The document laying out why North Carolina officials revoked a High Point dentist’s license after two patients died accuses her of ignoring warnings in their medical histories and changing records to conceal violations.
In a span of less than five months, paramedics wheeled two patients of Dr. Shawana Neopi Patterson out her office in a deep coma. Both later died.
On April 4, 2018, three days after the death of the second patient, the N.C. State Board of Dental Examiners issued an emergency suspension of Patterson’s general anesthesia permit, concluding it was in the interest of the public’s health, safety and welfare. The board revoked Patterson’s dental license and her general anesthesia permit on Jan. 11.
According to the board’s final agency review decision, Patterson did not heed warnings in the medical history submitted by the two patients — identified as RG and DM — that would have raised red flags that general anesthesia would endanger their lives. Patterson also did not contact their primary care doctors or specialists, where additional information would have raised more warnings.
That information, according to the decision, would have shown neither patient should have had any surgery — except in case of emergency — or “any anesthesia outside of a hospital setting.”
Doctors at High Point Regional Hospital and other experts testified that Patterson’s actions “caused or contributed to” their deaths. The board also found she “had fabricated or directed her employee(s) to fabricate her treatment records in an effort to conceal her violations.”
Attempts to reach Patterson for comment were unsuccessful, both her email inbox and her voicemail were full on Wednesday afternoon. Attorneys who represented Patterson at the dental board hearing also did not return a call and email for comment.
Patterson’s practices in performing the procedures also raised questions with the board and experts who testified.
The anesthetic used in both cases “was excessive” and Patterson did not have an assistant continuously monitoring the patient or recording sedation data throughout the procedures. She also did not use an EKG to monitor the patients’ hearts, the board found.
Both patients also suffered from diabetes — a condition known to Patterson in both instances — but she did not check their blood-glucose level before performing the operations, the report shows.
According to the decision, RG visited Patterson Oral & Maxillofacial Surgery at 801 Phillips Ave. on Nov. 9, 2017. He was there for alveoloplasty, a surgical procedure used to smooth and reshape a patient’s jawbone in areas where teeth have been extracted. The surgery often is performed before the placement of dentures.
A medical form, submitted to Patterson on a previous visit in September, indicated he had a cardiac pacemaker/defibrillator and a history of high blood pressure, heart attack, diabetes and other conditions.
Early during the admission of anesthesia, RG’s blood pressure dropped to levels inadequate to provide oxygen to his vital organs, including his brain. However, Patterson continued to administer additional anesthesia and performed the surgery, according to the decision.
Patterson’s assistant and other witnesses indicated RG was “ashen, gray, or blue at later times.”
Less than two hours after the surgery, RG was sweating heavily and unresponsive, prompting the staff to call EMS.
While Patterson did administer “reversal drugs,” she did not use an automated external defibrillator or administer epinephrine to RG, the document shows.
Emergency responders found he had an extremely low oxygen saturation level (55%) and an extremely high blood-glucose level (547).
Physicians at High Point Regional determined he had suffered a stroke and had conditions consistent with brain damage resulting from oxygen deprivation.
He died about three months later, on Feb. 11, 2018.
The next month, on March 28, DM went to Patterson’s office to have multiple teeth extracted. She also had completed a health form, indicating she had a history of kidney trouble (she was on dialysis and had a visible catheter in her arm), diabetes, high blood pressure and anemia.
According to the record, DM’s blood pressure before the surgery or anesthesia was 187 over 115, a dangerously high reading, and her blood oxygen concentration was at 73%.
“The vital signs recorded ... were characteristic of a poorly controlled and fragile patient,” the board said in its ruling.
Despite this, Patterson administered the anesthesia and performed the surgery. Eventually, recognizing DM’s “deteriorating vital signs, shallow breathing and motionless diaphragm,” Patterson used “basic life support measures and administered reversal agents but no advanced cardiac life support protocols,” the record shows.
Staff called EMS after Patterson determined she did not have a pulse. Paramedics determined DM was having a heart attack and were able to regain a pulse. She was placed on a ventilator at High Point Regional, but had another heart attack and died a few days later, on April 1.