Crosley Law Settles San Antonio Dental Malpractice Case Covering 253 Children

The Smile Center ran six dental clinics across San Antonio. According to parents and a later Texas Attorney General inquiry, the chain recruited Medicaid-eligible children in store parking lots, apartment complexes, and retail centers, using balloons, candy, and small prizes to bring them in. Once the kids were signed up, the clinics billed Medicaid for treatment that families said the children never needed.

Much of the billing centered on pulpotomies (baby root canals) and stainless steel crowns, two of the higher-paying pediatric procedures. One of the chain's dentists alone billed Medicaid more than $1.5 million for pulpotomies and crowns in a single year. Children were strapped to papoose boards to hold them still. Some were sedated with Versed that wore off before the work was finished, and a number of young patients left with injuries serious enough to require emergency care or hospitalization.

Former staff described production quotas and bonuses for dentists who exceeded them, an incentive the families argued put volume ahead of the children's actual needs. State figures showed the chain collected more than $55 million from Medicaid between 2008 and 2010.

Thomas Crosley of Crosley Law took on the families. What started as roughly 100 former patients grew into a claim covering 253 children against the chain and its owner, Stephen Simpton, DDS. The fight turned hostile early. After the conduct was reported by a local television station, Simpton sued Crosley's firm, the station, and a reporter for defamation. A Bexar County judge dismissed that suit in 2012 and ordered the Smile Center to pay $108,000 in sanctions and attorneys' fees to Crosley and $70,000 to the station.

Crosley's team built the civil case while the Texas Attorney General's Medicaid fraud unit ran its own investigation, at one point removing 180 boxes of records from the clinics. The Texas State Board of Dental Examiners separately found one of the chain's dentists had failed to meet the standard of care, imposing a 90-day suspension, a $10,000 fine, and seven years of probation.

The parties announced a confidential settlement covering all 253 patients in December 2013. The terms were not disclosed, though an attorney familiar with the matter estimated the total at several million dollars. The 131st District Court in Bexar County approved the agreement in 2014.