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Reporter explains how he wove data, human stories into compelling series on dental deaths Date: 01/13/16

By Mary Otto

In early 2014, a 4-year-old Dallas boy named Salomon Barahona Jr. died after undergoing sedation for a dental procedure.

The child’s death spurred Dallas Morning News reporter Brooks Egerton to embark upon what turned out to be a major reporting project – an 18-month investigation of dental safety in the United States.

Egerton sifted through thousands of records detailing patient harm and endangerment drawn from many sources: state and federal regulators, police, coroners, academic researchers, courts, litigators, insurers, dental schools and dentists themselves.

The project involved open-records requests to all 50 states and the District of Columbia, as well hundreds of interviews. With the help of data editors, Egerton also researched the systems states use to track and report dental deaths.

In the resulting seven-part series, “Deadly Dentistry,” Egerton set out to offer what he has described as a look “into dentistry’s netherworld, where professionals take chances with patients’ lives and the government largely tolerates it.”

In the series, Egerton raises questions about how many dental injuries and deaths may be going unreported across the country – and how many dentists may go undisciplined for malpractice.

“Since 2010, Texas has received at least 85 death reports. Projected out to the whole U.S. population, that’s a little over 1,000 deaths,” Egerton wrote. He described what he sees as “a national pattern… in which state dental enforcers ignore many malpractice cases and leave the public in the dark.”

In this Q & A, Egerton offers insights into how he wrote his Deadly Dentistry series:

 

Q: Please tell us a little more about how this project unfolded.

A: While completing another project last year and waiting on an editor, I was passing time by flipping through regulatory filings and found one related to a young dental patient's death here in Dallas. Deadly dentistry was an unfamiliar idea to me then, so I initially thought there might be nothing to do but a one-off story. Then I started trying to get some perspective from data – and here we are, 18 months later.

Q: What sources turned out to be the most helpful to you?

A: I'm not sure I can say which sources were most helpful. But two things come to mind immediately. First, I am eternally grateful to the Barahona family, whose 4-year-old son died here nearly two years ago, for opening their lives to me. Second, dental regulatory agencies, for all their failures to collect and disclose safety information, do contain troves of amazing information in their public disciplinary files.

Q: What was the most significant roadblock you confronted along the way and how did you overcome it?

A: Perhaps the most significant roadblock is one that we did not overcome: We never obtained the patient death and hospitalization reports that dentists must file in most states. We thought we had a good chance of getting these records here in Texas, which does not explicitly classify them as confidential. We spent significant time and money in suing for the records, but a judge ultimately ruled against us. There are a few states that are willing to share such records – which is fertile ground for further reporting.

Q: But you make the point that the lawsuit against the state did not turn out to be a wasted effort for your reporting.

A: Even though we lost the lawsuit against the state of Texas, we did get just enough data to come up with our first-of-its-kind estimate on how often U.S. dental patients die: roughly one every other day. And the experience — along with similar struggles to obtain statistics around the country — helped us realize that secrecy and government data-collection failures were central to the story.

Q: What kind of reactions have you gotten to the project so far?

A: Numerous dentists and other health-care professionals, not to mention patients, have expressed gratitude that someone finally spotlighted the long-neglected problem of deadly dentistry. I expected some dentists or dental trade associations to accuse us of making the whole profession look bad, but I haven’t seen any sign of that occurring. Some reaction occurred even before we published. For example, once we raised questions, Texas suspended the license of a dentist who had been practicing freely in this state despite discipline in Nevada for two patients' deaths. Texas officials also vowed to toughen background checks of license applicants, using the National Practitioner Data Bank – which most state dental boards, as our reporting showed, have not been employing fully.

Q: Are you planning to follow up with any more stories?

A: I’d love to do some follow-up stories, but none are specifically planned at this point. The bar will be high, given the huge amount of material we’ve published already.

Q: How did you keep your notes and other reporting materials organized over the course of the project?

A: I don’t have any bragging to do here. I did a decent job of promptly digitizing any paper records I obtained and creating an electronic filing structure, but I fell behind on transcribing some interview notes and updating timelines and spreadsheets. That led to some scrambles later when writing. One thing that did help with the writing: As soon as I felt fairly sure that material would become part of a full-length story, I banged out partial drafts — and they mostly turned out to be useful when I was writing final drafts.

Q: Do you have a pearl of wisdom you can share with the reporter who might tomorrow get a phone call that will set him or her off on a journey like this one?

A: Pearl of wisdom: Trust your gut! If you see something or hear something that shocks you, make time to check it out. Maybe no one has been down this road before — and maybe there is a way to quantify it.