A New Jersey dentist whose practice has been linked to 15 bacterial heart infections, including one death, continues to perform oral surgeries, Patch.com reported.

According to N.J. State Board of Dentistry records obtained by the website, oral surgeon John Vecchione, who practices in Mt. Olive and Parsippany, signed an agreement with the board to use “best practices in sanitation” after investigators linked the endocarditis infections to his practice.

According to the Mayo Clinic, endocarditis refers to an infection of the inner lining of the heart and usually occurs when bacteria from other parts of the body, like the mouth, travel through the bloodstream and reach damaged areas of the heart. Without treatment, endocarditis can damage heart valves and lead to life-threatening issues.

Investigators began inspecting Vecchione’s practice after Ryan Del Grosso, of Jefferson, was diagnosed with endocarditis about five weeks after a wisdom teeth operation, Patch.com reported. At the surgeon’s office authorities identified several non-sterile tools, as well as poor hand hygiene and storage issues.

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The patients infected at the New Jersey offices, ages 16 to 77, had to get surgery after exposure to what investigators said was likely the use of unsterilized IVs used for pre-operative sedation. Antibiotics and surgery are used to treat the infection, which is uncommon among people with healthy hearts, according to the Mayo Clinic.

Patch.com reported that eight of the patients had a history of murmur, and that three of the patients had pre-existing heart problems that may have left them at a higher risk of the infection. But “none of the 15 cases had a high-risk condition,” according to state records obtained by Patch.

The patient who died suffered complications stemming from the infection that resulted in cardiac surgery.