Section 828IAC1-1-22. Mandatory reporting

   (a) A report must be submitted to the board when:

(1) a mortality occurs in connection with dental procedures performed in a dentist's office;

(2) a procedure performed in the dentist's office results in permanent injury; or

(3) a procedure performed in a dentist's office results in hospitalization other than for the continuing treatment of infection that was the cause of the procedure or as a direct result of the patient's oral-facial pathology.

  (b) The report must be submitted to the board within seven (7) days after the incident occurs or the injury manifests itself.

  (c) The information provided to the board must include the following:

(1) Name, age, and address of the patient.

(2) Name of the dentist and other personnel present during the incident.

(3) Address of the facility or office where the incident took place.

(4) Technique, if any, of general anesthesia or sedation being utilized at the time of the incident.

(5) Dosages, if any, of drugs administered to the patient.

(6) A narrative description of the incident, including approximate times and evolution of symptoms.

  (d) Violation of this rule subjects the practitioner to disciplinary action under IC 25-1-9. (State Board of Dentistry; 828 IAC 1-1-22; filed Sep 21, 1992, 9:00 a.m.: 16 IR 718; readopted filed Apr 11, 2001, 3:21 p.m.: 24 IR 2896; readopted filed Oct 4, 2007, 3:36 p.m.: 20071031-IR-828070047RFA; readopted filed Nov 25, 2013, 9:23 a.m.: 20131225-IR-828130287RFA)