An administrative law judge with the State Office of Administrative Hearings has issued a scathing ruling recommending that Dr. Bethaniel Jefferson's dentistry license be permanently revoked, largely due to what happened to four-year-old Nevaeh Hall.
The child walked into Jefferson's dental office in January bubbly and happy, as we reported in our August 9 cover story, "Bad Teeth". By the time she was rushed out of the office that afternoon, Nevaeh had sustained significant brain damage.
This was Nevaeh's second trip to Jefferson's office. On a previous visit, in November 2015, Nevaeh had undergone a number of extractions, pulpotomies (where the infected pulpy inside of a tooth is removed) and stainless steel crowns. She'd been given three milligrams of Valium and five milligrams of Atarax for that appointment and "tolerated it well," according to administrative law court documents.
On the second visit, as her dental records show, the plan was to extract her damaged baby front teeth — she’d fallen down face first shortly after the teeth came in — and put crowns on the teeth on the right side of her mouth.
Nevaeh was given six milligrams of Meperdine and five milligrams of Atarax to sedate her, but once the procedure started she began screaming, shaking her head and trembling violently, according to the administrative law court documents. Jefferson reassured Clark and her husband, Derrick Hall, Nevaeh was only scared, according to a Texas State Board of Dental Examiners report and state district court documents.
A little after 11:30 a.m., Jefferson administered two doses of .031 milligrams of Halcion, according to the administrative law ruling. Nevaeh's blood oxygen level began to drop a few minutes later, and was mostly low for the next five hours.
Clark says the dental staff laid Nevaeh down on a cot and locked her parents out for hours. When Nevaeh didn't improve by that afternoon, an ambulance came and rushed her to Texas Children’s Hospital. There, her parents learned she’d been severely overmedicated on sedation drugs, had spent hours without enough oxygen and had suffered brain damage, according to a report from the Texas State Board of Dental Examiners.
"Keep in mind, Dr. Jefferson was certified to administer all of those drugs to sedate patients, but the certification is easy. She attended a six-hour course on a weekend and if you were alive at the beginning and the end you passed," says Jim Moriarty, a lawyer who specializes in dental malpractice and who is representing Clark on behalf of Nevaeh.
The story made national headlines and has resulted in a civil lawsuit filed by Clark in state district court in July.
The case also caused the Texas State Board of Dental Examiners to move toward revoking Jefferon's license, a slow process that requires an administrative law hearing and a vote from the Texas State Board of Dental Examiners.
Jefferson has a history of infractions with the state board starting in 2005, when the board reprimanded her for failing to enter patients’ vital signs in her records, according to board documents. She paid a $1,000 fine and took continuing education classes. In 2012 Jefferson again ran afoul of the board for not meeting standards of care while sedating a patient. She was fined $3,000 and once again ordered to take continuing education courses, but kept her license.
Jefferson's license was temporarily revoked by the Texas State Board of Dental Examiners in January because the board decided “continued practice of dentistry by Bethaniel Jefferson, D.D.S.…would constitute a clear imminent or continuing threat to a person’s physical health or well being.”
In May, Administrative Law Judge Holly Vandrovec heard arguments from both the Texas State Board of Dental Examiners and Jefferson's lawyer. She used those arguments to put together her 18-page findings of fact ruling, determining both the facts of the case and how each of the facts violates the law. The ruling was quietly issued on August 12.
In the ruling, Vandrovec went through what happened to Nevaeh. She also briefly delved into the treatment of another minor patient, unnamed in the ruling, who Jefferson allegedly "provided excessive treatment for" by placing sealants on the child's teeth, performing pulpotomies and putting on stainless steel crowns. Both the pulpotomies and the crowns failed shortly after Jefferson had done the work, causing infections and requiring the treated teeth to be extracted, according to the ruling.
Vandrovec concluded Jefferson had fallen "below the minimum standard of care in the treatment of two minor patients, failed to uphold the duty of fair dealing when providing care to Patient one, and engaged in dishonorable conduct when providing dental care to [Nevaeh Hall]."
She spelled it out in terms of the law, finding that Jefferson's actions constitute "dishonorable conduct", a failure to treat patients according to the "standard of care", violations of the law regarding dentistry regulations, and "negligence [that] causes injury or damage to a dental patient," all violations of the Texas Occupation Code and board rules.
This isn't quite the end of the line for Jefferson. The members of the Texas State Board of Dental Examiners have to vote on whether to revoke Jefferson's license at their annual meeting in November.
Texas State Board of Dental Examiners spokeswoman Lara Anton responded to our request for comment via email. "Our Executive Director, Kelly Parker, wanted me to convey that we respect the process but prefer not to comment until the decision is final. The Proposal for Decision is not yet final because the attorneys still have time to file exceptions," Anton stated.
Moriarty is sanguine about how the vote will turn out. "In my view, it's a sure thing they'll revoke her license," he says.
First, Moriarty contends Jefferson would have had to be deaf, dumb and blind not to know the child was in distress. Secondly, he says the filings from the state board and the administrative law judge show that both viewed the amount of time that passed between when Nevaeh first went into distress and when they finally called an ambulance as "a crazy amount of negligence," Moriarty says.
(We called Jefferson and left a message asking for comment. We'll update when and if we hear back.)
"If the board won't revoke Jefferson's license then we might as well do away with the Texas State Board of Dental Examiners entirely, because they won't serve any purpose," Moriarty says.
For now we'll just have to wait and see what happens in November.
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