Going to the dentist has become almost as routine as getting a haircut. And usually when you take your child to the dentist, you don't give it a second thought. Until you hear the story of what happened to this little boy. His parents took him to the dentist to get some cavities filled... and he left in an ambulance.
DAVID WALSKI: He walked in, walked up the hallway and into the room and just climbed right up in the chair.
LISA WALSKI: Holding your hand, right?
DAVID WALSKI: Yeah. And he smiled at us and just said, "Big."
VICKI MABREY: Big?
DAVID WALSKI: Big. He knew that that's what we told him, to be a big boy. And he's telling us that, "It's OK. I'm big."
David and Lisa Walski took their three-year-old son Jonathan to the family dentist in Wilkes-Barre, Pa., in 1996 to have a cavity filled. The dentist found others as well. But Jonathan was fidgety. So the dentist told the Walskis to schedule another appointment, when the cavities could be filled after making Jonathan sleepy.
DAVID WALSKI: I said, Are you telling me this is something that needs to be done in a hospital?
MABREY: You actually asked him that?
DAVID WALSKI: Yes. That was my check question. He said, "No. We take care of everything here."
It turns out, it wasn't that dentist taking care of things, but another one, an oral surgeon, Dr. Joseph Mazula. He administered the drugs that would sedate Jonathan.
DAVID WALSKI: As we left the room, though, I said to Mazula, I said, "Take care of my boy." And he said, "Oh, I will."
An hour into the procedure, an ambulance arrived.
DAVID WALSKI: All of a sudden, we hear sirens.
MABREY: But you didn't think they were for you.
DAVID WALSKI: Well, that's what I didn't want to believe.
LISA WALSKI: As a mom, I just thought, "He's the only one there. So it has to be for him."
It was. Jonathan's heart had stopped during the procedure. Paramedics began CPR and pumped oxygen to his lungs.
DAVID WALSKI: I'm yellin' to him, "C'mon, buddy, you can make it. You can do this."
MABREY: You just took him to the dentist.
DAVID WALKSI: Yeah. To get cavities filled. And now I'm going to the hospital, and he's not breathing.
An hour later, Jonathan was pronounced dead.
LISA WALSKI: Every week, there's a day that I cry. And just hold myself and sob.
Jonathan's death became even harder for the Walskis as they learned how many things the oral surgeon did wrong, facts that didn't come out until the local district attorney, Peter Olszewski, began an investigation.
MABREY: Why did the district attorney's office become involved in this case?
OLSZEWSKI: When they do not explain the risks associated with general anesthesia, when there is no pulse oximeter, when there i no IV equipment, when there is no trach tube, when there is no EKG machine, when there is no crash cart, and a young boy dies, we're going to take action and we're going to send a message.
Dr. Mazula pled guilty to a second-degree felony. He was sentenced to five years probation, and had his Pennsylvania anesthesia permit revoked.
The question, of course, is why do children need to be put under general anesthesia -- or even sedated -- just for cavities? Most dentists say it's to calm scared and screaming children -- to get them in the chair and prevent further gum and tooth disease.
MABREY: So is it worth it to put a child under to fill a cavity?
YASTER: That's an interesting question. There's no question that if you're going to do that, it has to be done the absolute safest way it can be done. It can't be done in a slipshod way, because the balance is out of whack.
Dr. Myron Yaster is a pediatric anesthesiologist at Johns Hopkins Hospital. Medical anesthesiologists like Dr. Yaster are required to have at least four years of anesthesia training after medical school. But many oral surgeons have a year and half of additional training, and some dentists perform some of the same sedation procedures -- and administer the same drugs -- with as little as 60 hours of training. Dr. Yaster is concerned about the ways sedation and anesthesia are used on children.
YASTER: For a cavity versus say a brain tumor, you're going to accept certain risks that are different. I don't sedate patients when they go to get a haircut. Children cry when they get a haircut. There's a risk, and there's a benefit.
And while Yaster ultimately agrees children may, in some cases, need to be sedated for cavities, he says it must be done by doctors or dentists who have the proper training and right equipment -- monitoring machines and emergency crash carts like these.
YASTER: Because children are different, and because children need a deeper level of sedation than adults do, that's why I think children need to be monitored more closely. Because once you go to that deeper level of sedation, you're on a slippery slope, and it could very easily become catastrophic.
Although there are no exact numbers on how many children have died, there is an ongoing study at Northwestern University which claims to document nearly 100 medical sedation disasters. And the lead author told us, quote, "a disproportionate number of sedation accidents are dental."
For example: Los Angeles, 1997. Four-year-old Javier Villa was overdosed with oral sedatives. He was positioned in a way that blocked his breathing and died while having six cavities filled.
Long Island, NY, 1993. Six-year-old Mark Bistany went to the oral surgeon to have a tooth pulled. He went into cardiac arrest and a coma, and suffered brain damage.
And San Francisco, 1997. Five-year-old Ben Shimshock died while getting cavities filled after hi oral surgeon gave him a lethal mix of drugs. Ben's parents Nicole and Gene were told he needed general anesthesia because he had so many cavities.
NICOLE SHIMSHOCK: I just kept hearing, "You'll be very satisfied with the results. We do this all the time. This is no big deal."
MABREY: You didn't think this would be dangerous at all.
