s office has not determined whether to file criminal charges against Garcia.

Neither the dentists nor their attorneys could be reached for comment Tuesday afternoon. All have denied wrongdoing in the past.

Villa was rushed to a hospital Aug. 4, 1997, after a dental hygienist at the Megdal Dental Clinic noticed he had stopped breathing.

The little boy, who was at the clinic to have eight cavities filled, was involuntarily strapped into a restraining device known as a papoose board and given 16 cubic centimeters of an oral sedative called chloryl hydrate, which can suppress breathing.

The amount of chloryl hydrate used by the clinic is at the upper end of the amount recommended for a child of Villa’s weight, according to experts interviewed by dental board investigators.

Santa Ana Police Sgt. Steve Despenas said officials decided to press for charges against Pham in part because a coroner’s report indicated the boy died from positional asphyxiation.

A pediatric dental expert told investigators that a simple rolled towel or pillow placed behind the little boy’s head--considered a standard procedure--could have kept his air passages open and saved his life, according to a search warrant.

The California Board of Dental Examiners accused Pham last week of failing to recognize a medical emergency when Villa appeared to stop breathing, and failing to protect his airway.

According to the dental board charges, Garcia failed to evaluate Villa before treatment, allowed an unlicensed person to administer a deep sedative and allowed Villa to be over-sedated.

The board also said Garcia placed his license at risk by not getting proper consent for the sedation, and by ordering the original dental record destroyed and a new one created. Clinic workers told investigators that Garcia ordered them to destroy Javier’s treatment record and say the boy received 6 cubic centimeters of the drug instead of 16 cubic centimeters.

“I’m glad to see it’s moving forward. I think we all are,” said John Hirai, supervising investigator for the dental board in Southern California. Sgt. Despenas said the timing of the arrest on the one-year anniversary of Villa’s death was coincidental. He said the investigation was lengthy because of extensive toxicology reports and expert-witness testimony that was needed.

“It’s a form of closure, somewhat, [because] everybody has been wondering [the] ‘if’ and ‘when’ on this case,” he said.

Since 1976, 10 children in California have experienced dental related deaths, eight from the use of oral sedatives. Other states have long required licensing or permits for the use of oral sedatives such as chloryl hydrate on children, but California does not have such requirements.

Legislation that would require certification for the use of oral sedatives has passed the state Assembly, and Tuesday it won the backing of the Senate Appropriations Committee.

Many dentists have objected to the law, saying it could keep professionals who already feel over-regulated from treating children.

Philip Megdal, the owner of the clinic where Villa died and several others across Southern California, is still being investigated by the state dental board staff for possible wrongdoing, Hirai said.