Not again. Another dental sedation death

[coffeebythelake]

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Morbidly obese man met horrific end after going to celebrity dentist

A morbidly obese man went to get three teeth removed from a world-class dentist, but things turned tragic as he did not survive the procedure.

www.dailymail.co.uk

 

[arkgal]

Morbidly obese man met horrific end after going to celebrity dentist

A morbidly obese man went to get three teeth removed from a world-class dentist, but things turned tragic as he did not survive the procedure.

www.dailymail.co.uk

A celebrity dentist? I didn't even know that was a thing. This happened in 2023, BTW.

 

[arkgal]

"According to the board, while anesthesia was being administered, Quereshy gave Miller medications, 'one after the other without any pause between administration to assess effectiveness and then, within minutes, placing a throat pack and starting surgery.'

Miller then lost his pulse and went into cardiac arrest.

'(Quereshy) failed to give Miller reversal agents to counter the narcotics and benzodiazepines,' alleged the board.

The board said the cause of death was acute hypoxic respiratory failure as a result of procedural sedation.

Also mentioned in the lawsuit was that '(Quereshy) assigned a research fellow who was not licensed to practice dentistry in Ohio to take the clinical role of dental assistant,' claimed the dental board, according to the outlet.

The lawsuit claims the dentist pushed for anesthesia despite Miller's medical history.

The dental board noted that the victim was at high risk and could stop breathing during the procedure.

A patient in Miller's condition is required to have a complete examination with a physician before surgery, according to the source.

The board allegedly found that the world class dentist failed to do that.

Court documents showed that the university denied that they were at fault for Miller's death."

 

[CopaceticOne]

Hmmmm, after looking at the pictures I wonder if the patient might have had a touch of sleep apnea. It would be such a surprise. </sarcasm>

 

[narcotics999]

82 page resume, lol

 

[gcc322]

It’s truly mind boggling that these guys still report to the dental board. As soon as a dentist starts administering medications, particularly sedatives, they are crossing the line from dentistry to medicine. IMO the medical board should review these cases. Gross negligence to give a patient like this narcotics while simultaneously performing the procedure and monitoring the patient.

 

[Teillard]

But in a professional forum discussing relevant topics with credible sources, this is what really should get our attention...

Saved By The Bell star Tiffani Thiessen, 51, still looks fantastic,...

The star with the winning smile first did beauty pageants before she appeared on hit TV shows like Saved By The Bell and Beverly Hills, 90210. At the same time she was on Married... with Children.

www.dailymail.co.uk

 

[Lab Lover]

It’s truly mind boggling that these guys still report to the dental board. As soon as a dentist starts administering medications, particularly sedatives, they are crossing the line from dentistry to medicine. IMO the medical board should review these cases. Gross negligence to give a patient like this narcotics while simultaneously performing the procedure and monitoring the patient.

These folks would like a word:

Home - ASDA

[...]Read More... from Home

www.asda.org

https://www.aana.com/

Shall we talk about GI docs, radiologists, other proceduralists giving sedative hypnotics?

 

[banister]

Poor guy. The only STOP-BANG criteria he probably wouldn't have met would be age >50.

 

[VA Hopeful Dr]

"Additionally, the board claimed Quereshy altered or permitted to have changed Miller’s preoperative anesthesia records after the day of surgery."

If this is true, this guy is absolutely screwed.

 

[jwk]

The article (with specifics provided by the plaintiff's attorney no doubt) doesn't specify who actually administered the anesthesia. It talks about a "dental assistant" but doesn't specify what that person did. I see no mention of an anesthesiologist, CRNA, or CAA in the article.

 

[VA Hopeful Dr]

The article (with specifics provided by the plaintiff's attorney no doubt) doesn't specify who actually administered the anesthesia. It talks about a "dental assistant" but doesn't specify what that person did. I see no mention of an anesthesiologist, CRNA, or CAA in the article.

Several of the pediatric dentists in my area use "dental anesthesiologists" for IV sedation.

My kids use the dentists that do IV sedation at the hospital with real anesthesiologists.

Anesthesia Services Pittsburgh PA, Ambulatory Anesthesia Associates

Ambulatory Anesthesia Associates & Drs. Laverick, Franceschelli, Nassif, Beicke, Pappas, Castele, Catalano, Cloninger, Hendley or Shammay in Pittsburgh PA offers Anesthesia Services, 412-937-1900

www.ambanes.com

 

[DrOwnage]

That dude looks like he has Awake Apnea

 

[coffeebythelake]

The article (with specifics provided by the plaintiff's attorney no doubt) doesn't specify who actually administered the anesthesia. It talks about a "dental assistant" but doesn't specify what that person did. I see no mention of an anesthesiologist, CRNA, or CAA in the article.

