The Iowa Dental Board has suspended the license of a dentist accused of incompetence in a patient’s death.
In November 2025, the licensing board charged dentist Robert O. Wolf, with six separate regulatory violations: employing or permitting an unlicensed person to practice dentistry, encouraging or assisting with the unauthorized practice of dentistry, practicing dentistry in a manner that is harmful or detrimental to the public, willful and gross neglect, failure to maintain a satisfactory standard of competency, and practicing beyond one’s training.
The board alleged that Wolf, who has been an Iowa-licensed dentist since 1981 and now operates his own general dentistry office in North Liberty, was involved in the treatment of 50-year-old Joseph Daniels on January 24, 2024.
Court records indicate Daniels had consulted with another dentist, Dr. Jonathan Karch of the Dental Studio of Iowa in Johnston, and inquired about receiving dental implants. Court records indicate Daniels had a history of hypertension and hyperlipidemia and was a cigarette smoker.
At the time of the consultation, Daniels’ blood pressure was allegedly noted as being “of great concern” to Karch. According to a lawsuit later filed by Daniels’ family, Daniels was to receive the dental implants from Karch, at a cost of about $50,000, two days after the consultation, subject to a pre-procedure clearance by Daniels’ primary care physician.
On January 25, Daniels was allegedly evaluated and cleared for surgery by Dr. Anish P. Keshwani at UnityPoint Clinic Family Medicine of East Des Moines -- although, the lawsuit claims, UnityPoint medical records indicate Daniels’ “uncontrolled” hypertension and hyperlipidemia would require “corrective actions before surgery,” such as the administration of prescribed drugs.
On January 26, the implant procedure began at 7:15 a.m. and was completed at 3:15 p.m., with patient care allegedly turned over to certified registered nurse anesthetist Nicky Newhoff, who was tasked with waking Daniels and initiating the recovery process.
The lawsuit alleges that at 3:30 p.m., a dental assistant notified Karch and Wolf they were needed in the surgical suite through a message that stated, “Joe is not doing well -- please come immediately.”
According to EMS medical records, paramedics were dispatched to Dental Studio of Iowa at 3:35 p.m. with a report of an “unconscious person.” According to the lawsuit, the paramedics arrived at 3:40 p.m. and found Daniels in a dental exam chair “pale, cyanotic, cool, and unresponsive.”
Within 25 minutes of their arrival and the administration of drugs, the paramedics had intubated Daniels, and by 4:27 p.m., they had initiated chest compressions, the lawsuit claims. Daniels was then taken to Iowa Methodist Medical Center, where he died at 5:51 p.m.
The Polk County Medical Examiner later determined Daniels’ manner of death was “natural,” and the result of hypertensive and atherosclerotic cardiovascular disease, with cigarette smoking being a contributing factor.
Board: Unlicensed dentist provided ‘hands-on’ care
The board alleges that at the time of Daniels’ surgery, Wolf was contracted part time by Karch to assist with full-arch restoration procedures at The Dental Studio, due to his experience in that area. Wolf, the board alleges, had just moved back to Iowa from California and was working in a practice in the Iowa City area.
Wolf allegedly knew dentist Marko Kamel, who is also alleged to have participated in Daniels’ treatment, from professional conferences. Kamel, however, was not licensed to practice dentistry in Iowa, and at the time of Daniels’ procedure, Kamel’s license in Minnesota was under a temporary suspension due to allegations of incompetence.
Board records show Wolf claimed to be unaware of the status of Kamel’s Minnesota license or that Kamel lacked a license in Iowa. Karch, the board alleges, was the only dentist involved in Daniels’ procedure who held an active permit for the use of moderate sedation in Iowa, although Wolf was “the primary dentist involved in the procedure,” with Karch’s work largely confined to the prosthetics lab about 15 feet from the operating room.
