Chinese authorities are investigating the case of an elderly man who died 13 days after having 23 teeth extracted and 12 implants inserted on the same day at a dental clinic.

Ms. Shu, a resident of Yongkang City, in China’s Zhejiang Province, recently filed a complaint with the Municipal Health Bureau against a local dental clinic after her father’s death. The woman presented evidence that her parent had had 23 teeth extracted and 12 new teeth implanted in a single session, which she claims caused his untimely demise 13 days later. Ms. Shu told authorities that her father suffered agonizing pain throughout the last 13 days of his life, before suffering a fatal heart attack on August 28. Now the woman wants those responsible to be brought to justice.

According to the patient consent form, Ms Shu’s father did in fact get 23 of his natural teeth extracted before having 12 holes drilled into his skull and mandible to have new teeth implanted. All of this was done in a single day, which meant he had to endure unimaginable pain after the anesthesia wore off. Although the number of extractions seems a bit excessive for a single session, a spokesperson for the clinic where the procedure was carried out said that the number of teeth that can be removed at one time needs to be determined by the doctor in a face-to-face consultation based on the patient’s physical condition.

According to Dewei Dental Hospital records, the 23 extractions were carried out by a doctor named Yuan, whose specialties include root canal treatment, removal of impacted wisdom teeth, and full dentures. Although there is currently no specific regulation on the number of teeth to be extracted in a single session, the clinic and the doctor must take into consideration the patient’s pain tolerance and the risk of infection.

“The more teeth you extract, the greater the patient’s pain response and the greater the probability of postoperative infection,” Xiang Guolin, director of the Oral Medicine Center of Wuhan Fourth Hospital, told The Paper.

An investigation in this case is currently underway, but a representative of the Municipal Health Bureau told journalists that proving causality could prove difficult, considering that the man’s death occurred 13 days after the controversial procedure.