AK: Dentist who rode hoverboard while pulling tooth faces patient in court

[Gabriel]

He should show up to court on a hoverboard.

 

[Bigtanker]

Sentenced to 12 years in jail. But it seems like a lot more than just the hoverboard stunt.

https://nypost.com/2020/09/16/dentist-who-extracted-tooth-on-hoverboard-gets-12-years/amp/

Seth Lookhart was sentenced Monday in Anchorage Superior Court on dozens of charges that stemmed from actions that ranged from his scooting antics to Medicaid fraud and removing a patient’s teeth without their permission, the Anchorage Daily News reported.

He was convicted back in January on charges of reckless endangerment, illegally practicing dentistry and medical assistance fraud.

 

[hoosierdoc]

I am irritated they can charge for sedation. Our payors have bundled that all together. Oh, you are putting a dislocated shoulder back in? here's one payment that includes sedation, sling, and the reduction procedure.

that's if it's one provider. if we have two providers then you can bill independently. Frankly it's safer to have two anyway, esp since hospotal ruled nurses can't push propofol. dosing meds yourself AND physically doing the procedure sucks.

but yes, I agree with Hough. the hoverboard is stupid but not malpractice. videotaping yourself working on a sedated patient and sending it to your friends? that may be a civil suit though?

 

[craigkim]

I haven't seen the details of this case at all but my initial thoughts:
-Hover board, meh, I don't need a stable platform to safely perform most all extractions. Bad idea, yes, malpractice, I'm not seeing it.
-Any time you see Medicaid or Medicare fraud PLEASE take it with a grain of salt! It is an interesting dynamic. YES there are Dr.'s/practices that are gaming the system for everything it is worth so policies are made to be strict and harsh to try and prevent it. But, it is a Gov. agency that cannot make logical decisions but rather has to make rules and then hires the otherwise unhireable to manage the entire thing. It is SCARY what can totally look like fraud due to extremely strange rules, constantly changing, and require a full time staff to keep on top of. You simply cannot practice with a good ethical conscious and assume you are not doing something that will be fraud to some auditor 5 years later.
-The stealing $250K from his partners: WOW, most likely something to that.

Unprofessional and dumb, but in the video it seemed like the operatory was properly equipped and the patient was being properly monitored during the sedation. I can't imagine why a patient would require sedation for an extraction that appeared to be that simple or "routine". Rarely do I get upper molars like that which are so compromised that I could remove them on a hover board.

I don't take medicaid in my office, but it is likely that his documentation was poor or non existent. He may have failed to render diagnoses in treating his patients which can be construed as performing "unnecessary" treatment. In order for treatment to be deemed necessary when reviewing the charts there must be a diagnosis. In the case of the tooth in the video it may be - Diagnosis: Severely periodontally involved and decayed upper molar for which the prognosis is hopeless". If he didn't render a diagnosis then, the treatment was deemed "unnecessary" regardless of whether it truly was or not.

Inadequate consent or lack of consent can result in patients believing that the "wrong" teeth were removed. You must have the consents signed by the patient in language that they can understand. So, again, in this case something on the consent such as, "Removal of upper right molar tooth". If you don't get good consent, we were always taught that you were performing battery. I remember one of my classmates several years back made the news for sedating a medicaid patient and "taking out all of his teeth without permission". The news was all over it. The attorneys met, the proper charting, documentation, and consents were produced in good order and they dropped the case but the damage to his reputation was still done. The news didn't cover the outcome.

I didn't delve into it too much but it seems like there was concern for patient safety during his IV sedations. There was discussion of patients having "breathing problems" or "irregular heart beats" during sedations. The judge seemed to think that he "almost killed people". If you are sedating enough patients, you will run into problems and you have to respect the possible complications. You must be well trained, screen patients carefully, monitor carefully, and plan for complications, because they will likely arise at some point.

All in all to me though, it seems like he was probably scamming the system, at least in regard to the number of sedations he was performing, which is sad. Makes dentists all look bad and hurts our profession.

 

[HoughMade]

I "cut my teeth" as a med mal defense attorney on dentist cases.

...amd, sorry friends, in the many years since, no group of healthcare providers has come close to matching the overall weirdness of my dentist clients back then.

I know, I know- my sample was dentists who had malpractice cases, often several, so it's not exactly representative.