The Tulsa, OK Dental Debacle: How Could This Happen???

       So, before I say another word, let me start out here by giving you the link to the actual Case Documents filed by the Oklahoma Board of Dentistry against W. Scott Harrington, who has surrendered all of his dental licenses. Here is the Link: Ok Board of Dentistry versus W. Scott Harrington. Ok, now that I've gotten that off my chest let's take a deep, dark and UGLY look at this absolute dental debacle of a magnitude that has been unsurpassed in my 30+ years in the field. And when I say this is UGLY, I mean it is UGLY. The laws of common sense did not exist in this destructive dental office, which has been labeled as a 'menace to public health'. There are many, many lessons that can be learned from this dental debacle, which is why I'm going to write about it, but I warn you...it is UGLY and may warrant a big, fat glass of Merlot, or a half a xanax to get through this whole blog entry calmly, due to its overwhelmingly disturbing nature. So, go get yourself a stiff drink, while I wait for you...no, no...go ahead; I'll wait. Believe you and me, you're going to NEED it.
       Ready? Alright. Where to start. I'm still shaking my head in utter disbelief. This makes that last Board of Dentistry meeting that I blogged about look like a walk in the park.......since I can't put this off any further...here goes. For the sake of reality, the former dentist (who is no longer a dentist) will be referred to as WSH (for W. Scott Harrington) in this blog posting.

Astounding Fact #1: WSH got his dental license in 1974 (OK dental license #3666). That's almost 40 years ago. He must be in his 70's and still "practicing" (ahem) when this all came to light and his Oral Surgery specialty license was granted in 1977. That license number is 59. 59!!! That's the same as having a social security number that's only 2 digits long! Due to limited record keeping (they couldn't find the stone tablets of his original dental patients?), the complaints only date back to the last 3 years. HOWEVER, over 7000 patients were notified that they may be at risk of contracting HIV, Hepatitis B and Hepatitis C, and should get tested immediately. Over 7000 patients in a 3 year time period? Was this an assembly line or a dental practice?? Original CNN Article About 'A Perfect Storm' for HIV

Astounding Fact #2: On March 15, 2013 ("beware the Ides of March", said Brutus to Caesar) investigators conducted an in-office investigation based on a complaint by a patient who contracted both HIV and Hepatitis C (both potentially fatal individually but together- a total powder keg) who had no other risk factors besides getting dental treatment done. The investigators found "multiple sterilization issues, multiple cross-contamination issues, the drug cabinet was unlocked and unattended during the day and dental assistants were routinely providing the IV sedation for the procedures". WHAT??? Did you just say that DENTAL ASSISTANTS were providing the IV SEDATION for the PROCEDURES??? HOW is this even POSSIBLE?? It's 2013 and we are in the United States of America here, for heaven's sakes!!! That defies basic LOGIC and COMMON SENSE!?!?! Dental assistants can't provide IV sedation and yet in this situation they not only PROVIDED it, they DETERMINED which drugs and time frames for each sedated patient they IV sedated!??!! My 5 year old grandson knows that can't happen! How and when did the dentist EVER think this was acceptable or allowed, and a better question to ask here: how the heck did the DENTAL ASSISTANTS think this was a 'delegatable' duty???? This one defies all sense of rationale. There is no way that either that 'dentist' or those 'dental assistants' could have thought this was acceptable. There are no courses for dental assistants to become certified to administer IV sedation. None.  It is clearly stated in the Oklahoma Dental Practice Act Here. 