It doesn't mention anyone else being sued aside from the dentist and the hospital system. So I take it as meaning he as acting as both proceduralist and anesthetist

 

[dannyboy1]

If you are not comfortable paralyzing ventilating and intubating the patient you should not be doing any form of procedual sedation. It really is that simple. As an aside why does this man need sedation for dental extractions? I’ve had it done under local with no problems. Dentist actually asked me if I wanted sedation, I said no, he asked me why, told him I was an anesthesiologist. He quickly changed the subject. 😉

 

[jwk]

It doesn't mention anyone else being sued aside from the dentist and the hospital system. So I take it as meaning he as acting as both proceduralist and anesthetist

That was my assumption. Surely a media-savvy malpractice lawyer knows to name every defendant. 🙂

 

[coffeebythelake]

If you are not comfortable paralyzing ventilating and intubating the patient you should not be doing any form of procedual sedation. It really is that simple. As an aside why does this man need sedation for dental extractions? I’ve had it done under local with no problems. Dentist actually asked me if I wanted sedation, I said no, he asked me why, told him I was an anesthesiologist. He quickly changed the subject. 😉

I've had sedation for my wisdom teeth removal but I was a college student and didn't know any better at the time. My wife had hers under just local and said it wasn't bad.

 

[Dantrolene FC]

I've had sedation for my wisdom teeth removal but I was a college student and didn't know any better at the time. My wife had hers under just local and said it wasn't bad.

I had all 4 wisdom teeth pulled under local in med school. I then used Tylenol, ibuprofen, and ice cream for pain control. It wasn’t that bad.

My HR was 120 bpm during the procedure. But I think that was a combination of anxiety and epinephrine in the local.

 

[psychbender]

My HR was 120 bpm during the procedure. But I think that was a combination of anxiety and epinephrine in the local.

Well, I hope the dentist documented that allergy to local.

 

[Maz777]

It’s truly mind boggling that these guys still report to the dental board. As soon as a dentist starts administering medications, particularly sedatives, they are crossing the line from dentistry to medicine. IMO the medical board should review these cases. Gross negligence to give a patient like this narcotics while simultaneously performing the procedure and monitoring the patient.

I would imagine there is or will be a medical board investigation. He's an OMFS MD playing pretend anesthesiologist. I'm sure it's already been reported to the Ohio Medical Board. His office website is nausea-inducing.

 

[Lab Lover]

I would imagine there is or will be a medical board investigator. He's an OMFS MD playing pretend anesthesiologist. I'm sure it's already been reported to the Ohio Medical Board. His office website is nausea-inducing.

Anesthesia is not just a practice of medicine. It is also a practice of nursing and a practice of dentistry. I doubt that this person answers in any way to the board of medicine.

 

[jwk]

Anesthesia is not just a practice of medicine. It is also a practice of nursing and a practice of dentistry. I doubt that this person answers in any way to the board of medicine.

He's listed as an MD, DDS, FACS on his website.

 

[Lab Lover]

He's listed as an MD, DDS, FACS on his website.

In that case...I stand corrected.

 

[AKMD_1984]

not a good case for clinic.
either decline or do it at least at an asc or better yet - hospital

these dentists really need to schedule 1-2 days a month at hospitals and do all high risk cases there under anesthesiologist care

shouldn’t be that hard to schedule it that way

 

[arkgal]

If you are not comfortable paralyzing ventilating and intubating the patient you should not be doing any form of procedual sedation. It really is that simple. As an aside why does this man need sedation for dental extractions? I’ve had it done under local with no problems. Dentist actually asked me if I wanted sedation, I said no, he asked me why, told him I was an anesthesiologist. He quickly changed the subject. 😉

Does that include versed and fentanyl sedation done by nurses?

 

[arkgal]

I've had sedation for my wisdom teeth removal but I was a college student and didn't know any better at the time. My wife had hers under just local and said it wasn't bad.

Likewise. I wanted GA. If I had wisdom teeth removed today, I'd probably just do local. My root canal was done awake and I didn't feel a thing.

 

[Maz777]

Anesthesia is not just a practice of medicine. It is also a practice of nursing and a practice of dentistry. I doubt that this person answers in any way to the board of medicine.

