Bill Text: HI HB1442 | 2016 | Regular Session | Introduced

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Bill Title: Dentistry; Board of Dental Examiners; Dentists; Anesthesia; Sedation; Recertification; Adverse Occurrence; Reporting Requirement; Penalties

Spectrum: Partisan Bill (Democrat 6-0)

Status: (Introduced - Dead) 2015-12-17 - Carried over to 2016 Regular Session. [HB1442 Detail]

Download: Hawaii-2016-HB1442-Introduced.html

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HOUSE OF REPRESENTATIVES	H.B. NO.	1442
TWENTY-EIGHTH LEGISLATURE, 2015
STATE OF HAWAII

A BILL FOR AN ACT

 

 

relating to dentistry.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 

     SECTION 1.  The legislature finds that the practice of sedation and anesthesia by licensed dentists is regulated by the State.  However, recent tragedies have led to calls for more oversight of the use of sedation and anesthesia by licensed dentists.  In January 2014, a three-year-old patient died after falling into a coma after a dental procedure.  It was later determined that the dentist had used five different sedatives on the young child, who weighed less than fifty pounds.  In March 2014, a twenty-four-year-old woman from Hilo fell into a coma while having two wisdom teeth removed.

     Although new sedation rules went into effect last year, the legislature concludes that additional oversight for the use of sedation and anesthesia by licensed dentists is needed.

     Accordingly, the purpose of this Act is to:

     (1)  Specify requirements for the administration of general anesthesia and sedation;

     (2)  Require licensed dentists to possess a written authorization or permit to administer general anesthesia, deep sedation, or moderate (conscious) sedation from the board of dental examiners;

     (3)  Require the board of dental examiners to establish a process and requirements, including a continuing education component, for the issuance of a written authorization or permit;

     (4)  Require the board of dental examiners to report to the legislature, no later than twenty days prior to the regular session of 2016, any updates to the written authorization or permit process, including the status of the five year recertification process and continuing education requirements;

     (5)  Require a report to the board of dental examiners within twenty-four hours of an adverse occurrence during or resulting from anesthesia; and

     (6)  Specify penalties for failure to report an adverse occurrence.

     SECTION 2.  Chapter 448, Hawaii Revised Statutes, is amended by adding two new sections to be appropriately designated and to read as follows:

     "§448-    Administration of general anesthesia and sedation; written authorization or permit; recertification.  (a)  No dentist shall administer or employ another person to administer general anesthesia, deep sedation, or moderate (conscious) sedation for dental patients, unless the licensed dentist possesses a written authorization or permit from the board of dental examiners.

     (b)  The board of dental examiners shall review the established process and requirements for the issuance and renewal of a written authorization or permit to administer or employ another person to administer general anesthesia, deep sedation, or moderate (conscious) sedation.  The written authorization or permit shall be required every five years, and the requirements for issuance or renewal of a written authorization or permit shall include a continuing education component, to be determined by the board.  No later than twenty days prior to the regular session of 2016, the board shall report to the legislature any updates to the written authorization or permit process, including the status of the five year renewal process and continuing education requirements.

     (c)  The board shall issue a written authorization or permit to a licensed dentist to use general anesthesia, deep sedation, or moderate (conscious) sedation if the licensed dentist employs or works in conjunction with a physician who is licensed in good standing pursuant to chapter 453 and who is a member of the anesthesiology staff of an accredited hospital; provided that the anesthesiologist shall remain on the premises of the dental facility until the patient is fully recovered and discharged from the facility.

     (d)  Licensed dentists intending to produce a given level of sedation shall have the capability and necessary training to rescue patients whose level of sedation becomes deeper than initially intended.

     (e)  Licensed dentists administering anesthesia shall provide twenty-four hour, on-call availability following an anesthesia procedure; provided that this section shall not apply to procedures using only local anesthetic.

     (f)  Dental assistants or technicians shall not administer any general or local anesthetic, including intravenous sedation.

     §448-    Adverse occurrences; report; failure to report.  (a)  All licensed dentists engaged in the practice of dentistry in the State shall submit a report to the board of dental examiners within twenty-four hours of any mortality or other incident that results in temporary or permanent physical or mental injury requiring hospitalization of a patient during or as a direct result of anesthesia related thereto; provided that if the mortality or other incident occurs on any Friday, or on any Saturday, Sunday, or legal holiday, the twenty-four hour period shall be extended until 4:30 p.m. on the first day following the weekend or legal holiday.

     (b)  The report required under subsection (a) shall include at minimum responses to the following:

     (1)  Description of the dental procedure;

     (2)  Description of the physical condition of the patient, unless the patient has a Class I status as defined by the American Society of Anesthesiologists;

     (3)  List of drugs and dosage administered;

     (4)  Detailed description of techniques utilized in administering the drugs utilized;

     (5)  Description of the adverse occurrence, including:

         (A)  Symptoms of any complications including but not limited to onset and type of symptoms of the patient;

         (B)  Treatment instituted on the patient; and

         (C)  Response of the patient to the treatment; and

     (6)  Description of the patient's condition on termination of any procedure undertaken.

     (c)  Failure to comply with subsection (a) when the occurrence is related to the use of general anesthesia, deep sedation, or moderate (conscious) sedation shall result in the temporary loss of the license to practice and disciplinary action by the board of dental examiners within thirty days."

     SECTION 3.  New statutory material is underscored.

     SECTION 4.  This Act shall take effect upon its approval.

 

INTRODUCED BY:	_____________________________

 

 

Report Title:

Dentistry; Board of Dental Examiners; Dentists; Anesthesia; Sedation; Recertification; Adverse Occurrence; Reporting Requirement; Penalties

 

Description:

Specifies requirements for the administration of general anesthesia and sedation.  Requires licensed dentists to possess a written authorization or permit to administer or employ another person to administer general anesthesia, deep sedation, or moderate (conscious) sedation from the board of dental examiners.  Requires the board to review the process and requirements for the issuance and renewal of written authorization or permit.  Requires the board to report to the legislature, no later than twenty days prior to the regular session of 2016, any updates to the written authorization or permit process, including the status of the five year renewal process and continuing education requirements.  Requires a report to the board of dental examiners within twenty-four hours of an adverse occurrence during or resulting from anesthesia.  Specifies penalties for failure to report an adverse occurrence.

 

 

 

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