Two years after dental anesthesia death, widow still waiting for reform

WILMINGTON, N.C. (WECT) - August 3rd marks two years since Henry Patel’s death. The beloved cardiologist was 53 years old when he died from being over-sedated during a routine dental procedure. On this difficult anniversary, Patel’s widow, Shital, is renewing her push for dental anesthesia reform. The North Carolina State Board of Dental Examiners plans to consider a rule change to requirements for dental anesthesia and sedation at their meeting in September.

Bobby White, the Dental Board’s CEO, says they’ve received more public comments on this topic than any other issue in the Board’s history. The Board has reviewed 1,300 pages of comments. Many have come from friends and family of the Patels, as well as members of the medical community at large, who were shocked over Dr. Patel’s senseless death. They would like to see the Dental Board require a Certified Registered Nurse Anesthetist or Anesthesiologist be present anytime a dental patient is put under deep sedation, which is already required when patients are put under for other medical procedures.

“The medical doctors aren’t allowed to do two things at once, like do the surgery, and give anesthesia or monitor a patient at the same time. And [medical doctors] are in a hospital setting or a surgical setting with plenty of other help around. But dentists, you know, solo practitioners are out [sedating patients] all the time,” Shital Patel said of the disconnect between the rules for dental and medical sedation. “I am so lucky that we have the support of our community, our state and beyond, because the [WECT] story went national.”

But there has also been pushback from members of the dental community, who say that having to hire a CRNA to supervise patients being sedated for dental procedures would drive up the cost to patients and prevent some people from seeking care. Patel said that is a weak argument.

“Don’t be naïve. The dentist or the oral surgeon is charging you a hefty fee already. The only thing is it’s a bigger portion going to them only because they don’t have to give it to a CRNA or anesthesiologist. So they are not providing a free service,” Patel reasoned. She said that CRNAs can be hired to monitor dental anesthesiology for about $100 per hour.

It took nearly a year to confirm through an autopsy report that anesthesia caused Dr. Patel’s death. But Patel’s oral surgeon, Dr. Mark Austin, had come under scrutiny almost immediately after Patel became unresponsive after being put under anesthesia for a dental implant on July 30, 2020.

According to a disciplinary action filed by the North Carolina State Board of Dental Examiners, “[Dr. Austin] administered sedative agents to patient [Henry Patel] prior to and during the procedure. Towards the end of the procedure, patient H.P.’s oxygen saturation levels began to drop significantly. [Dr. Austin] took certain measures to address H.P.’s de-saturation, such as attempting ventilation, an unsuccessful effort to place an endotracheal tube, and contacting 911, but H.P.’s oxygen levels remained in the 60-70% range for at least 20 minutes. When EMS arrived at [Dr. Austin’s] office at 3:50 P.M., patient H.P. was pulseless and apneic and in an asystole heart rhythm. [Dr. Austin] had not initiated CPR prior to arrival of EMS.”

What many first assumed to be a tragic accident took on a different tone when investigators learned about suspected drug abuse at Dr. Austin’s office. The Leland Police Department requested the SBI’s assistance four days after Patel’s dental procedure went wrong. It was the same day Patel was taken off life support after suffering irreversible brain damage.

Dr. Austin surrendered his license to practice sedation in January 2021, but was still able to perform other dental procedures. Several months later, after damning evidence came out from investigators, Austin signed a consent order with the Dental Board surrendering his dental license entirely.

“The current action is being taken based on... probable cause that [Dr. Austin] has committed significant additional violations,” the documents suspending Austin’s dental license read. “Specifically, the Board received information demonstrating that [Dr. Austin] has prescribed controlled substances for his staff members, including prescribing controlled substances outside the scope of practicing dentistry, such as narcotic cough suppressants and sedative-hypnotic medications. The Board also recently received evidence that during an audit by the Drug Enforcement Administration (DEA) conducted in 2021, [Dr. Austin] was unable to account for controlled substances that were supposed to be maintained at his office, including the schedule II- controlled substance Fentanyl. Most recently, the Board obtained evidence indicating that Respondent has taken controlled substances, including Fentanyl, from his dental practice and used them personally during portions of 2019 and 2020.”

A spokesperson for the NC Attorney General’s Office told WECT Wednesday afternoon that the SBI has completed its criminal investigation into suspected drug abuse at Austin’s office. The Attorney General is reviewing their findings and declined to comment further at this time.

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