Section 11.10. Reporting of adverse occurrences related to anesthesia administration.

  Dentists shall submit a report within 30 days to the board of any mortality or other incident which results in temporary or permanent physical or mental injury requiring hospitalization of a patient during, or as a result of, anesthesia administration under this chapter. The report shall be on a form approved by the board and shall include, at the minimum, responses to all of the following:

(1)  A description of the dental procedures.

(2)  The names of all participants in the dental procedure and any witnesses to the adverse occurrence.

(3)  A description of the preoperative physical condition of the patient.

(4)  A list of drugs and dosage administered before and during the dental procedures.

(5)  A detailed description of the techniques utilized in the administration of all drugs used during the dental procedure.

(6)  A description of the adverse occurrence, including the symptoms of any complications, any treatment given to the patient, and any patient response to the treatment.

(7)  A description of the patient's condition upon termination of any dental procedures undertaken.

History: CR 04-095 : cr. Register August 2006 No. 608 , eff. 1-1-07.

Note

Forms are available at the office of the Dentistry Examining Board located at 1400 East Washington Avenue, P.O. Box 8935, Madison, WI 53708. Microsoft Windows NT 6.1.7601 Service Pack 1