9 months after patient's death, 'emergency order' restricts dentist's license

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

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

The patient was then "transferred to emergency care and passed away," the board alleges. A subsequent investigation by an unspecified party revealed Karch "did not stay in the operatory for the duration of the procedure," the board alleges.

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

In issuing an emergency order restricting Karch's ability to practice, the board said it "recognizes (Karch) as an imminent threat to public safety" and that he "should not be permitted to participate in procedures involving sedation until further order."

Karch's license to practice dentistry remains otherwise unrestricted.

The board has charged Karch with the regulatory offense of failing to be present in the treatment room for the duration of a dental treatment. A hearing on the matter was scheduled for October 11, but a final decision in the case has yet to be published.

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

'Joe is not doing well -- please come immediately.'

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

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 inquired about receiving dental implants. According to the lawsuit, Daniels was 50 years old at the time, had smoked 1 1/2 packs of cigarettes per day, and had a history of hypertension and hyperlipidemia.

At the time of the consultation, Daniels' blood pressure was allegedly noted as being "of great concern" to Karch. The lawsuit alleges that at a cost of $50,000, Daniels was to receive the dental implants from Karch two days after the consultation, subject to a preprocedure clearance by Daniels' primary care physician.

On January 25, Daniels was allegedly evaluated and cleared for surgery by Dr. Anish P. Keshwani at UnityPoint Clinic Family Medicine of East Des Moines -- although, the lawsuit claims, UnityPoint medical records indicate Daniels' "uncontrolled" hypertension and hyperlipidemia would require "corrective actions before surgery," such as the administration of prescribed drugs.

On January 26, the implant procedure began at 7:15 a.m. and was completed at 3:15 p.m., with patient care allegedly turned 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 they were needed in the surgical suite through a message that stated, "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. with a report of an "unconscious person." According to the lawsuit, the 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 the administration of drugs, the paramedics intubated Daniels, and by 4:27 p.m., they initiated chest compressions, the lawsuit claims. 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, the defendants in the lawsuit include the 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 have filed an answer to the allegations, and they have denied any wrongdoing. In addition, they are asserting an affirmative defense by alleging 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 trial date has yet to be scheduled in the case.

This article was originally published in the Iowa Capital Dispatch and republished by DrBicuspid under the Creative Commons license CC BY-NC-ND 4.0. TheIowa Capital Dispatch is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. The Iowa Capital Dispatch maintains editorial independence.

Deputy Editor Clark Kauffman has worked during the past 30 years as both an investigative reporter and editorial writer at two of Iowa’s largest newspapers, the Des Moines Register and the Quad-City Times.