I literally told you he's an OMFS MD in that post. And, no, anesthesiology is not a legitimate practice of dentistry. Illegitimate. Dentists or OMSFers do a few anesthesia rotations, miss a bunch of airways, and lo and behold are now experts in anesthesiology. Sure, dude.

 

[arkgal]

I literally told you he's an OMFS MD in that post. And, no, anesthesiology is not a legitimate practice of dentistry. Illegitimate. Dentists or OMSFers do a few anesthesia rotations, miss a bunch of airways, and lo and behold are now experts in anesthesiology. Sure, dude.

Maybe they meant a dental anesthesiologist?

 

[aneftp]

The Asa is definitely afraid to put out a hard statement with clearly written “guidelines” a hard number say bmi 40, neck circumference X amount even without confirmed diagnoses of sleep apnea (because many people refuse to be tested)

Just come out with a guidelines and u avoid cases happening like this. But if they did this. It would likely knock off 10-% of outpatient ASC cases and hurt revenue.

 

[propadope]

not a good case for clinic.
either decline or do it at least at an asc or better yet - hospital

these dentists really need to schedule 1-2 days a month at hospitals and do all high risk cases there under anesthesiologist care

shouldn’t be that hard to schedule it that way

Thing is I’m not sure (being facetious) if he recognized the patient was high risk…. Probably slammed versed, fentanyl and propofol in his ‘standard’ cookbook way. He might have even thought: Big guy? Big dose…

 

[Maz777]

Maybe they meant a dental anesthesiologist?

Again, not a legitimate field. Not a term that we should ever be using. Similar to nurse anesthesiologist.

 

[arkgal]

Again, not a legitimate field. Not a term that we should ever be using. Similar to nurse anesthesiologist.

That's your opinion. Dental anesthesiology is a recognized dental specialty with its own fellowship. 36 months of training, much more than CRNAs get, and a year short of the amount of training an anesthesiologist gets. We can debate what terminology is appropriate, but that doesn't make the field any less valid. You could make an argument for using this specialty over a CRNA because their training is far more extensive.

Dental Anesthesiology

 

[Maz777]

That's your opinion. Dental anesthesiology is a recognized dental specialty with its own fellowship. 36 months of training, much more than CRNAs get, and a year short of the amount of training an anesthesiologist gets. We can debate what terminology is appropriate, but that doesn't make the field any less valid. You could make an argument for using this specialty over a CRNA because their training is far more extensive.

Dental Anesthesiology

Cool story.

My neighbor is a chiropractor anesthesiologist. Super nice guy. Very rigorous training I'm told.

My buddy from high school calls himself an accountant anesthesiologist. He's the best. Top notch.

All sarcasm aside. Just because dentists have made up a field and call themselves anesthesiologists, it still doesn't make it valid in the eyes of an actual anesthesiologist. Guess we should just ignore all these pediatric dental deaths happening around the country. No biggie.

 

[propadope]

Cool story.

My neighbor is a chiropractor anesthesiologist. Super nice guy. Very rigorous training I'm told.

My buddy from high school calls himself an accountant anesthesiologist. He's the best. Top notch.

All sarcasm aside. Just because dentists have made up a field and call themselves anesthesiologists, it still doesn't make it valid in the eyes of an actual anesthesiologist. Guess we should just ignore all these pediatric dental deaths happening around the country. No biggie.

Unfortunately there will always be bad outcomes, the question is who is providing the anesthesia? What are the circumstances? Poor patient selection? Unknown patient comorbidity? Lack of vigilance? Inadequate monitoring? Equipment failure? Misdiagnosis/treatment of a sentinel event? Lack of knowledge? Lack of skills? Complacency? Gross negligence? What are the state guidelines for administering deep sedation/GA and were they followed? Are the guidelines inadequate or deficient? Bad luck?

Toddler's death after dental procedure in Greensboro sparks anesthesia safety concerns

The death of a two-year-old boy, Er'Mias Mitchell, after a dental procedure has raised questions about anesthesia safety protocols. With at least eight deaths reported over 13 years, there are growing calls for reform, including stronger requirements for anesthesia practices.

www.wral.com

In the article above it states that the office uses board certified MDs and CRNAs. Its not always dentists providing anesthesia.

Of course in the OPs case, this looks like a slam dunk lawsuit: poor patient selection, poor patient management, not following state guidelines and an attempt to falsify a record/cover up.