Orthodontic patient sues over use of dirty equipment,

A South Florida woman whose young daughter was an orthodontics patient at a Nova Southeastern University clinic in Davie filed a lawsuit against the school this week for potentially exposing the girl to infectious diseases, including HIV and hepatitis, from dirty equipment used by dentists at the facility.

The lawsuit was filed in Broward circuit court late Monday by Tiffany Aguero, whose daughter was a patient at NSU’s Post-Graduate Orthodontic Clinic at 3200 South University Dr. during a 31-month period when university officials said some postdoctoral residents — dentists who were training in orthodontics — had failed to sterilize equipment.

Aguero’s lawsuit seeks class representation for the 1,152 patients who received notification letters from NSU in November informing the patients that they may have been exposed to infectious diseases due to the breach in sterilization protocols from July 2015 to February 2018.

Jay Cohen, a Fort Lauderdale attorney representing Aguero, said his client and others like her were unfairly subjected to the emotional distress of learning that they may have been exposed to HIV, hepatitis and other viruses as a result of NSU dentists using dirty equipment.

“All of these folks, especially parents and children, now not only have to be worried about it but they have to be tested,” Cohen said.

Brandon Hensler, an NSU spokesman, declined to comment on Aguero’s lawsuit, saying, “We cannot discuss an ongoing legal matter.”

It took NSU seven months, once they corrected the problem at the end of February, to inform patients via Fedex letters sent on Nov. 23 signed by Linda Niessen, dean of the College of Dental

Medicine.

Administrators said it took that long to send the letters because they had to conduct an “exhaustive” examination of patient records to determine who might have been exposed to the dirty equipment.

The university sent letters to patients who had braces placed on their teeth, braces removed or a bracket repaired by a group of 14 dental residents studying orthodontics at the clinic on South University Drive during the period.

The group of dentists identified as using the dirty equipment failed to use a complete heat sterilization process recommended by the Centers for Disease Control and Prevention for their high-speed dental drills, known as handpieces.

Instead, the dentists used a surface disinfectant wipe for their equipment, NSU officials said.

In the letter, Niessen informed patients that NSU had consulted with the CDC and an independent infection control expert about the lapse in sterilization protocol, and that the risk of patients being infected was “extremely low.”

Cohen said his client takes little comfort in NSU’s statement that the risk of infection is low.

He was not aware of any patients who have tested positive for infectious diseases as a result of exposure to dirty equipment at the orthodontic clinic, but added that Aguero is waiting for test results to confirm that her daughter is safe.

“The case is more about having to wait out that process, even if as they represent it’s a very, very small chance, or likelihood of contracting disease in that fashion,” he said. “The point is you had to go out and now send a letter to over 1,100 patients.”

Cohen also faulted the university for putting the onus on its students to purchase and maintain their own dental equipment, including sterilization, rather than leasing the necessary tools from a company that would also take charge of sterilizing.

“From what we can gather from some of the emails they did it because they weren’t funding the necessary equipment so that the dentists in training could have sterilized equipment,” he said.

An email sent by an NSU administrator to dental students in April shows that the university’s leaders knew that dental students were having trouble sterilizing their equipment in time to treat patients.

NSU requires dental students to own their handpieces and maintain them. Students provide dental services at reduced rates to patients of all ages at 12 NSU clinics in South Florida.

While only the post-doctoral orthodontic clinic on South University Drive was identified in the notification letter to patients, the email suggests that the sterilization lapse may be more widespread.

The email from Peter Keller, executive associate dean of NSU’s dental school, noted that students were having difficulty sterilizing their handpieces when the students were running late during a morning clinic session.

“This can result in a delay in obtaining their sterilized handpieces in time to provide patient care in the afternoon clinic,” Keller wrote in the email.

“We have also learned that there have been problems with students getting their handpieces sterilized in time to care for a patient in the morning, after they have been practicing in the [simulation] lab the night before.”

Keller added that the problem would be resolved by having students buy a second handpiece, which cost about $650 each. “When one handpiece is being sterilized, the second handpiece will be available for use,” Keller wrote.

An NSU spokeswoman said Keller’s email was sent to pre-doctoral students at other NSU clinics and not the orthodontic facility in question.

NSU’s dental school is certified by the Commission on Dental Accreditation or CODA, which develops and monitors quality standards for dental education programs.

Gregg Marquardt, a CODA spokesman, declined to comment on NSU’s policy of having students purchase their equipment rather than the university providing it for them.

“CODA’s process of accreditation and program review is confidential,” Marquardt said in an email.

CODA publishes a guidebook of accreditation standards for advanced specialty education programs in orthodontics that states accredited institutions should have the financial resources needed to develop and sustain the program, including to “purchase and maintain equipment.”

However, it is not clear what type of equipment the CODA guidebook is referring to in the statement.