NICOLE SHIMSHOCK: Oh, there was never, ever any indication that this would be a dangerous procedure. And I said, you know, "Is this commonly done?" And she goes, "Oh, we do this all the time. This is a very kind way to handle a child's cavity."
According to state documents, the oral surgeon, Dr. Marianne Truta, not only gave Ben a lethal cocktail of drugs, but also failed to record his vital signs. And she did not take appropriate life-saving measures after discovering too late that the little boy had stopped breathing.
MABREY: Dr. Truta, Vicki Mabrey from 60 Minutes.
We tried to talk to Dr. Truta outside her home, after calls to her attorney were not returned.
MABREY: How did Benjamin Shimshock die while he was in your care? Did you monitor him?
MABREY: How can so many things go wrong?
YASTER: Well, you can ask me why didn't they just put a bullet in the chamber of the gun and shoot him? I mean, they did nothing right. I mean, they did every single thing you could do, you know, short of just shooting this kid.
Nine months after the California Dental Board filed a formal accusation against her, Dr. Truta surrendered her license without admitting wrongdoing. The case upset Dr. Peter Hartmann, who sits on the California board and was the president when Ben Shimshock died. Dr. Hartmann was already investigating the growing problem in California.
HARTMANN: We have found that since 1991, we've had a preponderance of child deaths in dental offices being caused by oral sedation.
Five deaths, in fact, all children under the age of seven. From his research Dr. Hartmann discovered another disturbing fact.
HARTMANN: We have received testimony at one of our hearings that possiblyÂ…for each death there's 40 bad scenariosÂ… Something goes wrong. The child maybe becomes paralyzed. Something like that. SoÂ…that's quite a few children that are getting injured.
It would mean that at least 200 children in California alone have been injured from dental sedation or anesthesia since 1991, a fact that recently led Dr. Hartmann and the board to help pass tougher laws in California regulating dental sedation.
But with so many injuries and deaths, how carefully are dentists being policed? That depends on each state's laws, which are supposed to be enforced by each state's dental board. But those laws -- and their enforcement -- vary. In fact, just 32 state boards even have the right to inspect dental offices without a complaint. And of those 32, only 10 sid they conduct regular inspections. One that doesn't is Pennsylvania, where District Attorney Olszewski prosecuted the oral surgeon in Jonathan Walski's death.
OLSZEWSKI: The state goes and inspects barber shops in the Commonwealth of Pennsylvania. If we can inspect barbershops for proper equipment, I don't know why we can't inspect dental offices. It just seems a bit absurd that we don't.
That's not all that seems absurd to Olszewski. While the DA got a second-degree felony conviction against Dr. Mazula, the state dental board -- which wouldn't talk to us because of a related investigation -- merely suspended his license. Now that suspension has passed. Today, Dr. Mazula -- who also wouldn't talk on-camera -- is eligible to get his license back, meaning he could return to practicing dentistry while still on probation for the involuntary manslaughter of Jonathan Walski.
OLSZEWSKI: I think the dental board really needs to reevaluate itself and has to ask itself what kind of consequences are there for oral surgeons and dentists who act as recklessly and with such total disregard for the safety of a young child to kill the child? What comes of that? The answer as demonstrated by the board is not much.
MABREY: What were they doing? Just protecting one of their own?
OLSZEWSKI: I think that's certainly an argument that can be made. And if the board wants to take the position that this is the kind of person we want to practice dentistry in the Commonwealth of Pennsylvania, God help all of us.
Even with the deaths and serious injuries, the debate among dentists isn't whether children should be sedated at all, but who should be doing it. Most medical fields recognize anesthesia as a specialized area of care. Even veterinarians have a specialty. Dentists do not. To find out why, we asked Dr. Tim Rose, president of the American Dental Association.
MABREY: Other disciplines do recognize anesthesiology. I mean, even veterinary medicine. Is it more important to anesthetize my cat than it is to anesthetize a child?
ROSE: The issue here is not whether you're going to anesthetize your cat or a child. And the sense of the American Dental Association now is that there's ample opportunity and ample availability of certified, regulated, controlled and trained professionals to deliver that kind of care.
MABREY: The Walskis and the Shimshocks are educated people. They thought they were doing what was best for their children. How did their children end up dead, and the ADA is not taking a leading role in saying, "We need to make sure that this is a specialty?"
ROSE: We don't have within the dental profession a need for those people. We have people that are currently trained to deliver those kinds of services. There's also an abundant number of anesthesiologists in the medical community can do these same types of procedures.
And most of the dentists and oral surgeonwe talked to agreed. They say cases like these are rare. But for people like the California Dental Board's Dr. Hartman, even one death is too many. For them, the issue is simple -- each child who walks into a dentist's office should walk out.
HARTMANN: A child doesn't have to die in a dental office, and especially if it was a child that was being treated negligently and because the practitioner didn't know what they were doing. We don't want any deaths in the dental office. We don't need any deaths in the dental office.
DAVID WALSKI: They winged it. That's what they did, is they winged it. They knew that they didn't have the equipment with them necessary to do a three-year-old child. And they winged it. To me, that was a lack of concern for us and for their other patients that went through the same procedure probably, but were lucky. And they came home with their children.
A Deadly Visit To The Dentist
Keep Your Kids Safe || Transcript