VA dental service chief aware dentist failed to sterilize tools

DAYTON — At least one former supervisor at the Dayton VA Medical Center’s dental clinic took little action after learning a dentist often reused dental equipment on patients without sterilizing it first, according to testimony obtained Wednesday by the Dayton Daily News.

The dentist’s performance had been an issue for years. When told the dentist’s actions likely exposed veterans to blood-borne pathogens, a former dental service chief told investigators the dentist “was not trainable. He wouldn’t take direction. And given the circumstances — that I had not really any avenue to get him out of the service — there wasn’t a lot I felt I could do at the time.”

A 42-page Dayton VA investigation report shows several dental clinic employees knew for years a dentist was not following proper hygiene practices.

“I’ve seen him literally walk from his room with this patient’s denture in one hand, go across to another room, open this patient’s mouth with this denture of the opposite patient in his hand,” one dental assistant told investigators. “I’ve seen him use the same instruments, the same handpiece, the same burs all day long on every patient. I’ve seen him go out of the clinic and push the button on the elevators with dirty gloves on. I’ve seen him open lab doors with dirty gloves on; I’ve seen him go in the lunchroom and use the microwave with dirty gloves on.”

The dentist “repudiated” investigators’ claims against him, according to the report. He remains on the VA’s payroll, but has not seen patients since July 28. Administrative action against him is pending.

The report also:

  • Expressed concern about the dentist's cognitive status, saying that during his interview, the dentist often became confused, gave conflicting statements, and did not appear to understand fully the gravity of the situation. One person's testimony suggested the dentist is elderly, though the Dayton VA declined to disclose his age.
  • Alluded to testimony indicating the dentist spent "a good deal of clinic duty time conducting genealogy studies" on his work computer.
  • Found dental students were permitted to practice without the required level of supervision, and staff dentists entered themselves as the primary provider of care that was in fact provided by unlicensed students.
  • Found evaluations of professional staff were "wholly insufficient" and represented a "gross failure of leadership."
  • Exonerated Dayton VA Medical Center Director Guy Richardson, saying he had no knowledge of the dentist's conduct.

The Dayton VA did not immediately respond to a request for comment on the report, which was provided to the Dayton Daily News on Wednesday.

An employee raised concerns about infection control practices at the Dayton VA dental clinic while an internal VA panel was reviewing clinic operations in late July. VA officials closed the clinic Aug. 19 and reopened it Sept. 10.

The VA said Tuesday it would test at least 535 veterans to see if they may have contracted Hepatitis B, Hepatitis C or HIV as a result of the poor infection control.

It has set up a dental communication center, staffed around the clock, as well as a dental special care clinic open from 8 a.m. to 6 p.m. Monday through Friday, and 8:30 a.m. to 4:30 p.m. Saturday at Building 320 (Lakeside Manor) at the Dayton VA, 4100 W. Third St. For an appointment, veterans should call (877) 424-8214.

The Dayton VA on Tuesday began contacting at least 535 veterans, offering them free screenings to see if they were infected with Hepatitis B, Hepatitis C or HIV between 1992 and July 2010 due to the dentist’s poor infection-control practices. The testing is expected to cost $18,000 to $25,000, VA spokesman Todd Sledge said.

Contact this reporter at (937) 225-7457 or bsutherly @DaytonDailyNews.com.

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