A central Iowa dentist involved in an operation that ended with the patient’s death has been fined $7,500 by the Iowa Dental Board.
On April 30, the board entered a final order in the disciplinary case against Jonathan Karch of the Iowa Dental Studio in Johnston. This week, that decision was made public by the board, although some of the contents have been redacted from public view.
The order stipulates that Karch shall not be issued a permit to administer patient sedation until September 13, 2025, and that he shall pay a $7,500 civil penalty and complete some unspecified amount of additional continuing education, with some of that education related to professional ethics. The order also states that should Karch be issued a sedation permit, it will be placed on probationary status for three years, during which a practice monitor must be physically present in the treatment room for any sedation procedures handled by Karch.
Last fall, the board issued an emergency order restricting Karch’s practice after a patient who underwent a dental-implant procedure in January 2024 died. The order coincided with a civil lawsuit filed against Karch and others who were involved in the surgery. That lawsuit, filed in Polk County District Court by the family of Joseph Daniels, alleges that on Jan. 26, 2024, the 50-year-old Daniels underwent a dental-implant operation that began at 7:15 a.m. and was completed at 3:15 p.m.
Around 3:30 p.m., paramedics were dispatched to Dental Studio of Iowa 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.” Daniels was then taken to Iowa Methodist Medical Center, where he died at 5:51 p.m.
According to the board’s findings of fact, “R.W.” — identified in other board records as dentist Robert Wolf of Swisher — was the primary surgeon for the procedure, but did not have a sedation permit at the time. Karch did have a sedation permit but, by all accounts, he was only in the operatory sporadically and spent most of the time 10 to 15 feet away in an adjacent room working on the fabrication of temporary implants.
Wolf “nevertheless proceeded with the surgery, with a certified registered nurse anesthetist contracted by The Dental Studio of Iowa to administer and monitor” the sedation, the board determined.
Karch argued before the board that state regulations require a “dentist” and not a “permit holder” to be present for the entire procedure, and he noted that Wolf was the dentist performing the surgery.
The board rejected that argument, stating that “the rule does not make sense if interpreted to not require the permit holder to remain. In fact, no matter how (the rule) is viewed, its structure and language required a dentist with a sedation permit participating in the dental procedure to remain in the room, which did not occur when Dr. Karch left.” The rule, the board concluded, “required Dr. Karch, as the permit holder, to be present for the entire surgery, which he was not.”
The board added that “while it is true no evidence in the record exists that (Karch’s) presence outside of the surgery suite in a nearby room caused any adverse outcome, it is equally true this rule is critical for providing a high level of safety for patients.”
In its decision and order, the board also noted that Karch had “presented significant evidence about himself, including [redacted from public view] that caused him to be bullied as a child and his efforts to overcome this.”
The board noted that its disciplinary action has no impact on Karch’s general dentist license, as his alleged conduct relates only to his actions as the holder of a sedation permit.
In its decision against Karch, the board stated that a third dentist, publicly identified only by the initials “M.K.,” was present for Daniels’ surgery and assisted with patient care despite not having an Iowa license. The involvement of this third dentist would later become an issue for Wolf.
In September 2024, the Iowa Dental Board notified Wolf that it intended to deny his application for a permit to administer moderate sedation on patients. At the time, the board alleged that Wolf had participated in the operation that resulted in Daniels’ death and that he had “facilitated the practice of an unlicensed dentist and supervised the administration of anesthesia without having the proper credentials.”
The board document detailing that allegation was made public in error, according to the Iowa Department of Inspections, Appeals and Licensing, and it has since been pulled from the board’s website. The Iowa Dental Board has not charged Wolf with any wrongdoing in the Daniels case.
The civil lawsuit filed by the Daniels family is scheduled to be tried on September 28, 2026.
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. 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. 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.
