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

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

The patient was then “transferred to emergency care and died,” the board claims. A subsequent investigation by an unspecified party revealed that Karch “did not remain in the carrier during the proceedings,” the board claims.

State regulations require that when a patient is sedated and anesthesia services are 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 notice”.

Karch’s license to practice dentistry remains unrestricted.

The board charged Karch with the statutory offense of not being present in the treatment room during dental treatment. A hearing on the matter has been scheduled for October 11, but a final decision in the case has not yet been released.

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

“Joe is not doing well – please come at once.”

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

The suit, filed in Polk County District Court by the family of Joseph Daniels, alleges that on January 24, 2024, Daniels consulted with Karch and asked about receiving dental implants. According to the lawsuit, Daniels was 50 years old at the time, smoked 1 ½ packs of cigarettes a day and had a history of high blood pressure and hyperlipidemia.

At the time of the consultation, Daniels’ blood pressure was noted to be 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 pre-procedure authorization from Daniels’ primary care physician.

On Jan. 25, Daniels was evaluated and cleared for surgery by Dr. Anish P. Keshwani at the UnityPoint Family Medicine Clinic of East Des Moines — even though, the lawsuit claims, UnityPoint’s medical records indicate Daniels’ “uncontrolled” hypertension and hyperlipidemia. “corrective actions before surgery” such as taking prescribed medications.

On January 26, the implant procedure began at 7:15 a.m. and was completed at 3:15 p.m., with the care of the patient falling to 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 that they were needed in the surgery room with a text that read, “Joe is not doing well – please come right away.”

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

Within 25 minutes of their arrival and administering medication, paramedics had Daniels intubated and by 4:27 a.m. they had started chest compressions, the suit claims. Daniels was then taken to Iowa Methodist Medical Center, where he died at 5:51 pm.

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.

To date, Newhoff and Heartland are the only defendants to file a response to the allegations and deny any wrongdoing. Additionally, they assert an affirmative defense 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 court date has not yet been scheduled in the case.