A Fort Worth dentist was arrested Wednesday after police alleged failures in sedation, monitoring and emergency care three months ago contributed to the death of the dentist’s 4-year-old patient.
Dr. Chrishelle Hemphill, 48, was arrested about 3:42 p.m. on a charge of injury to a child causing serious bodily injury, Fort Worth police said.
An arrest-warrant affidavit accuses Hemphill of recklessly injuring Aithana Rodriguez Arriaga, who died April 1 after a procedure at Cuddle Kids Dental Care in the 5300 block of Sycamore School Road.
The charge is a second-degree felony.
Staff with the Tarrant County medical examiner classified Aithana’s death as accidental and attributed it to meperidine toxicity, according to a search-warrant affidavit. Meperidine, also known as Demerol, is an opioid pain medication.
Testing found 793 nanograms per milliliter of meperidine in Aithana’s blood, a concentration described in the search-warrant affidavit as lethal.
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A medical examiner and toxicologist later told police the level would have been high or toxic even for an adult, according to the arrest-warrant affidavit. The toxicologist said the concentration suggested Aithana might have received the drug twice, though investigators did not establish that a double dose occurred.
Aithana, who weighed 44 pounds, had been taken to the dental office for a frenectomy, a procedure intended to address a possible tongue-tie.
Her sedation record listed chloral hydrate, hydroxyzine, meperidine and nitrous oxide, according to the arrest-warrant affidavit.
That affidavit says a Texas State Board of Dental Examiners investigation concluded that the documented doses were individually below their maximum limits but that their combined effects were not adequately considered. The medications can suppress breathing.
Aithana’s mother told police that Hemphill said the child would be sedated but remain awake.
Hemphill provided a liquid medication that the mother in turn gave Aithana before the procedure, according to the affidavits. Hemphill also used nitrous oxide, the court documents say.
The mother said she was not allowed to remain in the procedure room.
About an hour later, she was allowed inside and saw Hemphill holding Aithana and trying to wake her with a popsicle. The mother told investigators that her daughter’s leg felt cold and that her head fell backward.
Fort Worth firefighters later found Aithana unresponsive and took her to Harris Southwest Hospital, where she was pronounced dead.
Hemphill told investigators that Aithana remained awake and did well during the procedure but began losing consciousness during recovery, according to the search-warrant affidavit.
A staff member told police that pink liquid began coming from Aithana’s nostrils. Staff then reapplied monitoring equipment and attempted rescue breathing, CPR and use of an automated external defibrillator, the arrest-warrant affidavit says.
The affidavit lists Aithana’s oxygen saturation at 63%, her pulse at about 115 beats per minute and her systolic blood pressure at about 64 during the emergency.
Hemphill can be heard on a 911 recording saying, “My patient won’t wake up. We sedated her. Trying to give her reversal meds,” according to the search-warrant affidavit.
The arrest-warrant affidavit alleges Hemphill gave Aithana flumazenil, which reverses benzodiazepines. Toxicology testing did not find benzodiazepines in Aithana’s system.
Meperidine is an opioid and can be reversed with naloxone. The affidavit says naloxone was not given at the dental office but was later administered at the hospital.
A board-certified anesthesiologist who reviewed the case told police that Aithana was suffering respiratory failure and needed assisted ventilation and naloxone, according to the arrest-warrant affidavit.
The expert said the pink fluid was consistent with pulmonary edema caused by respiratory failure, not evidence of a previously undisclosed sinus or breathing condition.
Hemphill told investigators she believed Aithana died because of an undisclosed breathing condition combined with meperidine.
Aithana’s mother said the child used nasal spray for snoring but had never been diagnosed with a breathing problem. Her nurse practitioner and an ear, nose and throat specialist also told police she had no known breathing problems.
Police allege Hemphill failed to account for the combined effects of the medications, properly monitor Aithana during recovery, recognize her respiratory distress and administer the appropriate reversal medication.
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