AUGUSTA — At one point during the hearing on the fate of a Lewiston oral surgeon, one of the five members of the Maine Board of Dental Practice had an unusual question for embattled Dr. Jan Kippax.
“Who’s ‘dog meat?’” asked Dr. Stephen Morse.
“Me,” Kippax responded.
It turned out that Kippax, who cherishes Great Pyrenees, used the moniker on his office computer for many years. But it took on a new resonance in the context of an ongoing administrative trial that will determine whether the longtime dentist will face censure, fines or the possible loss of the professional license that has allowed him to practice for the past 27 years.
Now pared to just four specific charges involving two patients — down from a list of 195 provided by 18 patients last winter — the hearing resumes Friday in a case that Kippax’s attorney, local James Belleau, insisted he can win completely.
Standing in his way at this point is, almost entirely, one woman: Christine Duplissis, 37, of Greene.
Duplissis took the stand on the second day of the hearing at the end of September and told her story to the five dental board members who have spent five days listening to testimony and weighing whether the state has proven its charges. Most of the allegations were either withdrawn by state lawyers or thrown out by the panel this month.
But three that involve Duplissis remain.
What she told the board was straightforward: that in July 2015 she needed an oral surgeon to pull a bad tooth. She said she wanted someone “willing to put me under” because she felt anxious at the thought of the procedure.
A MaineCare patient, Duplissis said there were “not a lot” of dentists she could choose, and Kippax got her business because she “could get in very quickly” to his Main Street practice in Lewiston.
A recovering drug user who had been clean for two years and well on her way to a better life, Duplissis said she was “a little shocked” when Kippax declined to use enough anesthesia to knock her out. He told she’d feel no pain with a lesser sedative.
Duplissis said she told the dentist it typically takes “a good half hour” before she feels numb in a dental chair. But instead of waiting, she said, Kippax started within minutes.
She said that Kippax began pushing the bad tooth back and forth, asking if she felt anything beyond some pressure.
He then began to pull it out, she said. It hurt so bad that “tears were rolling down the side of my face,” Duplissis said.
She told him to stop, she said, and he answered that it was nearly done.
“Oww, it hurts, stop,” Duplissis said she told him, and tried to raise her hands up to block him. She said, however, that her hands didn’t make it to her mouth.
“It was hurting. It was traumatic. I was scared,” Duplissis said.
Then it was over.
Soon after, her father-in-law and driver for the day, Rudy Duplissis, testified that she came back to him in the recovery room crying and hurting.
He said she told him right away that Kippax had started pulling the tooth before the numbing agent had time to work and that she tried to get him to stop. But he just kept yanking, he recalled her saying as she gasped for air.
That might have been the end of it for Duplissis, just a really bad day.
Kippax could not remember any problem involving Duplissis. One of his assistants, Lori Nakhen, testified that Duplissis “did not cry out” and that her case was routine.
But Duplissis was adamant about what she said happened.
She said she initially let it go because she knew Kippax cared for a lot of patients like her who didn’t have much money and may have a history of drug abuse.
“People like me go to dentists like him,” Duplissis said with a mix of sadness and anger. She said she knew they’d just blame her poor decisions in the past and try to discredit her.
But reading a newspaper story nine months later that let her know the state was looking into Kippax spurred her to search for information about him online. She discovered that he’d been in trouble with the board before but allowed to stay in business.
So she decided to file a complaint with the dental board.
“I was hoping something would happen this time,” said Duplissis, who has turned her life around and determined to claim her place as an upstanding citizen.
Kippax said that he has worked with addicts for a long time and is never sure whether they’re telling the truth about their drug history. Given the risk of exacerbating their problems, he said, he is “more conservative, more questioning” when choosing the sedatives he gives them.
He said it’s important to “make sure your safety margin is as wide as possible.”
Kippax also testified that patients are not always as clear about indicating they’re in pain as they think they are. Sometimes, he said, he “can’t tell they’re in pain” because the sounds and gestures they make are similar to ones that fully sedated patients may make.
“They’re inebriated to the point where they are really not conscious of what’s going on,” he said, and “making involuntary movements all the time.”
He said he tries to assess and reassess what’s going on as he works by observation and from the data that monitors provide, which can sometimes indicate distress.
“It’s our job to try to perceive what they’re feeling,” Kippax said.
Kippax said that he always respects the wishes of patients. He said he would have stopped the procedure if asked.
Two members of the dental panel, Drs. Lisa Howard and Glen Davis, each said they found Duplissis credible. The board determined there may be enough evidence to rule against Kippax in the case, though it hasn’t yet heard the defense’s version of events, merely testimony elicited by the state.
The other charge the board is weighing is about whether Kippax kept tabs on another patient as carefully as required.
So far in the hearing, the state attorney general’s office has laid out the case against Kippax. Belleau has yet to begin his defense of the charges.
He is expected to have experts in oral surgery and in pain management testify this week. Beyond that, it isn’t clear who might be called, if anyone.
How long it will be until the dental board makes a final decision on the case is also uncertain.
One thing is almost certain, though: If it rules against Kippax, the case will wind up in court.
Dr. Jan Kippax attends a hearing before the Maine Board of Dental Examiners in Augusta in September. (Sun Journal file photo)