In June, we sent an E-News concerning a proposed California law targeted at Dental practices which arose from the death of a 6-year-old boy in 2015. That law was passed in September. Here’s an Update on the law and it’s expected impacts. As always, if you have any questions about your business, real estate, estate planning, or any other legal issue, please let us know by e-mailing me at Also, remember that we do legal presentations for business and community organizations. If your group would like this, please contact me to setup a date and time.

Steve Beede


by BPE Law Attorneys, Keith Dunnagan and Matthew Kirkpatrick

On September 23, 2016, Governor Brown approved AB2235, also known as Caleb’s Law. Earlier this year we posted an article highlighting this bill and thought we should let you know what portions of it will be enacted into law.

In case you missed our prior article, Caleb’s Law came about after the death of six-year-old Caleb Sears in 2015. He went to his local oral surgeon’s office for a routine tooth extraction and while under general anesthesia Caleb stopped breathing and suffered massive injuries that resulted in his death. At least four other pediatric deaths similar to Caleb’s occurred just last year.

Deaths similar to Caleb’s have convinced our legislature to question whether the current status quo in pediatric dental anesthetics is effectively protecting the children in California. The final version of Caleb’s Law has three main provisions, all of which amend the Dentistry Chapter of the California Business and Professions Code.


The Dental Board will be mandated to formulate a systems-based approach in which to improve the quality of services provided to pediatric dental anesthesia patients in outpatient settings. By January 1, 2016, the Dental Board must report to the Legislature on whether current statutes and regulations for the administration and monitoring of pediatric anesthesia in dentistry provide adequate protection for pediatric dental patients.

Earlier versions of the bill required the Dental Board to form a committee which was to report to the Dental Board in November of 2017 with the Dental Board to provide recommendations to the Legislature by January 1, 2018. The shortened time frame may be an indication that this bill lost some of its political support during the legislative process.

Formal Reporting After Patient Hospital Transfer
To help with ongoing oversight of dental anesthesia there will be new requirements for the reports that practitioners must submit to the Dental Board after:

1) The death of his or her patient during the performance of any dental or dental hygiene procedure;

2) The discovery of the death of a patient whose death is related to a dental or dental hygiene procedure performed by him or her;

3) The removal of a patient to a hospital or emergency center for medical treatment for a period exceeding 24 hours as a result of dental or dental hygiene treatment or when oral conscious sedation, conscious sedation, or general anesthesia was administered, except in the case of a scheduled hospitalization.

The new report to will have to include:

1. The date of the procedure;
2. The patient’s age in years and months;
3. The patient’s weight and sex;
4. The patient’s American Society of Anesthesiologists (ASA) physical status;
5. The patient’s primary diagnosis;
6. The patient’s coexisting diagnoses;
7. The procedures performed;
8. The sedation setting;
9. The medications used;
10. The monitoring equipment used;
11. The category of the provider responsible for sedation oversight;
12. The category of the provider delivering sedation;
13. The category of the provider monitoring the patient during sedation;
14. Whether the person supervising the sedation performed one or more of the procedures;
15. The planned airway management;
16. The planned depth of sedation;
17. The complications that occurred;
18. A description of what was unexpected about the airway management;
19. Whether there was transportation of the patient during sedation;
20. The category of the provider conducting resuscitation measures;
21. The resuscitation equipment utilized.

Importantly, the form also must include a statement that shall not be considered an admission of guilt but is for educational, data, or investigative purposes.

Updated Informed Consent

Hopefully, you will never be subject to the new reporting guidelines. You will likely be subject to the final portion of Caleb’s law which imposes new requirements on informed consent. Under the new law, practitioners will be required to obtain written informed consent from a minor patient’s parent or guardian prior to administering general anesthesia or conscious sedation. The written informed consent must include the following statement:

“The administration and monitoring of general anesthesia may vary depending on the type of procedure, the type of practitioner, the age and health of the patient, and the setting in which anesthesia is provided. Risks may vary with each specific situation. You are encouraged to explore all the options available for your child’s anesthesia for his or her dental treatment, and consult with your dentist or pediatrician as needed.”

If you need help complying with the new requirements, or any other legal matter concerning your Practice, please contact us for help. For over 20 years, the attorneys of BPE Law Group, P.C. have been advising and representing business owners and professionals in dealing with their legal needs. Check us out on the Web at: If you would like a consultation with us, please call our office at (916) 966-2260 or e-mail me at

This article is not intended to be legal advice, lending advice, or a specific recommendation of any particular lender or company, and should not be taken as such advice.