November 14, 2014
Desmond D'Mello, the dentist at the centre of the biggest ever NHS recall, was storing dental equipment in the toilet, investigations have found.
A public appeal has been launched to trace 22,000 patients treated by dentist Desmond D'Mello, who allegedly did not follow proper procedures over 32 years in Nottinghamshire.
His patients in Nottinghamshire will be tested for blood-borne viruses including HIV, Hepatitis B and Hepatitis C.
Now investigations have revealed that his practice was storing dental equipment in the staff toilet.
Inspectors from the Care Quality Commission who visited the practice in July found that it did not meet cleanliness and infection control standards.
Their report said: "We observed the staff toilet and the room next to the toilet were being used as store rooms for equipment.
"This posed a risk of these items coming into contact with body fluids which may be contaminated. This risk had not been identified by staff at the dental surgery and no action had been taken to minimise it.
"We saw that mops and buckets for cleaning the practice were stored directly next to the staff toilet, in the same room, which again posed a risk of this cleaning equipment coming into contact with body fluids which may be contaminated."
The inspection occured in July, the month before Mr D'Mello was suspended by the General Medical Council.
A public appeal was launched on Wednesday morning to trace 22,000 patients who have been treated by Mr D'Mello, who allegedly did not follow proper procedures over 32 years.
All patients who come forward will be tested for blood-borne viruses including HIV, Hepatitis B and Hepatitis C.
NHS England stressed that Mr D'Mello is not infected with any of the viruses himself, but said his alleged failure to follow clinical standards may have put his patients at low risk of infection.
Mr D'Mello has been suspended after a whistleblower secretly filmed him allegedly breaching clinical standards, the NHS said.
NHS England is now contacting the 166 patients who were filmed without consent to explain what happened, and offer assurances that the footage is securely stored.
It is not known whether the whistlelblower was a member of staff, a patient or someone else who became concerned about lax safety procedures at the surgery. NHS England said their identity would not be disclosed, as they are protected by whistleblowing laws.
He was suspended in June this year and the NHS launched an immediate investigation into "apparent multiple failures in cross-infection control standard whilst undergoing dental treatment". The investigation is ongoing and no findings have been reported yet.
Mr D'Mello graduated from Manchester University in 1977 and is understood to have always worked in Nottinghamshire.
He was a sole practitioner but sometimes employed other dentists to work with him.Two nurses who were also filmed are also being investigated. The other dentist working with him at the time is not under any suspicion.
Based on clinical advice, Public Health England has recommended screening for all patients who have been treated by Mr D'Mello at the former Daybrook Dental Practice in Gedling, Nottinghamshire.
Dr Doug Black, medical director for NHS England in Nottinghamshire, apologised to the thousands of patients caught up in the recall.
He said: "Our investigation demonstrates that acceptable infection control standards do not appear to have been followed by Mr D'Mello whilst he was treating patients at the former Daybrook Dental Practice.
"Immediate actions were taken to protect current patients once these apparent lapses were identified.
"However, this alleged drop in clinical standards may have put people at a low risk of infection from hepatitis B, hepatitis C and HIV. Therefore, as a precautionary measure, we are advising all patients who have seen Mr D'Mello to seek further advice on what action they may need to take."
He added: "We are extremely sorry for the undoubted worry and concern people may feel on hearing this news. I would like to stress again that the risk is low but would encourage anyone affected to contact the advice line.
Professor Andrew Lee, a public health expert at the University of Sheffield, called for calm and said the risk to most patients will be low.
He said: "In reality I think the risk would be quite low and I think it is important that the public maintains a degree of perspective here about the real actual risk posed to them.
"It is easy to conflate our fears about visiting the dentist with these isolated incidents of poor practice. "Most patients attending the dentist will probably have pretty low-risk procedures carried out on them, often with single-use instruments, so they would not be at risk.
"There is a very small cohort of patients who have what is termed an 'exposure-prone procedure' - a more major dental procedure where the risk is potentially higher, so presumably they are the group of greater concern. Public Health England (PHE) states (this is) 160 such persons out of 22,000," he said.
Prof Lee said blood-borne viruses cannot survive for very long outside the human body. He added: "What NHS England and PHE are doing is following standard protocol in carrying out a 'look-back' exercise. This is good practice and precautionary."
Dr Black said: "We are working closely with Public Health England and the General Dental Council to resolve this issue as quickly as possible. We have separately contacted those who were filmed without consent to explain what has happened and we are providing ongoing support and assistance to all those who may be affected by this issue."
Dr Vanessa MacGregor, Consultant in Communicable Disease Control for Public Health England in the East Midlands, said: “We have worked hard to identify the potential risk to individuals who may have been at risk of contracting hepatitis B, hepatitis C and HIV and I would like to emphasise the risk of infection is low and that testing is being offered as a precautionary measure.