KRDO13 Investigates: State suspends El Paso County dentist’s license over infection-control and med spa concerns

MONUMENT, Colo. (KRDO) - An El Paso County dentist is responding to allegations of substandard patient care, infection-control failures and performing med spa services outside the scope of his dental license after the state ordered him to stop practicing.

The Colorado Dental Board suspended Dr. Scott Hirsbrunner’s license effective Sept. 11. The board determined emergency action was necessary to protect public health, safety and welfare and found reasonable grounds to believe Hirsbrunner had deliberately and willfully violated the Colorado Dental Practice Act.

Hirsbrunner owns White Diamond Dental in Monument. Its website also lists a second location on North Union Boulevard in Colorado Springs, although Hirsbrunner told KRDO13 Investigates that location has not opened.

During an exclusive interview, Hirsbrunner acknowledged several deficiencies identified by investigators, but maintained that his patients were safe.

"Of course, it’s an embarrassing thing, and I take it serious," Hirsbrunner said. "I care deeply about patients. I came into dentistry to make a difference in people’s lives."

Patient complaint prompted investigation

According to the suspension order, the investigation began after a former patient filed a complaint on April 13 alleging substandard treatment and violations of generally accepted infection-control standards.

The board found Hirsbrunner failed to take panoramic X-rays before extracting the patient’s wisdom teeth. It also found he performed scaling and root planing without justification on the same day as the surgical extraction.

Hirsbrunner acknowledged that he began the extraction without first taking a panoramic X-ray. He said the teeth were fully erupted and he initially believed the procedure would be straightforward.

"I didn’t have a panoramic," Hirsbrunner said. "I thought it would be a 20- or 30-minute procedure at the most. But then it got more difficult, and then we took a panoramic."

Hirsbrunner said he stopped during the procedure to take the X-ray before working on the lower wisdom teeth.

State identifies nine infection-control deficiencies

Investigators with the Colorado Department of Regulatory Agencies later conducted an unannounced inspection of White Diamond Dental in Monument.

The board’s order identified nine deficiencies:

• Failure to conduct spore testing for instrument sterilization and failure to maintain a written policy addressing failed spore tests;
• Improper instrument-sterilization practices;
• Failure to test dental waterlines;
• Failure to provide employees with annual training on OSHA and CDC guidelines;
• No infectious-waste contract;
• No records of tuberculosis testing for employees;
• No written bloodborne-pathogen exposure plan or established referral clinic;
• Failure to use antibacterial hand soap despite performing surgery; and
• Failure to use sterile gloves.

Hirsbrunner repeatedly characterized some of the findings as documentation problems.

"They jumped to conclusions and didn’t document everything and just assumed that some things weren’t there," he said.

However, the board’s order does not describe every deficiency as missing documentation. It specifically states that Hirsbrunner failed to conduct spore and dental-waterline testing and used improper instrument-sterilization practices.

Hirsbrunner told KRDO13 Investigates that his office had been sterilizing its instruments properly.

"We were doing the sterilization properly," he said. "There just wasn’t documentation."

While walking KRDO13 Investigates through the office, Hirsbrunner said his practice had been sending sterilization tests to a third-party laboratory once a month.

The Centers for Disease Control and Prevention recommends using a biological indicator (commonly called a spore test) at least once a week to monitor whether a sterilizer is working properly.

Hirsbrunner’s account also differs from the Dental Board’s written finding. The order does not say the practice conducted spore testing monthly. It states that Hirsbrunner failed to conduct spore testing and did not have a written policy for responding to a failed test.

He also acknowledged the office did not use sterile gloves during dental surgery.

"That’s true," Hirsbrunner said. "It was normal gloves that we normally use."

Hirsbrunner said he had recently purchased sterile gloves and showed them to KRDO13 Investigates during a walkthrough of the office. He argued that using nonsterile examination gloves during extractions was common at other dental practices. The board nevertheless identified his failure to use sterile gloves as a violation of generally accepted infection-control standards.

Hirsbrunner also showed KRDO13 Investigates antimicrobial hand soap that he said was purchased after the inspection. He said the office previously used soap kept in a decorative bottle labeled only as hand soap.

Regarding employee tuberculosis testing, Hirsbrunner initially said investigators did not ask for all of the office’s records and assumed none existed. However, he later acknowledged that some employees had not undergone the required testing.

"Some of our employees had it done, and some did not," Hirsbrunner said.

He also acknowledged that the practice did not have an infectious-waste contract and said the office has since completed employee training and addressed the other deficiencies.

Med spa procedures outside dental scope

The board also found that Hirsbrunner owned, operated and served as medical director of Beody Wellness Medspa, located adjacent to White Diamond Dental and accessible through the same entrance.

According to the order, Hirsbrunner told investigators he performed intense pulsed-light photofacials, laser hair removal and carbon-dioxide laser skin resurfacing.

The board determined those procedures and serving as a med spa medical director were outside the scope of practice allowed under his dental license.

Hirsbrunner said he believed he was authorized to perform the procedures because he had received training and certifications from companies that sold or manufactured the equipment.

"I thought that we could do that," Hirsbrunner said. "The companies that I got trained with, devices with, they talked about that I could be the medical director."

Training or certification from an equipment company does not change the scope of practice authorized by a Colorado dental license.

Hirsbrunner said he has since arranged for a medical doctor to serve as the med spa’s medical director.

Suspension restricts operation of dental practices

The suspension orders Hirsbrunner to immediately stop performing any work that requires a Colorado dental license.

While the suspension remains in effect, he is also prohibited from employing a dentist, dental therapist, dental hygienist or dental assistant. He may not directly or indirectly receive income from dental patient care performed by other licensees, except for treatment provided before the suspension began.

Hirsbrunner told KRDO13 Investigates that his employees remain employed, but are not treating patients. He said they have instead been working to bring the Monument office into compliance.

He also said no patients have been treated at White Diamond Dental or Beody Wellness Medspa since the suspension took effect. Hirsbrunner said the Monument dental office is closed to patients and that appointments have been postponed.

The North Union Boulevard location listed on White Diamond Dental’s website was locked when KRDO13 Investigates visited. Hirsbrunner said that the office is still being remodeled and has never opened to patients.

Hirsbrunner said he has addressed the deficiencies and submitted information to the state in hopes of having his license reinstated.

"I take full responsibility in making sure that it’s up to par with where OSHA infection control wants and the dental board wants," Hirsbrunner said.

The summary suspension remains in place pending further disciplinary proceedings before the Colorado Dental Board.

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