KAMLOOPS - The regulatory board for dental surgeons will continue operating on a complaint-based system for incidents, but plans to broaden its scope of inspection for sedation facilities after one Kamloops dentist’s failures caused a patient’s severe brain injury in 2012.
Last month, the College of Dental Surgeons of British Columbia posted their decision to impose a penalty on Dr. Bobby Rishiraj after the regulator investigated him and his practice, the Kamloops Oral Surgery and Implant Centre. The incident was not isolated, but rather a pattern of Rishiraj's practice, the regulator said. Investigators found Rishiraj advertised the service and provided deep sedation anaesthetic to 23 patients during surgery when he was only licensed to provide moderate sedation. The College became involved when he provided deep sedation to remove a patient's wisdom teeth in November 2012. During the surgery, the patient’s oxygen levels dropped which led to a heart attack and subsequent brain injury.
At the time of the incident, inspections at Rishiraj's clinic weren't required because, on paper, he provided moderate sedation.
"Currently, we perform inspections of dental offices where deep and (general anesthesia) sedation are provided, but we will be expanding the program to include inspections of moderate sedation facilities,” Anita Wilks, spokesperson for the college, says. "(The College) has stringent standards and guidelines for sedation and the issue here is that Dr. Rishiraj was not following them."
Wilks says College investigations are kickstarted by patient complaints or, in this case, a critical incident report.
“’(The) goal is to protect the public, and when this incident occurred we took immediate steps to ensure patients were not put at risk,” she says, adding cases like Rishiraj’s are ‘extremely rare’. "This case is about one practitioner who did not adhere to the standards and guidelines that are in place to protect the public, with terrible consequences.”
Wilks says the College places high expectations on those who enter the field to comply with regulations and a standard of ethics. From February 2014 to February 2015, Wilks says the College received 303 complaints. Only three were referred to discipline.
"We have quality assurance requirements that must be met on an ongoing basis, a code of ethics and standards of practice for registrants, and we publish standards and guidelines that set out (the College's) expectations for registrants," she says.
Rishiraj is still practicing under conditions which restrict him from providing more than moderate sedation. He is required to hire expert staff and change office procedures and protocols to meet the sedation requirements he’s licensed for. The college will impose its penalty - which could include either reprimand or Rishiraj's removal from the registry - at a later date.
Rishiraj declined to be interviewed. He currently works at the Kamloops Oral and Maxillofacial Surgery Centre.
To view what sedation method your dentist is approved for, search the online directory of dentists on the College’s website here.
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