AUSTIN, Texas (CN) – The parents of a 14-month-old girl who died from complications of being under anesthesia claim in court that she was undergoing painful and unnecessary dental work in a scheme to bilk Medicaid of taxpayer dollars.
Betty Squier and Elizandro Torres sued dentist Michael Melanson, Austin Children’s Dentistry, its owner Tal Shohamy, Texan Anesthesiology Association and anesthesiologist David Williams in Travis County District Court on Tuesday.
Squier and Torres are the parents of Daisy Lynn Torres, who died on March 29, 2016.
The lawsuit says children’s dentistry has become “a profit mill” where dental centers scheme to collect taxpayer-funded Medicaid money by systematically performing unnecessary dental procedures.
Dental centers specifically market to young, low-income parents whose infants and toddlers qualify for Medicaid-funded dental exams, according to the complaint. Dentists will recommend that parents consent to Medicaid-covered procedures for these children, whether or not such procedures are medically necessary, the complaint alleges.
The lawsuit also points out that pediatric dentistry is being impacted by changes to the corporate structure of children’s clinics.
“Austin Children’s Dentistry is another example of a trend within the industry: dental clinics, or more commonly, chains of dental clinics , owned or controlled by non-dentist investors…A focus on patient care and wellbeing is replaced with the profit-making mindset,” the complaint says.
At the recommendation of Dr. Melanson, Squier says she took Daisy for her first check-up at Austin Children’s Dentistry when she was about 6 months old in July 2015. The complaint notes that 6 months of age is the first time an appointment can be covered by Medicaid. Melanson allegedly did not make note of any problems with Daisy’s teeth at this time, nor did he at her next visit in November 2015.
On Jan. 6, 2016, Melanson saw Daisy again and noted a possible cavity and discoloration in a baby tooth, according to the complaint. She was to be re-evaluated in three months.
In March, Melanson allegedly said Daisy had two cavities that needed filling to prevent infection and also claimed that Daisy’s face was at risk of sinking in if the cavities were not filled. He told Squier to set up another appointment for Daisy but did not give details of the procedure to be performed, the complaint states.
The lawsuit then describes the tragic events of March 29. When Squier and Daisy arrived at Austin Children’s Dentistry in the early morning, they were given papers to sign by Dr. Williams, a mobile anesthesiologist with Texan Anesthesiology.
He allegedly did not explain the procedure to be performed on Daisy that morning or discuss the additional risks of performing it in the office setting. He also did not mention the need for any root canals or crowns, according to the lawsuit.
Melanson later arrived and took Squier and Daisy to the treatment area—what appeared to be a normal dental chair—where the two cavities would be filled. Melanson said they would put a mask on Daisy’s face, count to 10, and she would go under, the complaint states.
“When Ms. Squier asked some questions, they said they do it all the time and it was ‘no big deal.’ Ms. Squier complied…A mask was placed over Daisy Lynn’s face while she was moving and crying and then she appeared to fall asleep after about 10 seconds,” the complaint states. “Ms. Squier specifically asked to stay in the room with Daisy Lynn while the procedure was performed, but this request was refused. Ms. Squier was then told to leave the treatment room and wait outside. This was the last time Ms. Squier ever saw her daughter with any real life left in her body.”
A few minutes later, Melanson allegedly came out to the waiting room and told Squier that Daisy had six cavities instead of two that needed work. According to the complaint, he said he needed to do four root canals and place crowns on Daisy’s upper baby teeth, as well as do the two fillings on her bottom jaw.
Squier asked if that was normal, and she says Melanson insisted he needed to do the procedures now for Daisy’s safety and well-being and because it is what a good, responsible parent would do.
“Ms. Squier trusted that what Melanson told her was true—that the procedure and crowns were needed then for Daisy Lynn’s well-being,” the complaint states.
But approximately 15 minutes later, Melanson reportedly returned to the waiting room, asked Squier to step into another room, told her Daisy was having complications and said CPR was being performed.
“Dr. Melanson said everything was ‘under control,’ Daisy Lynn was fine and stable, and don’t ‘freak out and don’t panic.’ At the same time, he said emergency medical services had been called per normal procedure. Ms. Squier immediately asked to see her daughter, which Dr. Melanson refused,” the 37-page lawsuit says.
EMS arrived at Austin Children’s Dentistry and found Daisy in the dental chair with no pulse and unresponsive as she received CPR. Paramedics tried to revive her as her parents waited, though they were not allowed back to see their dying daughter, the complaint states. Squier says she watched her daughter get wheeled out on a stretcher and was told she was in cardiac arrest.
Daisy was then taken to the hospital, but staff found that she was not making any spontaneous movements or breathing efforts. She was moved to the pediatric intensive care unit, but she never improved and was pronounced dead after a final 34 minutes of failed CPR, and life support was removed.
The Travis County Medical Examiner concluded in an autopsy that Daisy died from complications caused by anesthesia. The autopsy also noted there was no evidence of dental or oral pathology and the medical examiner saw no problems that Melanson could have been trying to correct with his procedures, the lawsuit states.
For further investigation of Daisy’s dental records, the medical examiner retained Dr. Robert Williams, an independent forensic odontologist, according to the complaint. On July 5, 2016, Williams issued a report saying he did not see sufficient evidence of tooth decay or pain in Daisy’s records to justify the surgery performed by Melanson, Squier and Torres claim.
Following Williams’ report, Melanson and Austin Children’s Dentistry allegedly tried to pressure him into changing his opinions and threatened to sue him. Despite the threat, he confirmed his original opinion to the medical examiner, the complaint states.
As a result, Austin Children’s Dentistry sued Williams for defamation in a lawsuit filed in September in Travis County. It said the statements in Williams’ report were “alarming, damaging and controversial to ACD as it concluded, either directly or indirectly, that the dental procedures performed upon the deceased minor patient lacked dental necessity and were unjustified.”
This resulted in the medical examiner making a ruling of an “undetermined” cause of death instead of a “natural” designation, the dental center claimed.
The dental center also claimed in its lawsuit that it conducted an internal review of the incident and concluded that the treatment provided to Daisy was necessary and appropriate.
It says it sponsored independent expert reviews of Daisy’s patient records, which concluded that the “clear dental necessity for Dr. Melanson’s treatment was obvious and supported in the record entries and radiographs that were not even noted or referred to by Dr. Williams.”
Despite the independent reviews, Williams and the Travis County Medical Examiner ultimately decided not to revise the odontology report or autopsy. Williams previously agreed to do so, Austin Children’s Dentistry claimed.
“Dr. Williams and the TCMEO have conspired to conceal the problems evident in the autopsy report…and have maliciously allowed the erroneous report to damage the business reputation and goodwill of ACD and destroy the professional career of Dr. Michael Melanson,” Austin Children’s Dentistry said in the 2016 lawsuit.
Squier and Torres say other parents have complained about their children being subjected to unneeded dental work by Melanson and Austin Children’s Dentistry.
“What is not yet clear is now many other families these defendants have preyed upon,” their lawsuit says.
A spokeswoman for Austin Children’s Dentistry said she could not comment on the wrongful death lawsuit brought by Daisy’s parents, but said the girl’s death “is a tragedy no matter how you look at it.”
The Texan Anesthesiology Association did not respond Thursday to an email request for comment.
Squier and Torres seek actual and exemplary damages for claims of fraud, medical negligence and the undisclosed risk of the procedures resulting in Daisy’s death. They are represented by Sean Breen of Howry Breen & Herman in Austin.