Not again. Another dental sedation death

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"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."
 
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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.
 
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:



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

 
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
 
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. 😉
 
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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. 🙂
 
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.
 
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.
 
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.
 
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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.
 
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.
 
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
 
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?
 
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.
 
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.
 
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?
 
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.
 
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…
 
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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.

 
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.

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.
 
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?


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.
 

Remorseless narcissistic sociopath blabbing on a podcast. If I were in his position I would lay low.

At 44 min, he says he terminated his position with the university. CWRU actually terminated him. At 46 min they start discussing “economic pie” of delivering anesthesia, “single provider model”, etc. Host is a tool too. They’re completely aware of the safety compromise.



 
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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?


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
MDs delivering dental anesthesia. I talked to one of these suits a month ago. They don’t even have a ventilator. Doing up to BMI 50s, mild to moderate pHTN, moderate AS, claim to patients are screened by an NP with whatever, presumed, Mapleson D/ Bain circuits they have.

Rate $325.

Absolutely not incurring that kind of risk and definitely not for that garbage rate.
 

Remorseless sociopath blabbing on a podcast.

At 44 min, he says he terminated his position with the university. At 46 min they discuss “economic pie” of delivering anesthesia. Host is a tool too.



Not a lone sociopath. Tell me how this guy is any different than hospitals, AMCs, PE cutting docs and increasing staffing ratios, and substituting CRNA care for physicians like it’s equal. This is the reality of health care at this time, and honestly, probably always. In this country at least. $$$$$$$$.

This is not normal.
 
Not a lone sociopath. Tell me how this guy is any different than hospitals, AMCs, PE cutting docs and increasing staffing ratios, and substituting CRNA care for physicians like it’s equal. This is the reality of health care at this time, and honestly, probably always. In this country at least. $$$$$$$$.

This is not normal.


Agree except that it is normal in our capital driven healthcare system.
 
Not a lone sociopath. Tell me how this guy is any different than hospitals, AMCs, PE cutting docs and increasing staffing ratios, and substituting CRNA care for physicians like it’s equal. This is the reality of health care at this time, and honestly, probably always. In this country at least. $$$$$$$$.

This is not normal.
i think you expect better from dentists vs corporate know-nothings, it hurts more when the sell out happens by someone in healthcare themselves
 
Not a lone sociopath. Tell me how this guy is any different than hospitals, AMCs, PE cutting docs and increasing staffing ratios, and substituting CRNA care for physicians like it’s equal. This is the reality of health care at this time, and honestly, probably always. In this country at least. $$$$$$$$.

This is not normal.
Actually it is normal. Part of our job in this environment is to figure out where we can shave on costs and get away with it. Those who don't get away without causing harm or covering their asses get crucified.

The definition of a greedy uncaring selfish bastard is someone who shaves one millimeter more than I do.
 
Actually it is normal. Part of our job in this environment is to figure out where we can shave on costs and get away with it. Those who don't get away without causing harm or covering their asses get crucified.

The definition of a greedy uncaring selfish bastard is someone who shaves one millimeter more than I do.


And the definition of a dummy is someone who goes mouthing off on podcasts while under investigation by the state dental board and with an ongoing civil suit. He just can’t shut up like Keffe D.
 
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Just take one look at this guy and ask yourself if you would let an inexperienced CRNA even give anesthesia for an EGD on him.
 
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Just take one look at this guy and ask yourself if you would let an inexperienced CRNA even give anesthesia for an EGD on him.
What’s our anesthesia plan for that EGD Blade?

I can tell you it’s either something that definitely keeps him breathing… or just start with prop sux glide if I am running 3 other rooms and it’s not a slick GI
 
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Not a lone sociopath. Tell me how this guy is any different than hospitals, AMCs, PE cutting docs and increasing staffing ratios, and substituting CRNA care for physicians like it’s equal. This is the reality of health care at this time, and honestly, probably always. In this country at least. $$$$$$$$.

This is not normal.
There is no difference. They are killers as well and should be held accountable. Sadly, a catastrophe has to happen to bring these things to light. This dingus in the article says Ive done 20K anesthetics safely. Doesnt matter if they were risky anesthetics.
 
What’s our anesthesia plan for that EGD Blade?

I can tell you it’s either something that definitely keeps him breathing… or just start with prop sux glide if I am running 3 other rooms and it’s not a slick GI
Intubate. Done. Oh no, the BMI 50, no neck, full beard patient took 10 extra minutes!
The horror, the horror.
 
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