A California dentist who treated a 9-year-old girl hours before she died following a routine procedure was placed on probation years prior for another procedure mishap, documents show.

Back in 2020, Dr. Ryan Watkins was disciplined over a 2016 incident in which a 54-year-old man’s heart stopped after Watkins put him under anesthesia during a dental procedure.

According to a complaint filed with the Dental Board of California, Watkins engaged in “unprofessional conduct” after “clearly excessively administering drugs or treatment” to the patient, identified only as “MK.”

The man had seen Watkins approximately three times before the dental surgery and was considered to be in “excellent health” and was a triathlete. 

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However, it was noted that the victim had a low resting heart rate, dental phobia and had a history of fainting, which the complaint said Watkins did not investigate or document.

The patient’s heart stopped during the surgery where Watkins began CPR to revitalize it until EMS arrived, the documents said.

Hospital staff noted that the victim’s ribs were fractured due to Watkins performing chest compressions on him. The man was later diagnosed with a mild neurocognitive disorder caused by cardiac arrest, records show.

“A doctor concluded that the administration of ephedrine likely caused MK’s tachycardia (increased heart rate above 100 bpm) that would have subsided and that the use of adenosine was unnecessary and caused MK’s heart to stop (asystole),” the documents read.

Watkins was placed under probation for 35 months by the California Dental Board, which still allowed him to keep working at the practice as long as he complied with additional requirements and oversight. 

According to the decision, Watkins was also ordered to pay more than $19,000 to cover investigative and prosecution costs. 

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Watkins confirmed the previous incident to Fox News Digital, stating that “emergency protocols were immediately activated” once the patient developed cardiac arrhythmia during the procedure. 

“Following this incident, regulatory proceedings were initiated. Throughout this process, we maintained that comprehensive safety protocols were followed, all medications were administered according to manufacturer guidelines based on the patient’s age and weight, and the patient received continuous monitoring,” Watkins explained in a statement.

He added that “in an effort to resolve the matter and focus on patient care,” a settlement was reached without admission of wrongdoing and probation orders were completed.

“This experience has reinforced our unwavering commitment to patient safety. We continue to maintain rigorous adherence to established emergency response procedures, comprehensive safety protocols, and continuous patient monitoring systems to ensure the highest standard of care for all our patients.”

— Dr. Ryan Watkins, dentist anesthesiologist, Dreamtime Dentistry

Watkins is still practicing at Dreamtime Dentistry and reiterated that he was not at fault for 9-year-old Silvanna Moreno’s death and not aware of her health issues. 

“The coroner’s report showed her death to be an accident due to a pre-existing medical condition of which none of the parties were aware prior to the procedure,” the statement from Watkins read. 

“While the Medical Examiner has ruled this an accident, we take this outcome with the utmost seriousness,” the statement continued.

Watkins added that a thorough internal review of Moreno’s case is being conducted and that they are consulting with leading experts in dental anesthesia to ensure patient safety is provided. 

“The safety and well-being of our patients will always remain our highest priority. We are committed to learning from this tragic event and will implement any additional safety measures that may help prevent such occurrences in the future,” Watkins said. 

Moreno had been referred to the practice for dental treatment under general anesthesia “due to her young age and situational anxiety,” on March 18, where she was seen by Watkins, according to a previous statement obtained by Fox News Digital. 

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Watkins said that “the dosage administered was appropriate for the patient’s age and weight, following established medical protocols.”

“Any interactions or negative side effects were not due to dosage but instead due to her rare but undiagnosed/undetected medical condition,” Watkins shared in a statement with Fox News Digital. 

According to an autopsy report from the San Diego County Medical Examiner’s Office, authorities ruled that her manner of death was an accident caused by “methemoglobinemia in the setting of recent nitrous oxide administration.” 

“We are profoundly saddened by the tragic loss of Silvanna Moreno, and our hearts continue to go out to her family during this incredibly difficult time,” Watkins said. 

Stepheny Price is a writer for Fox News Digital and Fox Business. She covers topics including missing persons, homicides, national crime cases, illegal immigration, and more. Story tips and ideas can be sent to stepheny.price@fox.com