A second Iowa dentist is facing licensing sanctions related to a January 2024 dental procedure that resulted in the death of a 50-year-old patient.
Last fall, the Iowa Dental Board formally informed dentist Robert Wolf of Swisher that it intended to deny his application for a permit to use moderate sedation on patients. Wolf recently appealed that notice, and a hearing is now scheduled for April 25.
In its recently disclosed notice to Wolf, the board stated on January 26, 2024, Wolf participated in dental surgery on patient "J.D.," after which the patient died. The board alleges Wolf "participated in this surgery with an individual who was not licensed to practice dentistry" and that he did so without having the required permit to use sedation.
The board also says its investigation into the case indicates Wolf "was the only dentist in the operating room on more than one occasion while an advanced registered nurse administered and monitored the anesthesia to J.D."
Wolf, the board argued, "facilitated the practice of an unlicensed dentist and supervised the administration of anesthesia without having the proper credentials." The available board documents do not identify the "unlicensed dentist."
Two weeks after the patient died, the board claims that Wolf applied for a sedation permit. Aside from the notice of intent to deny the permit application, the board has imposed no other public sanctions against Wolf.
Wolf is the second Iowa dentist to face disciplinary action as a result of the January 26, 2024, procedure. Last fall, nine months after the patient died, the board issued an emergency order restricting the practice of Dr. Jonathan Karch of the Dental Studio of Iowa in Johnston. The board alleges Karch participated in the procedure and that an investigation by an unspecified party revealed Karch "did not stay in the operatory for the duration of the procedure."
State regulations require that when a patient is under sedation and anesthetic services are being provided, the dentist must remain in the room during the procedure, according to the board.
In issuing the emergency order restricting Karch's ability to practice, the board said it "recognizes (Karch) as an imminent threat to public safety" and that he "should not be permitted to participate in procedures involving sedation until further order." Karch's license to practice dentistry has remained otherwise unrestricted.
The Karch case remains unresolved. A hearing on the matter was scheduled for October 11, 2024, but a final decision in the matter has yet to be published by the board.
Lawsuit over death alleges negligence
Separate from the licensing board actions, a civil lawsuit has been filed against Karch, Wolf, and others involved in the surgery, all of whom have denied any wrongdoing.
The lawsuit, filed in Polk County District Court by the family of Joseph Daniels, alleges that on January 24, 2024, Daniels consulted with Karch and inquired about receiving dental implants. According to the lawsuit, Daniels was 50 years old at the time, had smoked 1 1/2 packs of cigarettes per day, and had a history of hypertension and hyperlipidemia.
At the time of the consultation, Daniels' blood pressure was allegedly noted as being "of great concern" to Karch. The lawsuit alleges that at a cost of $50,000, Daniels was to receive the dental implants from Karch two days after the consultation, subject to a preprocedure clearance by Daniels' primary care physician.
On January 25, Daniels was allegedly evaluated and cleared for surgery by Dr. Anish P. Keshwani at UnityPoint Clinic Family Medicine of East Des Moines -- although, the lawsuit claims, UnityPoint medical records indicate Daniels' "uncontrolled" hypertension and hyperlipidemia would require "corrective actions before surgery," such as the administration of prescribed drugs.
On January 26, the implant procedure began at 7:15 a.m. and was completed at 3:15 p.m., with patient care allegedly turned over to certified registered nurse anesthetist Nicky Newhoff, who was tasked with waking Daniels and initiating the recovery process.
The lawsuit alleges that at 3:30 p.m., a dental assistant notified Karch and Wolf they were needed in the surgical suite through a message that stated, "Joe is not doing well -- please come immediately."
According to emergency medical service records, paramedics were dispatched to Dental Studio of Iowa at 3:35 p.m. with a report of an "unconscious person." According to the lawsuit, the paramedics arrived at 3:40 p.m. and found Daniels in a dental exam chair "pale, cyanotic, cool, and unresponsive."
Within 25 minutes of their arrival and the administration of drugs, the paramedics intubated Daniels, and by 4:27 p.m., they initiated chest compressions, the lawsuit claims. Daniels was then taken to Iowa Methodist Medical Center, where he died at 5:51 p.m.
The lawsuit seeks unspecified actual and punitive damages for negligence. In addition to Karch, Wolf, Keshwani, and Newhoff, the defendants in the lawsuit include Dental Studio of Iowa, UnityPoint Clinic, Coral West Dental, and Heartland Anesthesia.
In their response to the lawsuit, lawyers for the defendants argue that Daniels caused his death, which they say stemmed from preexisting conditions. A trial date has yet to be scheduled in the case.
A criminal complaint is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.
This article was originally published in the Iowa Capital Dispatch and republished by DrBicuspid under the Creative Commons license CC BY-NC-ND 4.0. The Iowa Capital Dispatch is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. The Iowa Capital Dispatch maintains editorial independence.
Deputy Editor Clark Kauffman has worked during the past 30 years as both an investigative reporter and editorial writer at two of Iowa's largest newspapers, the Des Moines Register and the Quad-City Times.
