A dentist shall report to the Board, in writing, any death caused by or resulting from the dentist's administration of anxiolysis, moderate sedation, deep sedation, or general anesthesia within 7 days after its occurrence. A dentist shall report to the Board, in writing, any complication or disabling incident requiring admission to a hospital either for a period greater than 24 hours, or for purposes other than observation, as a result of the dentist’s administration of anxiolysis, moderate sedation, deep sedation, or general anesthesia within 15 days after its occurrence. The written report to the Board required in §§A and B of this regulation shall include: The date of the incident; The name, age, and address of the patient; The patient's original complete dental records; The name and license number of the licensee and the name and address of all other persons present during the incident; The address where the incident took place; The preoperative physical condition of the patient; The type of anesthesia and dosages of drugs administered to the patient; The techniques used in administering the drugs; Any adverse occurrence including: The patient's signs and symptoms; The treatment instituted in response to adverse occurrences; The patient's response to the treatment; and The patient's condition on termination of any procedures undertaken; and A narrative description of the incident including approximate times and evolution of symptoms. The duties outlined in §§A—C of this regulation apply to every dentist whether or not the dentist holds a permit. The Board may initiate a complaint based upon the contents of a morbidity or mortality report. A Board initiated complaint under §E of this regulation shall be independent of and may not prejudice the filing of a complaint by a third party.