Nine months after the patient’s death, an “emergency order” restricts the 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 implant surgery.

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

The patient was then “transferred to the emergency room and died,” the board claims. A subsequent investigation by an unnamed party found that Karch “did not remain in the operating room during the procedure,” the board alleges.

State regulations require that when a patient is under sedation and anesthesia services are provided, the dentist must remain in the room during the procedure, the board said.

In issuing an emergency order restricting Karch’s ability to practice, the board said it “recognizes Karch as an immediate threat to public safety” and that he is “barred from participating in procedures involving sedation until further notice.” ”

Karch’s license to practice dentistry remains otherwise unrestricted.

The board has accused Karch of not being present in the treatment room during the duration of dental treatment. A hearing on the case was scheduled for October 11, but a final decision in the case has yet to be published.

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

‘Joe is not doing well. Please come immediately.”

The emergency order, which comes 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 Karch and inquired about receiving dental implants. According to the lawsuit, Daniels was 50 years old at the time, had smoked one and a half packs of cigarettes per day and had a history of hypertension and hyperlipidemia.

At the time of the consultation, it was reportedly noted that Daniels’ blood pressure was “of great concern” to Karch. The lawsuit alleges that Daniels, at a cost of $50,000, would receive the dental implants two days after Karch’s consultation, subject to prior approval from Daniels’ primary care physician.

On January 25, Daniels was reportedly evaluated and cleared for surgery by Dr. Anish P. Keshwani of the UnityPoint Clinic Family Medicine in East Des Moines — although, the lawsuit alleges, UnityPoint’s medical records show that Daniels’ “uncontrolled” hypertension and hyperlipidemia required “corrective measures before surgery,” such as administering prescribed medications.

On January 26, the implant procedure began at 7:15 a.m. and was completed by 3:15 p.m., with patient care reportedly handed over to certified registered nurse anesthetist Nicky Newhoff, who was tasked with waking Daniels and initiating 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 operating room via a message that said, “Joe is not doing well – please come immediately.”

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

Within 25 minutes of their arrival and medication administration, paramedics had intubated Daniels and by 4:27 a.m. had begun chest compressions, the lawsuit alleges. 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.

To date, Newhoff and Heartland are the only defendants to file an answer to the allegations, and they have denied any wrongdoing. Furthermore, they raise an affirmative defense by alleging that the damages suffered by Daniels were “caused in whole or in part by (Daniels’) fault,” citing “pre-existing conditions or acts” beyond Newhoff and Heartland’s control. .

A trial date in the case has yet to be scheduled.