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Officials Investigate Death of Toddler After Fatal Dental Visit

June 7, 1986

NEW YORK (AP) _ Officials were investigating Friday whether charges should be lodged against a dentist whose 2 1/2 -year-old patient died hours after allegedly being given four drugs for a tooth extraction and filling.

The boy, Rifa Setiyono, died Thursday nearly five hours after Dr. Philip Howard, a dentist with 25 years’ experience, performed the dental work, police said.

The toddler was given at least three anesthetics - Pentothal, nitrous oxide and ketamine - and Valium, a muscle relaxant, said Detective Jerry Friedman of the 112th Precinct. Police were unsure of the amounts of drugs used or if all were administered before the dental procedure began.

No charges were filed, pending the results of an autopsy report, Friedman said.

Andrew Anzalone, chief of the medical examiner’s evidence unit, said Friday evening that the cause of death will be determined in a couple of weeks, after further study and chemical examination. No preliminary findings were being released, he said.

The child was in the recovery room 4 1/2 hours after the work was done when his father, Bambang Setiyono, noticed he was having trouble breathing and notified Howard.

The dentist tried to remove an obstruction in the boy’s throat with suction, and when there was no response began administering cardio-pulmonary resuscitation, police said.

Police and paramedics were called to the office and there was a brief argument between the dentist and the paramedics over who should treat the child, police said.

Police Sgt. Philip Goldberg said the dispute was settled and the child was rushed to Elmhurst Hospital in cardiac arrest. Despite efforts to revive the child, he died at 4:45 p.m.

A receptionist at Howard’s office said Friday the dentist ″was not available and had no comment at this time.″

The Queens district attorney’s office and the Office of Professional Discipline, which oversees doctors and dentists statewide, also were conducting an investigation into the child’s death.

Joseph Fisch, executive director of the discipline panel, noted that Howard has ″never been the subject of any prior disciplinary action.″

Howard, 52, is a dental surgeon who specializes in anesthesiology. He is not a pediatric dentist, and that brought criticism from the past president of the American Association of Pediatric Dentistry.

″I’ve been doing pediatric dentistry for 25 years. For two teeth I could have had it done in less time than you and I are spending talking - with the child awake,″ Dr. Stephen Moss said in an interview.

However, Moss, chairman of New York University’s Department of Pediatric Dentistry, stressed that the combination of drugs may have had nothing to do with the child’s death.

Although patients undergoing general anesthesia are cautioned not to eat anything hours before a procedure, Moss said, ″The child may have eaten something behind his parents back, vomited it during recovery and it got caught in the air tract.″

He also said it was not unusual to treat a child so young for tooth decay.

A friend who answered the phone at the Setiyonos’ said the parents were not at home.

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