Dentist Cleared in Death

A dentist charged with involuntary manslaughter in the death of a 4-year-old boy was cleared Monday when a prosecutor said the youngster had an underlying heart problem and the cause of his death could not be determined.

The charge against Dr. Gabriella Thanh-Ngoc Pham was dropped more than two years after Javier Villa died while being treated at a Santa Ana dental clinic. Pham was accused of gross negligence in the child’s death, but prosecutors could not prove the accusation beyond a reasonable doubt to obtain a conviction, district attorney spokeswoman Tori Richards said.

An autopsy by a prosecution pathologist found that the boy had myocarditis, an inflammation of the heart.

“Our expert found [that] this child basically could have died [at] any time from this condition. He could have died while on his way to the dentist,” Richards said.

Pham could not be reached for comment, but her attorney, Jennifer Keller, said prosecutors were correct in not charging her client.

“We are grateful that the district attorney decided not to prosecute. This is a case that should have never been filed,” Keller said.

Javier died Aug. 4, 1997, after he was given what investigators from the California Board of Dental Examiners determined was a high dose of the sedative chloral hydrate. The child had been taken to Megdal Dental Clinic to have eight cavities filled.

Although the sedative was prescribed by another dentist and administered by an assistant, authorities said Pham was responsible for Javier’s death because she was the attending dentist and failed to keep his airway open when he lost consciousness.

But according to Keller, the prosecution’s own experts differed on what could have caused the boy’s death. Keller said one expert reported Javier’s death also could be attributed to chloral hydrate toxicity, resulting from the 16 ccs of the drug given to him. The Board of Dental Examiners determined that 16 ccs was at the upper end of the recommended dosage for a child of Javier’s age and weight.

The oral sedative, which represses breathing, was prescribed by Dr. Miguel Angel Garcia. The state’s investigation revealed that Garcia altered the boy’s dental records to show that he had received 6 ccs of the drug instead of 16.

Garcia’s dental license was revoked in April, but he was never charged in the criminal case.

“There are any number of things that could have caused this child’s death,” Keller said. “It could have also been the lidocaine combining with the myocarditis to cause arrhythmia [irregular heartbeat], which could have led to death. This is what some prosecution experts also said.”

According to Keller, lidocaine was injected into the boy’s gums for the prescribed dental work.

The Board of Dental Examiners has scheduled a hearing in March to decide whether Pham’s license should be revoked. Pham voluntarily gave up her practice and is working as a dental hygienist while awaiting next year’s hearing, Keller said.

It is unclear what effect the district attorney’s decision not to prosecute Pham will have on a civil lawsuit filed by Javier’s parents, Javier and Yolanda Villa, against Pham, Garcia, Dr. Philip Megdal--the owner of the clinic--and dental assistant Alejandra Juarez.

The couple could not be reached for comment, and their attorney did not return telephone calls.

A spokeswoman for the Board of Dental Examiners said Megdal owned nine clinics in California at one time and is under investigation for several violations. The spokeswoman said he had been disciplined by Oregon officials in 1988 and 1989 and by California officials in 1994. Megdal, who has been licensed in California since 1967, could not be reached for comment.