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SilvermanDMD |
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The personal blog of Dr. Michael Silverman, president and co-founder of the Dental Organization for Conscious Sedation |
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A Case in Missouri Fraught with Missteps This entry was posted on 9/21/2007 2:45 PM and is filed under At Work. As proud as I am of the million-plus adult patients who’ve been treated safely and successfully with oral conscious sedation (OCS), I’m always on the lookout for any report of an injury or fatality arising in connection with an OCS patient. To me, investigating fully any allegation of injury caused by OCS is both a medical and moral imperative. As with physicians, our first responsibility to our patients is to do no harm.
That is why I want to call your attention to a case we are closely tracking in Missouri involving an adult patient who died allegedly as a result of being treated with OCS.
Let me say that whether the allegations ultimately prove to be true or not, the patient’s death is a tragedy and one that merits a close examination. Let me also say that I have no intent of serving as judge and jury for the dentist who administered the treatment. The Missouri Dental Board (and possibly the courts) are best equipped to play that role.
Nonetheless, I feel it important to share with you what I can ascertain about the case and keep you apprised as more information becomes available.
According to a formal complaint filed by the Missouri Dental Board against the dentist, he did not comply with many of the protocols taught by the Dental Organization for Conscious Sedation (DOCS) or required by state regulations. Among the dentist’s alleged oversights: failure to check the patient’s vital signs; failure to obtain a complete patient history; failure to ascertain a list of the patient’s current prescriptions; and failure to obtain a conscious sedation permit. Our own investigation found that the dentist in question was a DOCS member who has not attended a sedation DOCS program for 6 years. If the allegations prove true, I’m genuinely appalled. To know what are the safe and required protocols to treat an adult patient with OCS, and then to ignore them, is abominable. First and foremost, it risks the health of each and every patient who entrusts his or her care into your hands. Second, it is a blight on the dentistry profession as a whole, as tens of millions of people already avoid us out of fear and anxiety – and this only contributes credibility to their phobia. Thirdly, it is a direct insult to the thousands of OCS dentists who do attend courses, obtain their permits, follow protocols and regulations, and make every effort to bring honor to our profession. It is, of course, possible that when all the investigations are completed and the final cause of death is known, that the demise of this patient will be found to be unrelated to his OCS treatment. Will that vindicate the dentist? Not in my mind. It is only a matter of time if a dentist grossly violates safety protocols and regulations before one of his or her patients pays the price. Given what we’ve been able to ascertain about the Missouri case, the dentist in question was inexcusably negligent and should lose his license, even if it turns out that the patient died of natural causes or those unrelated to his dental treatment. We can’t regulate compliance with safety protocols. If a medical professional is hell-bent on violating the norms of conduct, he or she will ignore tougher regulations just as readily. What we can do is make a public example of what happens to medical professionals who know better, but act with blatant disregard of fundamental safety standards. What we can do is drum them – loudly – out of the profession. |
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