Brant Smiles Family Dentistry IPAC Lapse Report

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Public Health Infection Prevention and Control Lapse Report

Initial Report

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Establishment under investigation (name and address)	Brant Smiles Family Dentistry 415 Fairview Dr. Brantford, Ontario N3R 7M3
Establishment type	Dental clinic
Date health unit became aware of potential IPAC lapse	October 26, 2020
Date of initial report posting	January 14, 2021
Date of initial report update(s) (if applicable)
How was the IPAC lapse identified?	Complaint by member of the public
Date of on-site investigation	October 27, 2020

IPAC Lapse Investigation

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Did the IPAC lapse involve a member of a regulatory college?	Yes; Royal College of Dental Surgeons of Ontario
If yes, was the issue referred to the regulatory college?	Yes
Were corrective actions recommended and/or implemented?	Yes
Date of any order(s) or directive(s) issued to the owner/operator (if applicable)	October 27, 2020
Summary description of the IPAC lapse	1. During the complaint inspection it was observed that the cleaning, disinfection, and sterilization of reusable instruments on site did not follow Provincial Infectious Disease Advisory Committee (PIDAC) Best Practice Standards for reprocessing and infection control in a clinical office setting. 2. Flash sterilization or immediate use steam sterilization (IUSS) was used on non-critical equipment (e.g., rubber dam punch, and mouth props). 3. The reprocessing work area is physically separated from other work areas, however, the design does not allow for a one way flow of instruments from dirty to clean to prevent cross-contamination. 4. At time of the investigation instrument/equipment manufacturer’s instructions for use (MIFU’s) were not available for review. 5. Instruments were not pre-cleaned after use (an enzymatic cleaner was not used). 6. Inconsistent disassembling of instruments (e.g., two-piece mouth mirrors). 7. Pre-drawn syringes containing sodium-hypochlorite and EDTA were in drawers, four days after specialist last worked; the syringes were not labelled or dated.
Additional comments and/or updates to initial report	Staff members responsible for any or all steps in reprocessing must complete the Medical Device Reprocessing Techniques Online Course through the Medical Device Reprocessing Association of Ontario.

Final Report

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Brief description of corrective measures taken	One-way workflow in the reprocessing area has been improved. Manufacturer’s instructions are currently being used for all instruments. Instruments where manufacturer’s instructions were not found have been removed from the dental clinic. Flash sterilization or immediate use steam sterilization (IUSS) is no longer used on any instruments or equipment.
Date all corrective measures were confirmed to have been completed	December 21, 2020
Date of final report posting and/or any date of any updates to final posting	January 14, 2021
Date of follow-up to confirm corrective actions taken and completed	November 19, 2020
Additional comments	Staff members responsible for any or all steps in reprocessing must complete the Medical Device Reprocessing Techniques Online Course through the Medical Device Reprocessing Association of Ontario.

Infectious Disease Team
519-753-4937 ext. 454
infectioncontrol@bchu.org