Nine months after patient’s death, ’emergency order’ restricts dentist’s license • Iowa Capital Dispatch

The state of Iowa has issued an emergency order restricting the practice of an Iowa dentist whose patient died in January shortly after undergoing dental implant surgery.

The Iowa Dental Board alleges that in January 2024, Dr. Jonathan Karch of the Dental Studio of Iowa in Johnston participated in dental implant surgery on a patient and administered sedation when the patient became unresponsive.

The patient was then “transferred to the emergency department and died,” the commission says. A subsequent investigation by an unnamed party revealed that Karch “was not in the operating room for the entire duration of the procedure,” the commission said.

According to the committee, state regulations require that the dentist remain in the room during the procedure while the patient is under sedation and anesthesia.

In issuing an emergency order restricting Karch’s ability to practice, the board said it “finds (Karch) to be an imminent threat to public safety” and that he “should not be permitted to participate in procedures involving sedation until further order is issued.”

Karch’s license to practice dentistry remains unrestricted in any other way.

The commission accused Karch of violating the regulations by failing to appear in the treatment room during dental treatment. A hearing in the case has been scheduled for October 11, but the final decision in the case has not yet been published.

Karch did not return calls to the Dental Studio of Iowa on Tuesday.

“Joe isn’t feeling well. Please come immediately.”

The emergency order issued nine months after the alleged death coincides with a civil lawsuit filed against Karch and others involved in the operation.

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 asked about the possibility of dental implants. The lawsuit states that Daniels was 50 years old at the time, smoked 1.5 packs of cigarettes a day, and had a history of hypertension and hyperlipidemia.

During the consultation, Daniels’ blood pressure was allegedly deemed “very concerning” to Karch. The lawsuit alleges that Daniels was to receive dental implants from Karch for $50,000 two days after the consultation, provided he obtained approval from Daniels’ primary care physician before the procedure.

On January 25, Daniels was allegedly examined and cleared for surgery by Dr. Anish P. Keshwani at the UnityPoint Family Medicine clinic in East Des Moines – although, the lawsuit claims, UnityPoint medical records indicate that Daniels’ “uncontrolled” hypertension and hyperlipidemia would require “corrective action before surgery”, such as administering prescribed medications.

On January 26, the implant procedure began at 7:15 a.m. and ended at 3:15 p.m., with care of the patient allegedly handed over to certified nurse anesthetist Nicky Newhoff, who was tasked with waking Daniels and beginning the recovery process.

The lawsuit alleges that at 3:30 p.m., a dental assistant notified Karch and Wolf that they were needed in the surgical suite with a text that read: “Joe is not feeling well – please come immediately.”

According to EMS medical records, paramedics were dispatched to Dental Studio in Iowa at 3:35 p.m. for a report of an “unconscious person.” According to the lawsuit, paramedics arrived at 3:40 p.m. and found Daniels in the treatment chair “pale, cyanotic, cool and unresponsive.”

According to the lawsuit, within 25 minutes of arriving on scene and administering medications, paramedics intubated Daniels and began chest compressions at 4:27 a.m. 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, defendants in the lawsuit include Dental Studio of Iowa; Keshwani and his employer, UnityPoint Clinic; Dr. Robert Wolf and his employer, Coral West Dental; and Newhoff and her employer, Heartland Anesthesia.

So far, Newhoff and Heartland are the only defendants to have responded to the allegations and deny any wrongdoing. They further present an affirmative defense, maintaining that any damages suffered by Daniels “were caused in whole or in part by (Daniels’) fault,” citing “pre-existing conditions or acts” over which Newhoff and Heartland had no control.

A hearing date has not yet been set in this case.