Board records show that at an April 2026 hearing on his disciplinary charges, Wolf testified he could not identify anything -- apart from not performing the surgery at all -- that would have changed the outcome in the Daniels case. He also asserted he had nothing to do with the anesthesia, since a contracted certified registered nurse anesthetist was in charge of that. From a clinical standpoint, Wolf testified, the surgery went exactly as planned.
According to an affidavit filed by Kamel, he denied ever having examined, diagnosed, treated, sedated, anesthetized, or touched Daniels. In its decision on Wolf’s discipline, the board stated Kamel’s “account of not having touched (Daniels) is contradicted by every other professional who was present in the surgical procedure room.”
At his hearing, Wolf testified that while he took a break during the procedure, Kamel had, on his own, placed two implants on Daniels’ mandible, which, Wolf testified, had surprised him.
The board recently concluded Kamel was “involved in hands-on patient care” during the operation, adding that it did not credit Wolf’s testimony that Kamel’s hands-on care occurred only when Wolf was out of the room on a break.
“There is also a factual question regarding whether Wolf knew that (Kamel) was not licensed in Iowa at the time,” the board stated, noting Wolf was aware of Kamel’s efforts to recruit a nationwide network of providers to perform surgeries and that Wolf was personally involved with a search for locations to perform procedures in Des Moines.
“The board simply does not credit Wolf’s assertion that he would have been involved in, and connected with, (Kamel’s) business model to such an extent and would not have taken steps to ascertain (his) license status in Iowa,” the board stated.
Board: Anesthetic ‘significantly’ exceeded recommended dosage
The board also concluded that while not exceeding the absolute maximum dose, the combination of local anesthetics given to Daniels “significantly surpassed recommended dosage limits.” Local anesthetic systemic toxicity can lead to respiratory, cardiovascular, and neurological depression, including cardiac arrest, the board noted.
The board also noted that while Wolf was the primary dentist involved in the operation, Karch signed all of the documentation, despite his “minimal involvement” in Daniels’ care. “Reviewing the chart would lead one to believe that (Karch) executed the entire procedure, including the tooth extractions and surgical placement of implants,” the board noted.
The board concluded the evidence supported the charges against Wolf of permitting an unlicensed person to practice dentistry and encouraging or assisting with the unauthorized practice of dentistry. As Daniels’ primary surgeon, the board said, Wolf had the responsibility to ensure that anyone he permitted to practice dentistry on his patient had the appropriate licensure.
The board also concluded the evidence supported the charges of practicing dentistry in a harmful manner and failure to maintain a satisfactory standard of competency but found the evidence did not support the charges of practicing beyond his training and willful or gross neglect.
“Wolf’s conduct raises significant concerns for the board regarding patient safety, even where there is no conclusive evidence that Wolf’s actions contributed to (Daniels’) death,” the board stated in its ruling.
The board imposed a $10,000 civil penalty and ordered that Wolf’s license be immediately suspended for a minimum of six months. Prior to reinstatement, Wolf must complete a board-approved remediation course on recordkeeping, ethics, and the administration of local anesthetic. Once Wolf’s license is reinstated, it will be placed on probation for three years, during which time his work will be reviewed by a board-approved practice monitor.
The Iowa Capital Dispatch was not able to reach Wolf for comment.
In April 2025, the board ordered Karch to pay a $7,500 civil penalty as a result of the Daniels case and directed him to complete an unspecified amount of continuing education, with some of that education related to professional ethics.
The civil trial in the lawsuit filed by the Daniels family was originally scheduled to begin in August 2026 but has been delayed. Court records indicate a new trial date has yet to be established.
Deputy Editor Clark Kauffman has worked during the past 30 years as both an investigative reporter and editorial writer at two of Iowa’s largest newspapers, the Des Moines Register and the Quad-City Times.
This article was originally published in the Iowa Capital Dispatch and republished by DrBicuspid under the Creative Commons license CC BY-NC-ND 4.0. The Iowa Capital Dispatch is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. The Iowa Capital Dispatch maintains editorial independence.
