A dentist has been temporarily struck off after a patient died hours after having 10 teeth removed by him.
Tushar Patel has been banned from working for a year after being branded unfit to practise medicine following a ‘catalogue of errors’.
The General Dental Council was told the late female, known as ‘Patient A’, had visited Patel suffering with advanced gum disease and over two appointments had all of her top teeth removed.
However, despite the woman informing him she had been taking blood-thinning medicine Warfarin for her rare clotting condition, Patel failed to ‘weigh up the risks’ of his treatment and ignored guidance ‘well-known to dentists’.
Hours after her final appointment, Patient A was rushed A&E after collapsing at home while ‘bleeding from her mouth’. She later died.
The General Dental Council was informed of the death and a professional conduct hearing last week ruled Patel’s fitness to practice was impaired.
The GDC panel heard Patel failed to discuss with her the increased risk of bleeding because she was taking Warfarin, and didn’t carry out checks in line with industry-standard guidelines to assess the risks.
The report, published today (22 October), said: “You failed to adequately discuss or adequately record any discussions with Patient A regarding her complex medical history.
“This was in spite of the fact Patient A had provided you with a full medical history questionnaire […] before you embarked on any treatment. You failed to pack or suture the extraction sockets.
“Your failures placed Patient A at a significant and avoidable risk of harm and were in contrary to guidance.
“These were basic errors which placed Patient A at significant risk of harm, when this could have, and should have been avoided.
“This amounted to a repeated disregard for patient safety which can be described as serious.
“The committee has determined that your fitness to practice is currently impaired by reason of your misconduct.
“You failed to provide an acceptable standard of care for Patient A […] the committee has determined that your registration be suspended for the maximum period, 12 months.”
According to documents, Patel first examined Patient A in May 2013. Despite being told she needed to have some teeth removed, Patient A didn’t return for another appointment until 5 June 2017, when she complained of her ‘teeth falling out’.
Suffering with a condition called thrombotic thrombocytopenic purpura, which causes blood-clotting, the woman informed Patel that she had been taking Warfarin. It was also mentioned in her medical history.
According to the GDC’s report, Warfarin has been widely used for more than 50 years and the risk of post-operative bleeding complications is of concern to dentists.
Patel extracted five of the patient’s teeth on 13 July and a further five teeth five days later.
Hours after having the final five teeth removed, the patient experienced extensive bleeding from the extraction sites. The report also states that on neither visit were Patient A’s wounds packed or sutured following the treatment.
Several hours after her second appointment, Patient A went to A&E at King’s College Hospital, London, but was discharged following treatment to attempt to stop the bleeding.
She later collapsed at home, and on 19 July was rushed back to the same hospital but was pronounced dead.
A coroner’s investigation ruled the medical cause of death was haemorrhage from the tooth extraction site and Warfarin treatment and dental extraction.
The GDC charged Patel and found proved a total of eight charges relating to his treatment of Patient A.
Patel ‘fully accepted’ the shortcomings and the panel found him impaired to work, the report said.
It added: “The committee takes a serious view of the findings against you. There were multiple errors and a failure to follow the appropriate guidance.
“These were basic errors which placed the patient at significant risk of harm. This was not a single error, but a catalogue of errors.
“Patient A was a vulnerable patient and you failed to recognise this situation. Public confidence would be undermined if a finding of impairment were not made.”
A GDC hearing report ruled Patel breached clinical care and decided his behaviour is ‘fundamentally incompatible with remaining on the register’.
Patel has expressed remorse and has apologised to the patient’s family, the GDC report said.
Speaking about the ruling, Patel said: “The patient’s death was a tragedy and my sincere condolences go to the family.
“I always strive to provide the very best care for my patients, however, I accept the GDC’s findings and deeply regret that there have been deficiencies in my practice relating to one patient.
“I can confirm that those issues have now been addressed.”
Pending an appeal, Patel’s suspension will start on 11 November 2019.