Source: MIL-OSI Submissions
Source: Health and Disability Commissioner
The adequacy of dental care services provided to a man by a dentist and his failure to comply with professional standards was highlighted in a decision published by Deputy Health and Disability Commissioner Dr Vanessa Caldwell.
In her decision, Dr Caldwell found the dentist in breach of the Code of Health and Disability Services Consumers’ Rights (the Code), for failing to monitor his patient using capnography, while he was at least moderately sedated during wisdom tooth extractions, and to maintain adequate patient notes. She also found the dentist in breach of the Code for his failure to refer the man to a specialist or for an ACC treatment injury claim at a sufficiently early stage, and not conducting sufficiently detailed examinations of the man at two follow-up appointments.
A man underwent surgery for the extraction of his wisdom teeth. During the extraction of one of the teeth, the dentist severed the man’s lingual nerve accidentally and did not notice the injury at the time, or during either of two follow-up appointments.
Dr Caldwell considered the adequacy of the care provided to the man, both at the time of the extractions, and in the follow-up care, as well as the adequacy of the dentist’s clinical notes, and whether his sedation practice complied with professional standards. She acknowledged the dentist was an employee of the dental service, who had in place a number of company policies, which the dentist was required to follow.
“In my view, the dentist’s errors were the result of individual clinical decision-making, and were not directly the result of shortcomings in the policies and procedures of the dental service. I find that the dental service did not depart from the appropriate standard of care,” says Dr Caldwell.
Dr Caldwell recommended the dentist arrange for an audit of his patient notes, provide evidence of completion of safe sedation training, reflect on and review his practice in light of HDC’s expert advisor’s comments, and apologise to the man. She further recommended the dental service confirm implementation of new policies relating to safe sedation and treatment injury, audit compliance with those policies, and use this case as a basis for staff training.
Following these events, the dental service introduced new policies for Sedation and Treatment Injury to mitigate some of the risks to patients. The dentist has also told HDC he has taken this matter very seriously and made changes to his practice, and he has learned considerably from the incident, and is confident it will not be repeated.
“Complaints offer a significant learning opportunity, to reflect on how care could be improved – to create positive change for consumers and healthcare providers. The additional policies suggest that the dental service has taken the complaint seriously, and I am pleased to see the dentist has learned from this incident, and made changes to his practice,” says Dr Caldwell.
We anticipate that the Commissioner will name providers found in breach of the Code, unless it would not be in the public interest, or would unfairly compromise the privacy interests of an individual provider or a consumer.
More information for the media and HDC’s naming policy can be found on our website here.
