Charges Filed in Girl’s Death After Clinic Visit

Prosecutors have filed involuntary manslaughter charges against the alleged operator of a back-room medical clinic in Tustin where an 18-month-old girl received a drug injection hours before dying earlier this year.

The action marks the first criminal charges filed in the case of toddler Selene Segura Rios, whose February death raised awareness about underground clinics and prompted county officials to form a task force to help educate the public about the health risks.

The arrest warrant was issued for Laura Escalante, 37, who police say ran and prescribed medicine out of a clinic in the back of a strip-mall gift shop. Escalante is believed to have fled to Mexico, and authorities fear any extradition attempt would take years. Escalante allegedly supervised another worker who injected Selene with what police believe was a mixture of penicillin and eucalyptus.

In April, the Orange County coroner’s office ruled that the toddler died of acute dehydration and that the death was not directly related to the treatment she received in Escalante’s clinic.

The autopsy report, a copy of which was obtained by The Times, states that the girl had a painkiller in her system that was banned in the United States two decades ago because of its sometimes fatal side-effects. The report doesn’t indicate whether the drug, known as dipyrone, was administered at the clinic.

Dipyrone was taken off the U.S. market because it can destroy the body’s ability to fight off even minor infections. It has been banned or withdrawn in at least 22 countries and severely restricted in nine others. Yet, Mexican versions of the painkiller are the most common drug found in back-room shops here, officials said.

A Times series in May uncovered that many of the drugs found in the underground clinics catering to poor immigrants are banned or restricted in the United States because of serious and sometimes fatal side effects.

The coroner’s office declined to say what role if any the drug played in the toddler’s death or to comment on the autopsy report. Officials said a court order bars them from publicly discussing the case. The autopsy does not indicate whether the coroner’s office conducted tests to determine if the drug contributed to her death.

Police contend that Escalante is responsible because she falsely told customers that she was a qualified medical practitioner--a fact that allegedly prevented Selene’s parents from seeking legitimate treatment.

“We believe that she would not have died if the family had sought appropriate medical attention, which the family thought they were doing,” Tustin Police Lt. Michael Shanahan said. “She identified herself as ‘Dr. Laura.’ People went to her believing she was a qualified doctor.”

Escalante--who faces three felony charges including child endangerment and unauthorized practice of medicine--could receive a maximum sentence of 10 years if convicted.

Selene’s mother, Maria Lucia Rios, reached at home Tuesday, expressed support for the charges, which were filed Friday in Orange County Superior Court. The court papers were unsealed Monday evening.

“I believe she has some responsibility,” Rios, 27, said.

She and her husband still blame themselves for their daughter’s death, Rios said, fighting back tears. “It brings back bad memories. I am sorry, I can’t talk right now.”

According to authorities, the parents took their young daughter to Escalante’s clinic Feb. 22. The girl was vomiting and had diarrhea.

The clinic, located behind Los Hermanos Gift Shop on McFadden Avenue, is owned by Oscar King, Escalante’s brother. The family has had several run-ins with authorities over the dispensing of illegally imported pharmaceutical drugs. King, who’s being investigated by a grand jury in San Diego, could not be reached for comment Tuesday.

When the couple returned home, they noticed the girl’s condition was not improving. They took her to Anaheim Memorial Medical Center, where she died. The hospital is about two minutes away from the family’s home.

Selene’s death was the second in Orange County in the last two years involving underground clinics.

In 1998, a 13-month-old Santa Ana boy, Christopher Martinez, died after he visited a clinic. Gamaliel Castro Moreno, who allegedly posed as physician at the Santa Ana clinic, was later charged with involuntary manslaughter, but he fled the country. An arrest warrant is also pending in that case.

The issue prompted the county to form the Orange County Safe Healthcare Coalition to educate residents about the perils of back-room clinics.

Sara Murrieta, a health educator with the county’s Health Care Agency and a co-chair of the coalition, said the group is working to increase the resources available to the poor because many are driven to underground clinics for economic reasons.

“That’s what we have to work on: What the different hospitals can do and what kind of funding we can get on this,” she said.

The coalition’s hotline, which refers callers to low-cost and free health care clinics, has received about 35 calls since it was set up in late May, officials said.

In June, a team of Costa Mesa police officers swept through a swap meet in search of vendors illegally selling prescription drugs. Police cited six vendors on misdemeanor charges and promised more crackdowns in the future.

Authorities are now trying to determine whether Selene was injected with a drug called Respicil, a combination of penicillin and dipyrone that is not sold legally in the United States.

Dipyrone, the drug found in Selene’s system, has been linked to deaths of at least four children in California and Texas, some doctors told The Times in May. In those cases, doctors said, the children succumbed to massive infections after taking dipyrone. As a side effect, the painkiller can suppress the production of white blood cells, which fight off infection.