A grand jury indicted Lilly Geyer Thursday on 37 counts, including manslaughter, medical assistance fraud and assault, the state attorney general's office said.
Finley Boyle lapsed into a coma after receiving an array of sedatives and anesthesia in preparation for cavity fillings and root canals, according to an autopsy report. The report concluded the heart attack was likely the result of the five drugs, which included Demerol, hydroxyzine and chlorohydrate. She was also given laughing gas and an injection of a local anesthetic, lidocaine with epinephrine, the report said.
Geyer's practice, Island Dentistry for Children in Kailua, has since closed.
Geyer is currently travelling, said her attorney, Michael Green. He said he would make arrangements for her to surrender to authorities.
"She's not practicing so they can't say she remains a danger to anybody," Green said. "I'm not unsympathetic to the family of this little girl who died, but this was not a woman who was hell bent on hurting people."
Geyer has been distraught since the girl's death, Green said. "I'm just really worried about her mental health," he said.
The Honolulu medical examiner classified the death as an accident.
Geyer's insurance company settled a lawsuit by the Boyle family for an undisclosed amount.
Richard Fried, the attorney who represented the parents in their lawsuit, said they're pleased about the indictment. The case frightened Hawaii parents and changed how they select dentists for young children, he said: "I think folks are much more cautious now about credentials and sedation."
After the girl's death, the state started investigating Geyer's use of the drugs on patients.
The indictment accuses Geyer of making false statements to the medical assistance program to get higher compensation than she was entitled to receive. She's accused of illegally administering Meperidine and Chloral-Hydrate. One of those patients was a two-year-old child who suffered serious injury, according to the indictment.
A dental assistant at Geyer's former office was charged earlier this year with assault and drug violations for the two-year-old, who was unconscious for 12 hours after she was given the narcotics during a routine checkup.