Overview

• The San Diego County Medical Examiner’s Office concluded on May 30 that Silvanna Moreno’s March 18 death was an accident caused by methemoglobinemia in the setting of recent nitrous oxide administration.
• Silvanna underwent a three-hour outpatient procedure under general anesthesia at Dreamtime Dentistry in Vista, California, and was monitored until she appeared awake with stable vital signs.
• Autopsy findings show she had a 101-degree fever the day before surgery and received Children’s Tylenol, but she did not display distress during anesthesia or recovery.
• After leaving the clinic, Silvanna fell asleep in the car, was placed in bed at home, and was later found unresponsive with hypoxemia and asystole, prompting emergency resuscitation.
• Dreamtime Dentistry has launched an internal review with leading anesthesia experts, and its anesthesiologist, Dr. Ryan Watkins, was previously investigated by the Dental Board of California in 2016.