HEBER CITY, Utah — University of Utah Health and Intermountain Healthcare have both promised to investigate the death of a Heber City man who died one week after getting nine of his teeth pulled at the University of Utah student dental clinic.
Joshua Cordery, 35, was also discharged from Intermountain’s Heber Valley Hospital two days before his death.
The patient was not prescribed antibiotics during either visit.
According to his death certificate, Joshua Cordery died of lung damage caused partly due to a bacterial infection known as streptococcus intermedius bacteremia. A medical examiner wrote Influenza A and bronchopneumonia also contributed to the lung damage.
“He died on Valentine’s Day,” sighed Jamie Cordery, looking at photos of her husband from a happier time. “We got married in 2011. It will be ten years this year... This is him holding our daughter up. She was five when he passed away. She’s six now. She looks just like him. Every day, I see him in her.”
Jamie Cordery said her husband chose to have the procedure done at the student dental clinic, believing it would be less expensive.
“I think that they were trying to just put everything they had done or learned into practice and do it before they graduated. That was my impression,” Jamie Cordery said. “I feel like he was being used as a class project!”
According to the University of Utah Health website, “When you get care from a student dentist, you can be sure you’re getting safe, high-quality care. That’s because all of our student dentists are supervised by faculty who are licensed dentists in Utah.”
After years of not taking care of his mouth, Jamie Cordery said her husband finally made the decision to brush and floss his teeth regularly.
Still, a few days later, she described noticing something “putrid” coming from her husband’s mouth.
“They said if you take of it normal, it shouldn’t get infected,” Jamie Cordery recalled. “When he opened his mouth, it was yellow and white, and his breath smelled foul.”
When she called the student dental clinic, Jamie Cordery said University of Utah Health still would not prescribe antibiotics, at least not over the phone.
The next day, Joshua Cordery went to the emergency room at Intermountain’s Heber Valley Medical Center with a bad cough.
“He looks like death!” Jamie Cordery recalled. “He can barely talk. He has to text me everything he wants to say to me.”
Medical records indicate Joshua Cordery tested positive for Influenza A.
The patient was not diagnosed at that time with pneumonia or a bacterial infection in his mouth or bloodstream.
“The likelihood for pneumonia is 54%,” according to Intermountain Healthcare records. “Likelihood of pneumonia: Unlikely.”
“They treated the flu. Not his mouth. They didn’t send him home with any antibiotics,” Jamie Cordery said. “They didn’t keep him for observation… Hindsight’s 2020, but they ignored what we went there for.”
Records indicate a doctor looked at the patient’s mouth and noticed “upper molar teeth removed” with “some swelling” but no pus.
Dr. Amesh Adalja, an infectious disease and emergency medicine physician who analyzes cases as part of the Expert Institute helped FOX 13 review the case as a neutral third party.
“Pus is a sign of infection, but not every infection is going to have pus,” Dr. Adalja said. “Pus could have been removed. The patient could have spit, could have rinsed his mouth.”
Two days later, Jamie Cordery found her husband unconscious in the bathroom.
“My first response was, ‘Josh, quit joking with me!’ because he had such a kidding personality,” Jamie Cordery recalled. “Then I found out it was for real.”
Jamie Cordery said she started CPR until medical personnel arrived.
Body camera video from a responding sergeant with the Heber City Police Department shows Jamie Cordery and her mother interacting with first responders.
“Joshua! Don’t die on me! Don’t die on me Josh!” she yelled.
“He did have oral surgery a week and a half, two weeks ago,” the mother immediately reported.
“He’s been sick?” the sergeant asked.
“Flu type A! Flu type A!” Jamie Cordery responded.
“Oral surgery and the flu?” the officer continued.
“He just got out of the hospital a couple days ago,” Jamie Cordery’s mother responded.
An autopsy revealed streptococcus intermedius bacteremia in the patient’s bloodstream matched the bacteria in his mouth.
“Streptococcus intermedius is treated like many other bacterial infections, with a standard course of antibiotics,” Dr. Adalja said.
“Do you feel that antibiotics would have made a difference in this case?” asked FOX 13 investigative reporter Adam Herbets.
“In retrospect, yes,” Dr. Adalja said. “Antibiotics would have made a difference, but the question is could you have known ahead of time?”
Dr. Stanley Lane, an attorney and oral surgeon not affiliated with this case, said he believes Joshua Cordery should have been prescribed antibiotics at the time of his teeth extraction due to a medical record showing risk factors of periodontitis, opioid abuse, and poor oral hygiene.
“People who are long-time drug uses generally have a compromised immune system,” Dr. Lane described. “This guy was not taking care of his mouth.”
Medical records indicate Joshua Cordery had been diagnosed with periodontitis, an infection that spread into the bone and tissue surrounding his teeth, at the time of the procedure.
“There’s no question, when an infection is present… antibiotics should be given either before the surgery, during the surgery, or for sure subsequent to the surgery,” Dr. Lane said.
A spokesperson for University of Utah Health disagreed, releasing the following statement to FOX 13.
“We were deeply saddened to learn of the passing of Mr. Cordery. The safety and care of our patients is our primary concern and while treating this patient, our team provided care based on best practices and on guidelines recommended by the American Dental Association and the American Heart Association. We are currently interviewing our teams and looking into our processes to gain a better understanding of what happened in this case and we are committed to making changes if needed to improve our care. We only just learned of Mr. Cordery’s passing but we will be reaching out to family members to discuss their concerns.”
Dr. Adalja noted that emergency room doctors at Intermountain’s Heber Valley Hospital arrived at a partially accurate conclusion in diagnosing the patient with Influenza A.
Although Intermountain medical records indicate the patient had only a “54%” or “unlikely” chance for pneumonia, Dr. Adalja said the decision whether to diagnose pneumonia typically comes from a chest x-ray.
He said it’s difficult to know whether proper care was given without seeing the patient’s mouth or chest x-ray at the time of the emergency room visit.
"If there was an untreated mouth infection, which now seems to be the case, that could lead to a predisposition to pneumonia specifically when influenza is also present,” Dr. Adalja said. “I would say, from the emergency department visit, I don’t see a breach in the standard of care. There may have been a breach in the standard of care at the dental level, but that’s something for a dentist to opine on.”
Intermountain Healthcare sent an email to FOX 13 promising to investigate.
“Intermountain Heber Valley Hospital takes all patient concerns seriously,” a spokesperson wrote. “We investigate each complaint and work to resolve any issues with those involved. We are investigating this concern and will discuss the results with the family at its conclusion.”
Since the release of the statement, Jamie Cordery said she has received a phone call from Intermountain Healthcare’s patient advocacy team in which a representative told her the investigation could take a month to finish.
She said she is “frustrated across the board” and wants University of Utah Health and Intermountain Healthcare to “be held responsible and take accountability.”
“(Josh) had a sense of humor that could make me smile on the toughest days,” Jamie Cordery said. “That’s the first man that ever made me feel like I was truly beautiful.”