Jacksonville, FL – A Jacksonville periodontist has been disciplined by the Florida Board of Dentistry after a patient died during implant surgery under sedation.
Dr. Richard Aguila of Jacksonville Dental Specialists is prohibited from administering anesthesia for at least 12 months, though he may continue using local anesthesia. For procedures requiring moderate or general sedation, he must now employ a medical doctor anesthesiologist, osteopathic anesthesiologist, or certified registered nurse anesthesiologist.
Aguila is also required to complete 60 didactic hours and 20 supervised moderate sedation cases through an accredited program, pay a $10,000 fine, and cover $5,300 in costs.
A 73-year-old man with hypertension, diabetes, and sleep apnea underwent bilateral maxillary sinus lift surgery and dental implant surgery. The patient received local anesthesia and intravenous sedation with sedative drugs including midazolam, dexamethasone, promethazine, and fentanyl.
Following the sedation, the patient’s oxygen levels dropped. While Aguila repositioned the patient’s head to improve oxygenation, he did not reduce the sedation despite it deepening beyond the moderate level. The surgery proceeded at 9:18 a.m., during which the patient’s oxygen saturation repeatedly fell below 85%, even reaching 38%.
State regulators noted that Aguila failed to continuously monitor vital signs and did not stop the surgery to stabilize the patient, a clear breach of the minimum standard of care. At 9:22 a.m., the patient stopped breathing. CPR, oxygen, and sedation reversal agents were administered, and emergency services arrived at 9:35 a.m. The patient later died at 10:37 a.m.
The Florida Board concluded that Aguila violated state statutes by not reducing sedation and failing to halt surgery during a medical emergency.
