Dentist reprimanded for practising outside scope of practice

23 Dec 2020

A tribunal has reprimanded a dentist who sedated a patient for an extended length of time and practised outside of his scope of practice.

Dr Barry Creighton was reprimanded by the Victorian Civil and Administrative Tribunal (the tribunal) and ordered to do 20 hours of one-on-one education.

Dr Creighton is an experienced dental practitioner with an endorsement in conscious sedation and administers twilight sedation to enable suitable patients to undergo dental procedures in the general dental surgery setting.

In August 2015, Dr Creighton administered dental sedation to a patient during a complicated procedure performed by another dentist. The procedure involved extracting eight of the patient’s upper teeth and seven of their lower teeth, as well as the insertion of eight titanium dental implants. It was planned to take three to four hours but the procedure ended up taking about seven hours.

The Dental Board of Australia (the Board) investigated Dr Creighton’s conduct after the patient had made a complaint about the conduct of the practitioner who had performed the dental surgery.

Following the Board’s investigation, two matters were referred to the tribunal:

• that Dr Creighton inserted a urinary catheter when that was outside the scope of his endorsement in conscious sedation
• that he did not provide good patient care during the procedure by administering a quantity and combination of medications to sedate the patient over an unacceptable length of time.

In April 2019, the tribunal was told that Dr Creighton had revealed he believed the urinary catheter was necessary as he had to administer fluid replacement to the patient due to the duration of the procedure.

The tribunal considered expert evidence which explained that as part of the approved program of study for endorsement in dental sedation, practitioners are taught that patients should not be sedated for procedures over 90 minutes.

The evidence also stated that the use of urinary catheters as part of a dental procedure was something not taught to practitioners. The tribunal found urinary catheterisation is far outside Dr Creighton’s scope of practice.

The tribunal said that Dr Creighton actions were a significant departure from good practice and were substantially below the standard reasonably expected of a health practitioner of his level of training or experience.

The order to do 20 hours of further education was deemed necessary by the tribunal to consolidate Dr Creighton’s knowledge at a fundamental level and to minimise the chances of any similar errors of judgement occurring in the future.

The decision is published on the AustLII website.