Khaled Hashem cannot call himself a "dentist", "dental surgeon" or "doctor", nor say he's qualified to perform dental work, after an Ontario Superior Court order issued Wednesday.
That decision is the latest in a string of disciplinary moves against Hashem dating back to 1996, which include cautions, suspensions of his licence and ultimately the loss of his certificate of registration in June of this year, according to legal documents provided by the Royal College of Dental Surgeons of Ontario.
"There are so many different areas of reprehensible conduct, from lack of patient informed consent, daring to transplant a tooth from one patient to another, lack of proper infection prevention control," said Irwin Fefergrad, who's been managing dentist licences for the College over the last 12 years.
"Each one of those in and of themselves is problematic but when you combine them and have them all residing with one practitioner, it’s probably the most egregious case I’ve seen.”
According to the College, Hashem had been working in Ottawa since 1985.
He was cautioned in 1996 for not completing a procedure that was charged for, then twice again in 2011 for improper infection control and financial bookkeeping concerns.
Hashem then lost his licence for five months last year, again over health and financial concerns but also when he was found to have performed a partial, "substandard" root canal on a patient without her consent.
Patient 'disgusted and mortified'
The incident that ultimately led to the loss of his licence happened March 24, 2012, according to the legal documents.
A 23-year-old female Carleton University student identified only as K.W. had lost her retainer, leaving her with a gap in her teeth.
She called two emergency clinics she found online and got a hold of Hashem, who told her to come into his clinic.
After she said she wanted a "full smile", K.W. said they discussed "putting crowns in" and the procedure was done.
The legal documents describe what followed with K.W., Hashem and K.W.'s regular dentist, Dr. Tadeusz Henike:
"K.W. was able to observe her appearance, and became dissatisfied. To her, it looked like a piece of chewed up gum had been put into her mouth," the disciplinary panel wrote.
"On inspection, Dr. Henike ‘thought the work looked a little rough’… X-rays confirmed that these were someone else’s teeth.
“It was Dr. Henike’s evidence that he had never before encountered the situation of someone else’s teeth being cemented into a patient’s mouth… He informed K.W. that the dentist who had done this work had not met the standard of care in Ontario.
“K.W. testified that on learning that Dr. Henike suspected that these were human teeth, she was ‘completely disgusted and mortified.’”
Dr. Henike removed the tooth fragments and later called Hashem, who told him he did what he did because K.W. was "pleading for teeth."
Hashem was 'ungovernable,' panel says
The College's disciplinary panel ruled in June 2014 that Hashem was "ungovernable" and later that month, took away his licence to practice.
"The evidence presented to the panel demonstrated a prolonged and repetitive nature of misconduct without any evidence that he has learned from the past or attempted to remediate his conduct,” the decision reads.
"The panel has concluded that if Dr. Hashem is allowed to continue to practice dentistry, members of the public will be put at risk related to poor infection control, lack of informed consent and irregularities in charging of fees.”
Experts who testified at the disciplinary hearing, which Hashem did not attend, said they had never heard of this procedure being taught anywhere.
The loss of his licence means he wouldn't receive the necessary approval to practice dentistry in another province, according to the College.
Loss of licence rare
Fefergrad said when they found out Hashem was practicing "underground" without a licence, they asked for and received a court order banning him from identifying himself as a dentist or saying he's qualified to practice dentistry or give substantial medical advice.
“We felt we had a continuing, ongoing obligation to protect the public interest,” he said.
“If we find out, and we are going to be monitoring the situation, that he’s going to be flaunting this Superior Court order, in a heartbeat we will go to the Superior Court and seek further remedies alleging he’s in contempt of the court order and ask he be arrested and incarcerated.”
Fefergrad said "monitoring the situation" includes letting the public know to call them if they find Hashem practising dentistry, along with asking investigators to "keep an eye out for us."
He added that there are around 9,400 licensed dentists in Ontario and over the last five years, there have only been one or two other cases where one's lost their licence.
Hashem has no listed professional address with the College. His personal phone number is unlisted.