Dentist Charged With Felonies in Use of Sedative

A Pasadena dentist is facing felony child abuse charges for allegedly over-sedating five children to the point that one adolescent was left brain-damaged, another child fell and struck his head on a table and others were released to their parents in what a prosecutor called “a rag doll state.”

The case involving Dr. Drueciel Ford, which is scheduled for a preliminary hearing in the next few weeks, is one of a small but steady series nationally in which children have been harmed through alleged misuse of the oral medication chloral hydrate.

The syrup, intended to sedate frightened or squirming youngsters during cavity-fillings, extractions and other routine procedures, is considered relatively safe by most experts if the patient is monitored and the dosage is proper.

The case against Ford also has revived a larger debate over whether--and when--it is appropriate to charge a medical professional with a crime for problems that occur during treatment.

Ford, 49, whose dental license has been suspended, faces eight felony and six misdemeanor counts, including child abuse, obstructing an emergency medical technician, falsifying evidence, dissuading a witness from reporting a crime and unprofessional conduct. Through her attorney, she categorically denied the charges.

Ford, who has practiced for 27 years, is a doting mother of at least three adopted children and “would never hurt a child,” said defense attorney Robert H. McNeill.

But Deputy Dist. Atty. Albert H. MacKenzie said prosecutors will prove that “this was a long-standing problem in the office, with children being conked out, parents not being allowed to be present during any of the procedures and . . . [then] told to drive around to back of the building with the kid released to them in rag doll state.”

He added, “If you are constantly overdosing kids on chloral hydrate and releasing them in a stupor, if you’re not monitoring children and not administering it correctly, it’s an accident waiting to happen.”

MacKenzie said he had received more than 100 complaints against Ford from parents since the initial charges became public in February. He is preparing to file additional charges involving other children as early as next week, he said.

McNeill said that his client is being “improperly prosecuted” and that the case could have chilling repercussions for all health care providers. They “are going to be painfully aware that even though they intend to do good, somebody can look back on [a case that didn’t go well] and they could be prosecuted.”

In any case, he said, the law allows only a misdemeanor charge in a case of this sort.

It is apparently unusual for prosecutors to file felony charges against a physician for alleged harm to a patient when the patient does not die. Records show that the Los Angeles County deputy district attorney in charge of medical cases did not believe the McGrath case merited felony charges. But MacKenzie said the district attorney’s Pasadena office disagreed after doing additional research, consulting experts and finding a pattern of problems in Ford’s practice.

MacKenzie said the most “egregious” allegations against Ford involve her treatment on March 15, 1999, of 15-year-old Melissa Marie McGrath.

According to prosecutors, after swallowing two large dosages of chloral hydrate within a few hours, McGrath went into cardiac arrest and stopped breathing.

MacKenzie said Ford failed to monitor the patient, delayed calling 911, then lied to emergency workers about the girl’s medical condition, suggesting that the girl might have used illegal drugs. Although the doctor indicated she had given the girl a standard dose of chloral hydrate, an expert hired by prosecutors concluded that it may have been six to 12 times higher--a lethal dose--Mackenzie said.

Formerly a popular, active A- student, McGrath now slurs her words and is incapable of speaking above a whisper, according to her octogenarian grandmother, Grace Williams, who raised her from the time she was a preschooler. She cannot walk without assistance and is living in a West Covina group home where her grandmother visits her twice a week.

“I can’t get over it; she’s so sweet and adorable and I miss her and I want her to come home,” said Williams, who cries whenever she discusses the girl’s condition. “She had half a tooth to be pulled out. She ate hard candy and the tooth broke. It was just a little tooth and this is what happened to the poor little thing.”

Records indicate that nine days after the McGrath case, a boy of about 4, Jeremy Ortiz, received a dose of chloral hydrate after which he fell and cut his face on a table.

MacKenzie said he believes that Ford used high doses of chloral hydrate for one reason: “Money.” He said it is possible for a dentist to do more procedures in a shorter span of time if young patients are heavily sedated.

Ford’s patients would not be the first to be allegedly harmed by misuse of chloral hydrate in a dentist’s office. Santa Barbara dentist Peter Hartmann, former president of the Dental Board of California, said the oral sedative has been associated with about one death a year among young children in the state since 1991. For each fatality, Hartmann estimated, about 20 patients may suffer poor outcomes short of death.

Over the past several years, deaths associated with sedation among children at dentists’ offices have been reported in Texas, Pennsylvania, Illinois and other states.

It was primarily the death of a 4-year-old boy at a Santa Ana dentist’s office in 1997 that led to a new California law requiring dentists to be certified before they can use such sedatives on children younger than 13. Hartmann said he hopes that certification and spelling out standards of care will prevent future tragedies. But the law, which mandates proper monitoring of patients and use of emergency equipment, will not be fully implemented until Dec. 31.

“Chloral hydrate is safe if it’s used at the correct dose,” said Dr. Christine Quinn, a dentist-anesthesiologist at UCLA. She said dosage is calculated according to a child’s weight. The drug is typically used on young children--up to 5 years old--and it should not be used in the dentist’s office to render a child unconscious or unresponsive, she said. The danger is that an excessive dose can cause a child to stop breathing.

A child should typically not be released from the office until he can sit up on his own and hold his head up, she said. If the child falls asleep and can easily be awakened, that is acceptable, she said.

Quinn, however, said that although chloral hydrate has its uses, “there are better drugs” for young dental patients. She prefers to use drugs in the Valium family, which have a greater margin of safety.

In any case, experts on children’s dental treatment said parents should feel free to ask questions of dentists about their experience with sedatives, their monitoring procedures and their preparation for emergencies. Experts say proper equipment would include a pulse oximeter, which measures blood oxygen levels, and a crash cart.

“We don’t want to scare anyone away from treatment,” Hartmann said. “Delaying treatment can be just as harmful” as anything else.