       WSH's one dental assistant was with him for over 27 years, and the other for over 6 yrs. Both of them could read and write. Neither of them were blind, nor developmentally disabled. Therefore, they could have CLEARLY seen the Oklahoma Dental Practice Act and unless these ladies lived under a ROCK, there is no way they would have ever SEEN anything stating that they could perform such medical procedures when they didn't even have formal dental assisting training or permitting as assistants! This is just criminal, in my opinion. Ignorance is not a defense. It is impossible for these ladies to have NOT known they couldn't perform this service. Impossible.  However, WILLFUL violations not only get licenses/permits revoked, but can cause a dentist and dental assistants to face criminal charges for this type of heinous disregard towards over 7000 patients. It's not often that I advocate criminal charges, but in THIS case, I believe they are warranted AND that the dental assistants should be charged as aiding and abetting, willful accomplices. I believe the phrase Charlatans comes to mind, like the circus 'scammers' pawning their elixirs to fix what ails you. These are life threatening illnesses that patients were at risk of getting, with one already contracting two of them. It really should be attempted murder, but hey, that's just my opinion, and it's the first time I've felt this way in over 30+ years of my career. This is unimaginable, inexcusable, and intolerable.

Astounding Fact #3: The Oklahoma Health Department held a free screening for patients of WSH on 3/30/13, to test them for HIV, Hepatitis B and Hepatitis C, plus established and are manning a phone hot line. 420 prior patients were tested. This, of course, is at the expense of the taxpayers of Oklahoma, which is, in my opinion, a double jeopardy for patients and citizens. It was a fantastic and quick response (by the OK Health Department) for testing the panicked 7000 prior patients of WSH, but HIV can lay dormant for years (as established by significant prior available research), which means regular and routine testing over the next 7-10 years will need to be conducted on all of those patients. At who's expense, is still undetermined. Personally, I would urge the Oklahoma Board of Dentistry to estimate out the cost of that present and future expense, and add it to the Case against WSH for him, or his estate if need be, to reimburse the state of Oklahoma for that resulting consequence of being a "menace to public health". But, again, that's just my humble opinion....And by the way, the PUBLIC hearing for ex-dentist WSH to face the OK Board of Dentistry (the public is invited to attend ALL Board of Dentistry meetings and I WISH I could attend this one!) is slated for April 19, 2013 at the State Board of Dentistry headquarters at 201 N.E. 38th Terrace, Suite 2, Oklahoma City, Oklahoma, and begins at 10:00am, should any of you decide you wish to attend this hearing where WSH will be sanctioned....I'm just saying.....

Astounding Fact #4: When asked to see where the dentist, dental hygienist, and dental assistants' licenses and permits were located (they should be clearly placed where all patients can see them as current), the office manager found some in a file folder in a cabinet and others were missing. That's right; they were missing. That would be the same thing as not having them, or never having gotten licensed/permitted, as required by the state of OK. The one dental assistant had NO radiography permit, nor ANY formal dental assisting training AT ALL, EVER, the ex-dentist only had licenses for ONE of his TWO office locations, and the ex-dentist did not have an IV sedation certificate/education/training/license/permit; let alone his assistants who performed the actual IV procedures. In fact, they weren't fully trained even in dental assisting! How's THAT for a slap in the face reality-check! This prompted the office manager to state to the investigators (who advised her they should be active, current, and placed in a conspicuous place), "we need YOU (the investigators) to educate us on that". I don't even know how the investigators could've kept calm on this site visit! Honest to God! I would have stood there stupefied, with an open mouth, and a seriously twitching left eyebrow, in SHOCK from hearing that absurd statement leave the office manager's mouth!! Oklahoma has a clear, comprehensible website with their rules and statutes easily seen and listed on the website, as does OSHA, HIPAA, Dept. of Labor, CDC, DEA, Board of Dentistry, ADA, AND, on top of THAT, Continuing Education required of WSH would have provided him and his staff with that information on a regular biannual basis!! In other words, there are NO excuses for this level of ignorance, which only leaves readers and investigators with the conclusion that this was blatant and willful, which should be prosecuted to the fullest extent of the law.  "Additional counts may be added as the investigation continues...", states the Case document by the Oklahoma Board of Dentistry. Wow.This is a no brainer, folks. My guess, is that these 17 counts of serious violations, are the tip of the iceberg, and other agencies will be notified (such as OSHA, HIPAA, HHS, DEA, CDC, OK Attorney General's Office, etc, etc,) to jump in the ring here and conduct their own investigations of what other violations occurred. Stay tuned for more violations and charges to likely become known when these other agencies conduct their own investigations; which I believe will happen.

