State health officials are alleging unprofessional conduct by two Vancouver dentists linked to the death of 4-year-old Mykel Wayne Peterson.
The state health department’s Dental Quality Assurance Commission filed charges Tuesday against dentists Prashant Gagneja and Monisha Gagneja. The couple own Must Love Kids Pediatric Dentistry in Vancouver.
The dental practice began using anesthesia services from Northwest Mobile Anesthesia Group in 2013. From Jan. 1, 2016 to March 10, 2017, the company provided anesthesia services for about 146 pediatric patients at Must Love Kids. At no time during that period did the dental office have a written contract with the company, according to the dental commission documents.
On March 10, Mykel underwent general anesthesia, administered by Dr. Chester Hu, at the dental practice. While in the recovery room, the boy stopped breathing. He was transported to the hospital but could not be resuscitated, according to the documents.
At the time of Mykel’s death, the dental office did not have a contract with the anesthesia company or Hu stating that the anesthesia provider must meet specific criteria — including facility, equipment, monitoring and training requirements for all personnel — as required by the dental commission and state administrative code. As a result, the commission is charging both dentists with unprofessional conduct, defined as incompetence, negligence or malpractice that results in the injury or creates and unreasonable risk of injury for a patient.
Prashant and Monisha Gagneja each have 20 days to respond to the charges. The dental commission has the authority to level disciplinary action against the dentists’ licenses, which could include additional training, suspension or license revocation, among other options.
They can continue to practice until the charges are resolved, and the dental office remains open.
In an emailed statement to The Columbian, Prashant Gagneja and Monisha Gagneja said they “strongly disagree and refute all allegations.”
“It is very important to understand the Commission’s allegation is based on a technicality only, that the agreement between the clinic and the independent anesthesiologist company, though it met the state requirement, was not in written form,” the doctors said in the statement. “The undisputed fact is, our clinic and the anesthesiologist company had a very clear agreement as to the delineation of responsibilities. The independent contractor anesthesiologist agrees they were responsible for all aspects of the anesthesiology services, including the monitoring and recovery of our patient.”
“Though a very tragic outcome, at no time during the procedure would the presence of a contract have changed the outcome of the patient’s care, which was under direct supervision of a board-certified anesthesiologist,” the statement said.
Hu and Northwest Mobile Anesthesia Group could not be reached for comment.
Observation required
Prashant Gagneja has been a licensed dentist in the state since August 2004. Monisha Gagneja received her state dental license in August 2007. Both are board certified pediatric dentists.
According to charging documents, Prashant Gagneja was not Mykel’s treating dentist during his March 10 visit to the dental office, but he was present and assisted Hu during portions of the boy’s post-operative recovery.
Prashant Gagneja said he helped the anesthesiologist and medical assistant when asked to assist in the emergency. Monisha Gagneja was not in the office on March 10, according to the statement from the dental office.
While Mykel was in the recovery room, he was not continually observed and no pulse oximeter — used to measure oxygen saturation — was applied until the boy began having breathing problems, according to the charging documents.
State administrative code requires a patient be continually observed by the anesthesia provider or credentialed personnel during the recovery phase. Mykel was monitored by a medical assistant who checked on him every 10 to 15 minutes, according to charging documents.
The state’s Medical Quality Assurance Commission recently charged Hu — a licensed physician and surgeon who is board certified in anesthesiology — with unprofessional conduct. State health officials say Hu failed to meet the standard of care by not using monitoring equipment or having an appropriately credentialed and trained person monitoring Mykel as he emerged from sedation.
