Kamloops Oral & Maxillofacial Surgery Center   
      
      
   KAMLOOPS, B.C. - A British Columbia dental surgeon failed to properly monitor   
   a young patient who went into cardiac arrest and suffered severe brain damage,   
   the province's regulatory authority for dentists has ruled.   
      
   A discipline panel of the College of Dental Surgeons of B.C. said in a written   
   decision that Dr. Bobby Rishiraj provided deep sedation using three drugs   
   without being approved to perform such a procedure.   
      
   The patient identified only as HZ went to the Kamloops Oral Surgery and   
   Implant Centre in November 2012 to have her wisdom teeth removed, the college   
   said.   
      
   It said that a monitor showed HZ was experiencing significant cardiac trouble   
   but Rishiraj continued extracting a tooth and that even when he took action,   
   it was inadequate for a patient who had no pulse.   
      
   A certified dental assistant asked if she should start CPR, and Rishiraj told   
   her to go ahead while instructing another assistant to call 911 and bring in   
   equipment so he could ventilate HZ. But she had trouble finding it, the   
   decision said.   
      
   When it was located, it did not fit HZ properly and "he did not hook it up to   
   an oxygen source" and did not administer the drug epinephrine, which was later   
   given to the patient by ambulance attendants, the college said.   
      
   "The panel has concluded that Dr. Rishiraj failed to exercise the level of   
   care, skill and knowledge of a competent practitioner in that he failed to   
   recognize Ms. HZ's cardiac arrest in a timely way and delayed resuscitative   
   measures as a result," the    
   ruling said.   
      
   The ruling also said Rishiraj would leave a sedated patient in order to attend   
   to another patient in his busy practice, where he performed five or six   
   surgeries in a morning.   
      
   "Even his (certified dental assistant) cut corners in that she left a patient   
   who was coming out of sedation to wash her instruments, presumably to prepare   
   for the next surgery."   
      
   The decision said Rishiraj was authorized to provide moderate sedation only.   
   An expert witness told the panel that the dentist regularly administered a   
   powerful combination of three drugs in rapid succession without waiting to   
   observe their impact on a    
   patient and making any necessary adjustments for weight and age, for example.   
      
   Rishiraj, who also works on call at Royal Inland Hospital in Kamloops,   
   attended hearings and admitted that he was not operating his facility in   
   compliance with required sedation and general anesthetic standards.   
      
   He continues to practise, with sedation limits imposed by the college, pending   
   the outcome of a hearing that will determine a penalty.   
      
   The panel has yet to decide if Rishiraj also provided deep sedation to seven   
   other patients.   
      
   -- By Camille Bains in Vancouver.   
      
   Note to readers: This is a corrected version. A previous story reported the   
   doctors works on call at Royal Columbian Hospital.   
      
   http://www.huffingtonpost.ca/2015/07/08/bc-dentists-incompeten_n   
   7755862.html?&ncid=fcbklnkushpmg00000063   
      
   --- SoupGate-Win32 v1.05   
    * Origin: you cannot sedate... all the things you hate (1:229/2)