Astounding Fact #5: Drugs and anesthetics in WSH's office were scattered willy-nilly all over the place (including inside of blood stained boxes that were carried to the OTHER unlicensed location by these dental assistants), were not inventoried nor logs kept of their daily usages on patients, were reused on other patients, were NOT kept in a secured, locked cabinet (all of these are requirements; hint, hint), and were EXPIRED with some dating back to an expiration date of 1993! That's TWENTY years ago!! How in the HECK did NO ONE who worked in this office have the common DECENCY to say, 'Hey Doc, we really need to think about going through our scattered drugs in this office and trash the ones that are EXPIRED from TWENTY years ago' (!). Not ONE single employee. Not a one. It doesn't appear that they were bullied, or harassed, or threatened by this ex-dentist so what the HECK, ladies??!!?? These were your neighbors, your fellow community members, the single moms, the poorest and sickest people living in your towns and not ONE of you had the GUTS to stand up and say this isn't RIGHT?? THIS, to me, is the worst of the worst of these offenses. In other words, and in my HUMBLE opinion, these other employees were JUST as guilty as the ex-dentist. They should face criminal negligence charges (IMHO). I have NO idea how these ladies, who were named in the complaints (Shout out to this country's most notoriously insensitive, dangerous, additional  "menaces to their communities", Terry (Waugh) Valega and Lisa Young) could even SLEEP at night over this. I just have NO IDEA how they can LIVE with themselves over this willful disregard and danger they put their neighbors in, who now has/may have, life-threatening diseases. I'm so disturbed by this lack of humanitarian action. How no one could say anything about how wrong this all was is just beyond comprehension. It's unfathomable.......(still shaking my head in total disbelief).....

       So, here we are. A dental debacle of significant proportions that will live on in the minds of our potential and future patients for many years to come. We, in dentistry, are stuck looking at each other with a deer-in-the-headlights look of "How could this have happened for so long??". There just are no answers at this time. Hopefully, as the case evolves, some answers will come to light that we can really evaluate and create solutions from. In the meantime, the damage continues....

       These mind-boggling factual details of this Case No: 13-005 will grow as the investigations, case, and sanctions grow and evolve. They say that 'something good comes out of something bad eventually' (author unknown). I'm not sure if the trusting patient who now has HIV and Hepatitis C can embrace that inspiring quote, nor should they be able to right about now, but these are actionable and criminal offenses, in my eyes. In the long run, when the shock and outrage and sadness wears off (theoretically and in a perfect world), we will dissect this case, beef up our training schedules and requirements for dentists and their staff ALL over the country, and learn enough to NOT have history repeat itself with a similar dental debacle (hopefully).

       For now, though, this is an incredibly sad day for dentistry, as a whole, and an even sadder day for 7000 patients who trusted their ex-dentist. We have damage control to take care of immediately, to restore the faith lost in our field of dentistry. I will be posting additional blogs very soon on damage control, restoring faith in dentistry, and ensuring our offices, teams, and patients feel confident with our safety, compliance, and infection control protocols and procedures. We simply MUST learn from this. We simply must. And learn from it we will, because dentistry is too important and society needs dentistry and dentists whom they can trust. Unfortunately, we have a lot of work ahead of us but I'm confident that we can do it. I'm tired just thinking about all of the work that we have ahead of us to correct this...I just wish that ex-dentists like this, and complicit staff would stop making it so hard for the dentists and teams who are honorable, trust-worthy, and put their patients' needs and safety FIRST, who will now have to work harder to overcome these negative dental stereotypes that this OK dental debacle just created. In the end, the reality is that the vast majority of dentists and dental teams are inherently good, and that will outshine the darkness of this bad situation, any day.

       Well, that's enough from me today. Thanks for stopping by and remember; you only have to brush and floss the teeth that you ABSOLUTELY, POSITIVELY want to keep. That's it. Nothing more.

Dr. Driscoll