Around 10 am Silvanna Moreno, 9, was put under anesthesia for the dental procedure, which lasted about three hours — but at 5:44 p.m. that afternoon she was dead
A nine-year-old girl who fell asleep in the car on the way to the dentist died tragically just hours later.
Silvanna Moreno first complained of tooth pain last October, according to the autopsy report, and was eventually referred for surgery, and after consultation, the surgery was booked for March this year.
On March 17, the morning before the procedure, Silvanna had a fever of 101 degrees, according to the autopsy report. She took Children’s Tylenol and her symptoms seemed to subside. The next morning, she “complained of a headache” but didn’t seem distressed – and at around 10am local time, she was put under anesthesia for the procedure, which took about three hours.
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Dreamtime Dentistry in Vista, California confirmed that the procedure was done under general anesthesia due to her young age and the intense stress of the situation. After the procedure, she was taken to a room to recover, during which she was described as “out of it” and “mumbling unintelligibly,” according to the autopsy report.
Silvanna left the office in a wheelchair, but was reportedly able to stand up and be helped into the back seat of a car. On the way home she fell asleep and when they got home she was asleep for about an hour and a half before her snoring started to “calm down and slow down”.
Moreno’s family checked on her regularly, but when she became unresponsive, they called 911 at 4:46 p.m. They performed CPR until first responders arrived and rushed her to the hospital. Staff at Rady Children’s Hospital tried to save her, but were unable to, and she was pronounced dead at 5:44 p.m. local time.
Her cause of death was listed as methemoglobinemia from recent nitrous oxide administration, according to an autopsy report by the San Diego County Medical Examiner (SDCME).
In a statement on Friday, May 30, a spokesperson for Dreamtime Dentistry claimed that they were “not aware of a fever or any illness” and that Silvanna had a normal temperature the day of the surgery, it says. PEOPLE.
“Dreamtime Dentistry records show that the patient’s mother completed and signed a pre-op check-in form indicating ‘NO’ when asked if the patient was sick. Dr. Watkins follows standard protocol.
In his statement, Dr. Ryan Watkins previously described Silvana as a “healthy nine-year-old with a history of regular medical exams” and said she underwent a “thorough review of her medical and dental history” before the procedure. Watkins also said that “all medications were administered according to the manufacturer’s instructions based on Silvanna’s age and weight.”
Watkins said Silvanna “never showed” any warning signs of methemoglobinemia either during the procedure or during her recovery. According to Watkins, Silvanna remained under observation “until she awoke with stable vital signs” — and before being released into her mother’s care “awake, alert, and with all protective reflexes intact,” the child was checked for “oxygenation, respiratory stability, consciousness, postoperative pain, nausea and vomiting.”
In addition to her cause of death, the coroner listed contributing factors as “administration of dexamethasone, glucopyrrolate, hydromorphone, isoflurane, ketorolac, midazolam, ondansetron, propofol and sevoflurane.” According to Dreamtime Dentistry, all of these drugs are “standard anesthetic drugs commonly used in pediatric dental sedation procedures” and claim that “any interactions or negative side effects were not due to the dosage, but to her rare but undiagnosed/undetected medical condition.”
“While the medical examiner has ruled this to be an accident, we take this result with the utmost seriousness. We are conducting a thorough internal review of this case and are consulting with leading experts in dental anesthesia to ensure we continue to provide the safest possible care to our patients,” said Watkins.
Watkins added, “We extend our deepest condolences to Silvanna’s family and ask for continued respect for their privacy during this time of grief.”
Moreno’s family has created one GoFundMe page to raise money to cover the funeral expenses of their “bright and happy” daughter. The fundraiser said: “Silvanna was a smart and loving third grader at Sherman Elementary School in San Diego. She was the sunshine in every room she entered, always greeting staff and classmates with a big smile and an even bigger hug. Her friends describe her as kind, loving and always happy, a true friend to everyone she met.”
You can donate to the GoFundMe page from by clicking here.
