A 2-year-old Greensboro boy who died July 17 at Valleygate Dental Surgery Center had not had any dental procedures before experiencing a fatal medical emergency, the N.C. State Board of Dental Examiners said Tuesday.
The cause of death for Er’Mias Mitchell has not been determined. His death is the subject of separate N.C. Department of Health and Human Services and Greensboro Police Department investigations.
The dental board said in Tuesday’s statement that its investigative panel concluded that “no dentist or other dental personnel were involved in the administration of any anesthesia or sedation to the patient.”
“Rather, these services were performed by other licensed medical providers.
“The board understands that the investigation of those providers by other agencies may be ongoing, and that the medical examiner has not yet issued a report, including the cause of death.”
Valleygate, based in Fayetteville, is doing business as Valleygate Dental Surgery Center of the Triad at 510 Hickory Ridge Drive in Greensboro.
Valleygate’s four facilities in North Carolina provide dental surgical procedures in a hospital-like setting while the patient is under general anesthesia.
Bobby White, the board’s chief executive, posted shortly after the child’s death that the board would conduct an investigation to determine whether the boy’s death “resulted from anesthesia provided by a medical provider or certified registered nursing assistant (over which the board has no jurisdiction), or was the result of a dental procedure that fell below the standard of care.”
White wrote the board “has rules, procedures and protocols that must be followed at any time pediatric sedation is administered in a dental office/facility by a dentist who is the holder of a pediatric sedation permit.”
“However, Valleygate Dental Surgical Center is an ambulatory surgical center licensed by the N.C. Department of Health and Human Services. It is not considered a dental office.
“Dentists will often schedule procedures in hospitals or surgical centers, and medical staff at those facilities will provide the sedation services. This frees the dentist to concentrate only on the dental procedure,” White wrote.
Fatality at practice
Greensboro police officers responded to a call for “law assistance,” police spokeswoman Annette Ayres said on July 18.
At the time, it is unclear what caused the child’s death. It is also unclear if the child died at the center or at a local hospital.
Greensboro police could not be immediately reached Wednesday for an update on its investigation.
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Valleygate chief executive Virginia Jones said in a July 18 statement that they were “heartbroken” by the death.
“Our thoughts are with their family and loved ones during this unimaginably difficult time. The health and well-being of every patient is our highest priority,” Jones said.
According to Jones’ statement, “since 2019, more than 13,000 patients have safely received care at our Greensboro ambulatory surgery center.”
“We are actively reviewing yesterday’s circumstances in collaboration with all relevant agencies.”
DHHS investigation
DHHS said Wednesday when asked for an update on its investigation that “we cannot comment on potential or ongoing investigations.”
In September, DHHS stopped Valleygate from using three new procedure rooms because they didn’t conform to state regulations.
A formal cease-and-desist notification was sent to the provider.
The 23 deficiencies listed include wiring issues, building code violations, leaks in the medical gas system and mechanical emergency stop switches not functioning.
“Valleygate must immediately cease and desist the provision of any and all services in the newly constructed procedure rooms or other modified areas at the Facility unless and until the Construction Section expressly approves their use,” DHHS said.
“Failure to immediately comply with the provisions of this notice may result in the department seeking injunctive relief to prevent operation of the facility. Further, the department reserves the right to take any administrative action on your license as warranted.”
According to the DHHS notification, Valleygate completed in July the addition of the three new procedure rooms, as well as made other modifications to the facility.
DHHS said that plans for the additions were not submitted for review and inspection to see if they met regulatory requirements, state building codes and federal Life Safety Code.
During a Sept. 4 inspection of the Greensboro facility, the state Division of Health Service Regulation’s Construction section “identified numerous deficiencies and areas of non-compliance with applicable statutes and rules.”
The cease-and-desist letter was required, DHHS said, “due to the severity of the non-compliance identified during the Construction Section’s inspection, and Valley gate’s failure to submit a copy of the construction plans and specifications for the procedure rooms and other modifications prior to their construction as required.”
A supplemental report on the inspection listed deficiencies to be corrected that include issues with: HVAC, office lighting and wiring; missing nurse’s emergency call functions, also known as “Code Blue;” fire shutters not closing properly; mechanical emergency stop switches not functioning; leaks in the medical gas vacuum system; and strobe lights that were deemed as potentially unnecessary.
“When the deficiencies … have been corrected, we must receive a letter addressing each and confirming that the work is complete,” according to the notification. “Once the letter is received, we will schedule a reinspection.”
rcraver@wsjournal.com
336-727-7376
@rcraverWSJ
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