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BOARD OF DENTISTRY vs. PETER KURACHEK, 87-003291 (1987)

Court: Division of Administrative Hearings, Florida Number: 87-003291 Visitors: 27
Judges: J. LAWRENCE JOHNSTON
Agency: Department of Health
Latest Update: Mar. 15, 1988
Summary: Dentist had assistant perform nondelegable, irremediable tasks. Uncertified assistant performed expanded duties. No violation for other remediable tasks
87-3291

STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS


DEPARTMENT OF PROFESSIONAL ) REGULATION, )

)

Petitioner, )

)

vs. ) CASE NO. 87-3291

)

PETER KURACHEK, D.D.S., )

)

Respondent. )

)


APPEARANCES


For Petitioner: Theodore C. Eastmoore, Esquire

1550 Ringling Boulevard

Sarasota, Florida 34236


For Respondent: Peter Kurachek, pro se 1/

Sarasota, Florida RECOMMENDED ORDER

By a six count administrative complaint filed April 16, 1987, petitioner, Department of Professional Regulation, charged that respondent, Peter Kurachek, D.D.S., improperly delegated professional responsibilities to certain persons when respondent knew or had reason to know that such persons were not qualified by training, experience, or licensure to perform them, thus violating Section 466.028, Florida Statutes (1983). Respondent executed his election of rights form on July 21, 1987, requesting a formal hearing pursuant to Section 120.57(1), Florida Statutes (1983).


Final hearing was held in Sarasota on October 20, 1987. The petitioner ordered the preparation of a transcript of the final hearing, and the parties asked for 30 days from the filing of the transcript in which to file proposed recommended orders. The transcript was not filed until December 28, 1987, which would have made proposed recommended orders due on January 27, 1988. However, the respondent, through his attorney, moved without objection for an enlargement of the time to February 15, 1988, and the motion was granted.


The petitioner's proposed recommended order was filed on February 16, 1988; the respondent's proposed recommended order was filed on February 19, 1988.

Explicit ruling on the parties' proposed findings of fact may be found in the attached Appendix To Recommended Order, Case No. 87-3291.


FINDINGS OF FACT


  1. At all times relevant, respondent, Peter Kurachek, held a license to practice dentistry, No. DN005429, issued by the State of Florida, Department of Professional Regulation, Board of Dentistry.

  2. In 1983, respondent employed Deborah Burr as a chairside dental assistant. Ms. Burr was not licensed by the State of Florida as a dentist or dental hygienist nor did she hold an expanded duties certificate.


  3. During the employment, respondent directed Ms. Burr to cement and remove temporary crowns, fabricate temporary crowns, fabricate temporary bridgework, make adjustments on permanent dentures, and pack retraction cord. All of the foregoing were done without respondent's direct supervision.


  4. From a period of 1983 into 1985, respondent employed Craig Marcum as a chairside dental assistant. Mr. Marcum was not licensed by the State of Florida as a dentist or dental hygienist nor did he hold an expanded duties certificate.


  5. During this employment, respondent directed Mr. Marcum to cement and remove temporary crowns, fabricate temporary crowns, make adjustments on temporary bridgework, make adjustments on permanent dentures, pack retraction cord, and take opposing impressions for dentures. All of the foregoing were done without respondent's direct supervision.


  6. Many patients confused Mr. Marcum as a dentist. But the evidence did not prove that the respondent was aware of this behavior. This behavior became a greater problem when the respondent was opening a Sarasota office between May and December, 1984, and Marcum was in the Venice office under the supervision of other dentists. When the respondent re-assigned a trusted assistant to Venice in September, 1984, she told the respondent that Marcum was referring to himself, and holding himself out, as a dentist. The respondent reprimanded Marcum and had him sign a written promise to cease that behavior. There was no evidence that Marcum continued this behavior after the reprimand.


  7. On at least one occasion, Eugena Whitehead, respondent's receptionist, observed Mr. Marcum using a low speed drill inside a patient's mouth. Ms. Whitehead immediately informed respondent of Mr. Marcum's conduct. Respondent took no immediate action but allowed Mr. Marcum to continue using the drill.


  8. While in respondent's employ, Mr. Marcum wrote dental prescriptions under respondent's name. But the evidence did not prove that the respondent did not dictate the prescription or, if he did not, that the respondent knew about forged prescriptions.


  9. In 1983, respondent employed Pam Anderson as a chairside dental assistant. Ms. Anderson was not licensed by the State of Florida as a dentist or dental hygienist nor did she hold an expanded duties certificate.


  10. During this employment, respondent directed Ms. Anderson to cement and remove temporary crowns, fabricate temporary crowns, do temporary fillings, make adjustments on permanent dentures, and pack retraction cord. All of the foregoing were done without respondent's direct supervision.


  11. In 1983, respondent employed Patricia M. Lacher as a chairside dental assistant. Ms. Lacher was not licensed by the State of Florida as a dentist or dental hygienist nor did she hold an expanded duties certificate.


  12. During this employment, respondent directed Ms. Lacher to cement and remove temporary crowns, fabricate temporary crowns, make adjustments on temporary bridgework, take opposing impressions for permanent dentures, make adjustments on permanent dentures, remove sutures, and pack retraction cord. All of the foregoing were done without respondent's direct supervision.

  13. In 1983, respondent employed Gwen Green as a chairside dental assistant. Ms. Green was not licensed by the State of Florida as a dentist or dental hygienist nor did she hold an expanded duties certificate.


  14. During this employment, respondent directed Ms. Green to cement and remove temporary crowns, fabricate temporary crowns, make adjustments on temporary bridgework, make adjustments on permanent dentures, and pack retraction cord. All of the foregoing were done without respondent's direct supervision.


