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July 06, 2015 - 9:00 PM
KAMLOOPS - A local dental surgeon continues to work at his practice while he waits to hear what penalty a professional panel imposes for a series of failures which led to a patient’s cardiac arrest during surgery.
A team of investigators for the Inquiry Committee of the College of Dental Surgeons of British Columbia examined Dr. Bobby Rishiraj, 52, and his practice, the Kamloops Oral Surgery and Implant Centre after a female patient, identified only as ‘HZ’ sustained a brain injury from the cardiac arrest caused by oxygen deficiency during her wisdom teeth removal surgery.
“Dr. Rishiraj’s failure to adequately monitor his patients and to recognize HZ’s cardiac arrest could be characterized as incompetent practice,” the report said.
In November 2012, Rishiraj sedated HZ with three different drugs to cause deep sedation although he nor his practice was authorized to do so. HZ’s oxygen levels dropped and the panel found the doctor "failed to recognize (her) cardiac arrest in a timely way" by continuing the surgery.
Critics of Rishiraj say he did not use adrenaline or AED on the patient - both of which were available to him — which caused a delay in resuscitation. An attempt to use a manual resuscitator failed because it didn’t fit the patient. Instead, the report said, paramedics treated the patient after staff called 9-1-1.
Staff for the doctor, which the report said were untrained for all patient emergency scenarios, testified about their work environment during surgery. Members said Rishiraj would allow patients’ oxygen saturation levels (oxygen amounts within the blood) to drop substantially and would set an alarm to ring when levels dropped to 85. The report said the doctor would not always provide nasal breathing tubes and occasionally allowed levels to drop below that amount, which professionals said was already too low to begin with.
The panel said Rishiraj ran his practice to "promote efficiencies" and tried to treat as many patients "in as short a time as possible." The team often had back-to-back appointments throughout the day. To prepare for future clients, the report said staff would leave post-op patients completely alone in the operating room as they awoke from sedation.
Rishiraj admitted to some allegations of professional misconduct and agreed he did not operate the location in compliance with professional standards.
While permitted to continue with his practice before a penalty hearing, Risharaj does not have the right to sedate patients beyond moderate sedation. The discipline committee required him to hire expert staff and change office procedures.
To contact a reporter for this story, email Glynn Brothen at gbrothen@infonews.ca, or call 250-319-7494. To contact the editor, email mjones@infonews.ca or call 250-718-2724.
News from © iNFOnews, 2015