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WEST VIRGINIA CODE
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WVC 30 - 4 A- 10 §30-4A-10. Reporting of Death, Serious Complications or Injury.

     If a death, any serious complication or any injury occurs which may have resulted from the administration of general anesthesia/deep conscious sedation, conscious sedation/moderate sedation, anxiolysis/minimal sedation, or relative analgesia/minimal sedation, the licensee performing the dental procedure shall submit a written detailed report to the board within seventy-two hours of the incident along with copies of the patient's original complete dental records. If the anesthetic agent was administered by a person other than the person performing the dental procedure, that person shall also submit a detailed written report. The detailed report(s) shall include:

     (1) Name, age and address of patient;

     (2) Name of the licensee and other persons present during the incident along with their names and addresses;

     (3) Address where the incident took place;

     (4) Type of anesthesia and dosages of drugs administered to the patient including local anesthesia;

     (5) A narrative description of the incident including approximate times and evolution of symptoms; and

     (6) The anesthesia record and the signed informed consent form for the anesthesia.

Note: WV Code updated with legislation passed through the 2014 1st Special Session
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