DECLARATION AND STATEMENT OF FACTS
Regarding Dental…read moreTreatment Rendered on July 22, 2026
Provider: Christopher Heath Brown, D.D.S.
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Declarant Name (print full legal name)
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Full Legal Name of Dental Practice
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Dr. Christopher Heath Brown, D.D.S. -- License Number (if known)
I, the declarant identified above, make the following statement based on my personal knowledge of the events described below. The facts are presented in chronological order, to the best of my recollection. Where I describe my own subjective belief, fear, or interpretation rather than an observed fact, I have identified it as such. Where I am uncertain of an exact date, time, name, or the precise order of closely-occurring events, I have noted that uncertainty directly rather than stating it as settled fact.
I. Events Preceding the Appointment
1. On July 22, 2026, at approximately__________ (approx. time), I presented to the dental office identified above for a scheduled full-mouth extraction. I have a pre-existing, significant fear of dental treatment; it is one of my two most significant fears.
2. While en route to the appointment, I searched online for reviews of the treating dentist, Christopher Heath Brown, D.D.S. I observed a number of negative reviews. I told my wife, Melissa_______________ (Melissa's last name), that if Dr. Brown treated me poorly in any respect, I intended to leave before treatment.
3. Upon arrival and check-in, I was visibly anxious and repeatedly stated that I did not believe I could go through with the procedure. My wife informed clinical staff, on multiple separate occasions that morning, that I was terrified of the procedure and asked that this be taken into account.
4. Before being taken back for treatment, I left and re-entered the building three times due to my anxiety. I was then called back for the procedure and escorted to the treatment room by a staff member_______________ (staff member's name, if known).
5. I was tearful at this point. I removed my hoodie and gave it to my wife before entering the treatment room. (optional: one sentence -- what this moment felt like)
II. Pre-Operative Preparation
6. Once in the treatment room, I sat up in the dental chair. A staff member offered verbal reassurance that I would be "fine."
7. An anesthesiologist_______________ (anesthesiologist's name, if known) placed an intravenous (IV) line.
8. Dr. Brown entered the room and spoke with staff positioned behind me. Staff informed him that I was nervous. Dr. Brown said to me, "just relax." (optional: one sentence -- what this landed like for you)
9. I responded by referencing stress I was experiencing at home, including my wife carrying a disproportionate share of household burdens; I raised this as a way of expressing/deflecting from my underlying fear of the procedure. Dr. Brown cut me off before I finished and said, "be calm."
10. Staff placed an orange bite block in my mouth and began reclining the chair.
III. Withdrawal of Consent and Physical Restraint
11. I have a pre-existing spinal condition and, due to this condition, experienced difficulty tolerating the reclined position. I began to say, "I have had surgery on my back," and Dr. Brown again cut me off before I could finish.
12. I then stated, in substance: "That's it, do not touch me. I withdraw my consent. You're not talking over me this way." I began to sit up.
13. I was told that sedation medication had already been administered and that it was "too late," and that the procedure was going to proceed. I responded, "Let the medication run its course. Do not do this."
14. At that point, I went to sit up and Dr. Brown pulled me back into the chair by my left shoulder. I had thrown the bite block. A physical struggle followed, during which Dr. Brown held me down while the bite block was placed back into my mouth.
15. By this time the sedative medication was taking effect, and I was physically unable to resist further. My ability to move was also limited by the IV line and my positioning in the chair.
16. The extraction procedure was then performed. I did not consent to the procedure proceeding after the point described in the preceding paragraphs, and I had affirmatively and verbally withdrawn my consent before it was performed
