Dr. Bobby Rishiraj
A penalty hearing is underway in Vancouver this week for a Kamloops dental surgeon who improperly sedated a young woman during a routine operation, leaving her with a severe brain injury.
The patient, then-18-year-old Hamu Zindoga, was deeply sedated in November 2012 while having her wisdom teeth removed, even though Dr. Bobby Rishiraj had not been approved to perform such a procedure.
During a hearing earlier this year before a discipline panel of the College of Dental Surgeons of B.C., Rishiraj admitted to some of the allegations against him, including that he committed professional misconduct or unprofessional conduct by providing deep sedation at his facility, when it was not approved as a deep sedation facility and despite the fact he was not approved to provide deep sedation to patients; and by not operating the facility in compliance with the college’s sedation and general anesthetic standards.
Following evidence and submissions, the college’s discipline panel issued its decision on June 23.
It found Rishiraj:
• • Administered deep sedation to Zindoga when neither he nor the facility were authorized to do so, and without complying with CDSBC’s guidelines for deep sedation;
• • Ran his practice to promote “efficiencies” by treating as many patients in as short a time as possible;
• • Failed to recognize Zindoga’s cardiac arrest in a timely way and delayed resuscitative measures as a result; and
• • Failed to adequately monitor his patients while they were under sedation.
• The discipline panel concluded that Rishiraj’s failure to adequately monitor his patients and to recognize HZ’s cardiac arrest could be characterized as incompetent practice.
On Monday, college lawyers told the penalty hearing that Rishiraj was reckless and cavalier and any penalty must reflect his great misconduct.
The dentist could face a fine, suspension or both.
Following the college’s decision last month, Rishiraj filed notice he was appealing the June decision by the college. He continues to practise as an oral surgeon in Kamloops, under limits and conditions imposed by the college.
Rishiraj is not entitled to administer anesthesia beyond moderate sedation using only one class of agent (benzodiazepenes) and was required to hire additional expert staff and to change protocols and procedures in his office. Any deep sedation required is provided by authorized medical practitioners and Rishiraj must ensure patients are continuously monitored by accredited staff.
Meanwhile, Zindoga, has separately filed a medical malpractice lawsuit against Rishiraj, as well as against his dental assistant, Sara Chalmers, in B.C. Supreme Court.
It seeks unspecified damages for Zindoga, who is represented by her mother as a litigation guardian. Zindoga now lives in a Okanagan residential treatment centre for people with brain injuries.
The malpractice suit also claims an ambulance attendant discovered a piece of gauze blocking Zindoga’s airway.
After the gauze was removed, the paramedic intubated Zindoga, who had stopped breathing.
Rishiraj filed a response in B.C. Supreme Court, admitting he was not approved to provide deep sedation, but denying other allegations. The response said Rishiraj and Chalmers recognized Zindoga’s cardiac arrest and started appropriate resuscitation.
The response to the lawsuit also claims Zindoga’s mother, Evelyn, failed to disclose her daughter was admitted to Royal Inland Hospital’s emergency department for complaints of chest pain prior to surgery.
The response also stated Rishiraj was not told Zindoga was being treated and taking medication for migraines and psychiatric illness.
The trial is scheduled for Oct. 17, 2016.
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