Nine months after patient's death, 'emergency order' restricts 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 shortly after dental implant surgery in January.

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

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

State regulations require that if a patient is under sedation and anesthesia procedures are being performed, the dentist must remain in the room during the procedure, the agency said.

In issuing an emergency order restricting Karch's ability to exercise, the agency said it “recognized (Karch) as an imminent threat to public safety” and that he “shall not be permitted to participate in sedation procedures until further order.”

Karch's license to practice medicine otherwise remains unrestricted.

The board charged Karch with a misdemeanor for not being present in the treatment room during dental treatment. A hearing on the matter was scheduled for Oct. 11, but a final decision in the case has yet to be released.

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

“Joe isn’t feeling well – please come immediately.”

The emergency order, which comes nine months after the alleged death, coincides with a civil lawsuit against Karch and others involved in the operation.

The lawsuit filed by Joseph Daniels' family in Polk County District Court alleges that Daniels consulted with Karch on January 24, 2024 and inquired about receiving dental implants. According to the lawsuit, Daniels was 50 at the time, smoked a pack and a half of cigarettes a day, and had a history of hypertension and hyperlipidemia.

At the time of the consultation, it was reportedly noted that Daniels' blood pressure was “very concerning” for Karch. The lawsuit alleges that Daniels was scheduled to receive Karch's dental implants two days after the consultation at a cost of $50,000, subject to pre-procedure approval from Daniels' primary care physician.

On January 25, Daniels was allegedly murdered by Dr. Anish P. Keshwani at UnityPoint Clinic Family Medicine in East Des Moines and cleared for surgery — even though, according to the lawsuit, UnityPoint's medical records indicated that Daniels' “uncontrolled” hypertension and hyperlipidemia would require “corrective measures prior to surgery.” , for example the administration of prescribed medication.

On January 26, the implantation process began at 7:15 a.m. and was completed at 3:15 p.m. Patient care was reportedly handed over to trained anesthetist Nicky Newhoff, who was tasked with awakening Daniels and beginning the recovery process.

The lawsuit alleges that a dental assistant notified Karch and Wolf that they were needed in the operating room at 3:30 p.m. with a message: “Joe is not feeling well – please come immediately.”

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

Within 25 minutes of arriving and administering medication, paramedics intubated Daniels and began chest compressions at 4:27 p.m., the lawsuit says. 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.

So far, Newhoff and Heartland are the only defendants to have filed a response to the allegations and denied any wrongdoing. In addition, they assert an affirmative defense by asserting that any damages suffered by Daniels were “caused in whole or in part by (Daniel's) fault,” relying on “pre-existing conditions or acts” that Newhoff and Heartland allege had no influence.

A trial date for the case has not yet been set.