By Laurel Rosenhall | CALmatters
It has become a familiar routine for the Sears family: Gather the medical experts, trek to Sacramento, and tell another panel of lawmakers how their 6-year-old son died from the anesthesia a dentist gave him to pull a tooth. Then watch as legislators water down the solution that pediatricians insist would prevent other California children from dying the same way.
Each time, the Bay Area family accepted incremental changes as they kept working toward their goal: a new law to require that two highly trained medical professionals—instead of one—tend to children under age 7 who undergo anesthesia in a dentist’s office.
But after two years of advocacy, research and heart-wrenching public testimony, their appeal suffered a major defeat last week when a Senate panel refused to vote for the family-backed bill. Saying that moving ahead with a diluted version would do “incredible harm” to their effort to advance children’s safety, the assemblyman carrying the legislation opted instead to shelve the bill. The decision effectively kills the bill for at least a year—and marks a win for Sacramento’s influential dental lobby.
“It’s a horrible disappointment,” Tim Sears said afterward, as he and his wife Eliza received hugs from friends and family in the hallway outside the hearing room.
Her face drawn with sadness, Eliza Sears remarked that “the battle here has been much more challenging and political and difficult than we ever could have realized.”
Their son Caleb died in 2015 after the anesthesia he was given for an oral surgery caused him to stop breathing. Following Caleb’s death, the couple learned that oral surgeons are the only medical professionals allowed to both administer anesthesia and operate on a patient. The two complex duties are separated in hospitals so that one provider can monitor the patient’s response to anesthesia while the other performs surgery.
The Sears family set out to change the law to give very young children—already more susceptible to the risks involved in anesthesia—an extra layer of protection when they’re operated on in a dentist’s office. A pediatrician and Harvard anesthesiology professor who testified in favor of their bill likened the concept to commercial airplanes, where a pilot and co-pilot are equipped to handle emergencies.
If the dentist performing a surgery doesn’t have a highly-trained “co-pilot,” Dr. Charles Cote said, “there is no one there that can help rescue the child.”
The family’s effort to keep other Californians from experiencing their pain gained national attention this week, featured in a segment on NBC’s Sunday Night with Megyn Kelly.
The California chapter of the American Academy of Pediatrics backed the bill requiring oral surgeries on children to include a second highly-trained professional to monitor the response to anesthesia. A study by the state’s Dental Board—prompted by a bill the Sears family lobbied for last year—recommended the change too, along with further research on potential impacts.
But the bill hit trouble in April when an Assembly committee weakened it by allowing lower-level technicians to assist dentists sedating young patients.The Sears family and the bill’s author, Democratic Assemblyman Tony Thurmond of Richmond, didn’t like the changes but moved ahead with the bill anyway. They proposed tougher amendments—specifying that the second provider must be another dentist, an anesthesiologist or a highly educated nurse—which they hoped the Senate panel would approve this week.
Instead, senators on the committee said they were unconvinced that the two-provider approach would save lives, citing two cases in the last year in which California toddlers died during oral surgery despite the presence of an anesthesia specialist. They also said raising the standards would increase the cost of treatment, making it harder for some children to get care.
“I don’t think it’s our responsibility as legislators to respond to … one particular family,” said Sen. Jerry Hill, the San Mateo Democrat who chairs the committee that refused to vote for the Sears’ family bill.
“We have to look out for the 40 million people who live in California and make sure our decisions are thoughtful, balanced and that they reflect the evidence that’s presented to us,” Hill continued. “The evidence in this case seems to clearly indicate that regardless of the person in that room, it has not historically changed the outcome.”
His panel, the Senate Business and Professions Committee, approved a different bill—one backed by the dentists’ and oral surgeons’ lobbying groups. Senate Bill 501 would study the cost and safety impact of implementing the tough standards the Sears family seeks, but it would allow dentists to continue their current practice of employing technicians with less education to assist them during surgery.
George Maranon, an oral surgeon who heads the California Association of Oral & Maxillofacial Surgeons, said those assistants are “extraordinarily well trained,” in emergency response and pharmacology, and that it’s unrealistic to think that dentists can hire anesthesiologists or high-level nurses. Most already have full-time jobs, he said, and enlisting them would be more costly—he noted that nurse practitioners earn more than $100,000 a year.
Pediatricians oppose SB 501, saying it gives a false sense of security. The assistants permitted under the bill could have only a high school diploma plus specialized emergency training. The Sears family calls the measure insufficient, pointing out that the two assistants present during Caleb’s surgery didn’t help his dentist save his life.
An investigation by the state’s Dental Board found that Caleb’s dentist, Michael Doucet of Albany, made several mistakes in trying to rescue Caleb after he stopped breathing, and he waited too long to call 911. The state revoked Doucet’s permit to administer anesthesia and put his dental license on probation for five years. Doucet’s disciplinary record states that he no longer wants to administer anesthesia. Instead, when surgeries require sedating patients, he hires an anesthesiologist.
CALmatters.org is a nonprofit, nonpartisan media venture explaining California policies and politics.
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