Dentist who preyed on nursing home residents could be back in two years

A DENTIST was driven by “speed and greed” when he destroyed the teeth of 69 patients for government cash. Now he wants to practise again.

Andrew Istephan enters court.

A ROGUE dentist who used nursing homes to perform involuntary dental surgery on helpless elderly patients — including one who was 99 years old — just so he could claim government cash could be back practising in two years.

Dr Andrew Istephan — who also happens to be a former Liberal Party councillor — was driven by “speed and greed” and had “no moral compass” when he destroyed the teeth of elderly patients at five aged care facilities — all in a six week period — so he could claim up to $4,250 in federal government funding per patient.

Of the 69 patients, 52 were unable to give informed consent and even among those who were able to consent, Dr Istephan failed to obtain it, according to a decision of the NSW Civil and Administrative Tribunal on Tuesday.

The procedure mostly involved filing down teeth for crowns because this attracted the most money under the scheme. Meanwhile he ignored other problems like “obvious decay”.

“The treatment received by the majority of the patients was invasive and irreversible,” the tribunal found.

“It involved preparation for the placement of crowns on the patients’ teeth. The preparation necessarily caused destruction of the patients’ teeth.”

In some cases the treatment was so brutal and non-consensual that the dentist was charged with assault.

This included the case of a 99-year-old patient at a Manly Vale nursing home who had two teeth prepared for crowns without their consent.

“The practitioner was later charged with, and pleaded guilty to, assault occasioning actual bodily harm in respect of this patient.”

At another facility at Lewisham he treated seven patients in a single day, with six of them having their teeth prepared for crowns.

Dr Andrew Istephan arrives at Downing Centre Court.

“Five of the patients were incapable of giving informed consent due to cognitive impairment.”

The tribunal found that Dr Istephan was overwhelmingly motivated by greed in conducting the procedures.

“Before us the practitioner acknowledged he acted with ‘speed and greed’ and that his values at that time were motivated by status, politics and financial success,” the four-member tribunal found.

It added: “We cannot ignore that the practitioner demonstrated no moral compass when treating his aged, frail and vulnerable patients.”

In fact the tribunal, which included two doctors as professional members, found “the practitioner’s conduct was of the most serious kind”.

“The conduct requires strong denunciation. It is hard to imagine a more vulnerable group of patients.”

And yet it rejected a move by the Health Care Complaints Commission to effectively ban Dr Istephan for life, arguing that because he performed all the operations within a “discrete time-frame” and was unlikely to reoffend.

Instead, the tribunal said Dr Istephan, who was once deputy mayor of the Sydney suburb of Hurstville, should instead “reflect” on his actions with his psychologist before reapplying for registration in two years’ time.

“During the next two years the practitioner will have the opportunity to reflect on our reasons, hopefully with the ongoing assistance of his psychologist,” the tribunal found.

“At any reinstatement application expert evidence from a treating specialist may inform and assist the Tribunal. The practitioner should be able to use his obvious intellectual ability that enabled him to graduate with honours and become an elected councillor to engage in ongoing professional education and/or community work.”