  15. Through 1983 and 1984, Dr. Kurachek imposed an office policy that dental assistants, not dentists or dental hygienists, perform the duties of packing retraction cord, fabricating temporary crowns and bridges to a dentist's specifications, and adjusting permanent dentures to a dentist's specifications, all without direct supervision.


  16. Since some time in 1985, the respondent altered his practices to some extent. He no longer has dental assistants place or remove temporary restorations or cement temporary crowns and bridges or take study impressions unless the dental assistant has an expanded duties certificate and is under direct supervision. He does not allow dental assistants to place or remove or cement or recement permanent crowns or bridges, take final impressions for dentures, pack retraction cord, use a handpiece, or drill, in a patient's mouth or do temporary fillings regardless whether the dental assistant has an expanded duties certificate. He still has dental assistants, with or without the expanded duties certificate, make temporary crowns and bridges to his or another dentist's specifications outside of the mouth and adjust permanent dentures to his or another dentist's specifications, both outside the mouth either in a laboratory or in the operatory which serves as a laboratory and both under the direct supervision of the responsible dentist. The respondent understands that these procedures are legal based on his understanding of what DPR representatives have told dental assistants in his employ.


    CONCLUSIONS OF LAW


  17. Section 466.028, Florida Statutes (1983), provides in pertinent part:


    1. The following acts shall constitute grounds for which the disciplinary actions specified in subsection (2) may be taken:

      * * *

      (g) Aiding, assisting, procuring, or advising any unlicensed person to practice dentistry or dental hygiene contrary to this chapter or to a rule of the department or the board.

      * * * (aa) Delegating professional

      responsibilities to a person when the licensee delegating such responsibilities knows, or has reason to know, that such person is not qualified by training, experience, or licensure to perform them.

      (bb) The violation or the repeated violation of this chapter, chapter 455, or any rule promulgated pursuant to chapter

      455 or this chapter; or the violation of a lawful order of the board or department previously entered in a disciplinary hearing; or failure to comply with a lawfully issued subpoena of the board or department.


  18. Section 466.026, Florida Statutes (1983), provides in pertinent part:


    1. Each of the following acts constitutes a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084:

      * * *

      (c) Knowingly employing any person to perform duties outside the scope allowed such person under this chapter or the rules of the board.


  19. Section 446.024, Florida Statutes (1983), provides in pertinent part:


    1. A dentist may not delegate irremediable tasks to a dental hygienist or dental auxiliary, except as provided by law. A dentist may delegate remediable tasks to a dental hygienist or dental auxiliary. The board by rule shall also designate which tasks are remediable, except that the following are by law found to be remediable:

      1. Taking impressions for study casts but not for the purpose of fabricating any intra-oral restorations or orthodontic appliance.

        * * *

        (d) Removing sutures.

        * * *

        (g) Placing or removing temporary restorations.

        * * *

        (j) Polishing clinical crowns of the teeth for the purpose of removing stains but not changing the existing contour of the tooth.

        * * * Nothing in this subsection shall be construed to limit remediable tasks to those specified therein.

        * * *

        1. All other remediable tasks shall be performed under the direct, indirect, or general supervision of a dentist, as determined by rule of the board, and after such formal or on-the-job training by the dental hygienist or dental auxiliary as the board by rule may require. The board by rule may establish a certification process

          for expanded-duty dental auxiliaries, establishing such training or experience criteria or examinations as it deems necessary and specifying which tasks may be delegable only to such auxiliaries. If the board does establish such a certification process, the department shall implement the application process for such certification and administer any examinations required.

        2. Notwithstanding subsection (1), a dentist may not delegate to anyone other than another licensed dentist:

        * * *

        (b) Any diagnosis for treatment or treatment planning.

        * * *

        (6) Effective July 1, 1980, no dental auxiliary shall perform an intra-oral procedure except after such formal or on- the-job training as the board by rule shall prescribe.

  20. Section 466.003, Florida Statutes (1983), provides in pertinent part: As used in this chapter:

    * * *

    (6) "Dental auxiliary" means a person, other than a dental hygienist, who, under the supervision and authorization of a dentist, provides dental care services directly to a patient.

    * * *

    1. "Direct supervision" means supervision whereby a dentist diagnoses the condition to be treated, a dentist authorizes the procedure to be performed, a dentist remains on the premises while the procedures are performed, and a dentist approves the work performed before dismissal of the patient.

    2. "Indirect supervision" means supervision whereby a dentist authorizes the procedure and a dentist is on the premises while the procedures are performed.

    3. "General supervision" means supervision whereby a dentist authorizes the procedures which are being carried out but need not be present when the authorized procedures are being performed. The authorized procedures may also be performed at a place other than the dentist's usual place of practice. The issuance of a written work authorization to a commercial dental laboratory by a dentist does not constitute general supervision.

    4. "Irremediable tasks" are those

      intra-oral treatment tasks which, when performed, are irreversible and create unalterable changes within the oral cavity or the contiguous structures or which cause an increased risk to the patient. The administration of anesthetics other than topical anesthesia is considered to be an "irremediable task" for purposes of this chapter.

    5. "Remediable tasks" are those intra- oral treatment tasks which are reversible and do not create unalterable changes within the oral cavity or the contiguous structures and which do not cause an increased risk to the patient.


  21. Rule 21G-16.001, Florida Administrative Code, provides in pertinent part:


    21G-16.001 Remediable Tasks.

    1. In addition to the tasks set forth in Section 446.024(1), F.S., the following dentistry tasks are the only tasks deemed remediable by the Board of Dentistry, and, accordingly, may be delegated by a dentist to a dental hygienist or dental assistant:

      * * *

      1. Removing excess cement from dental restorations and appliances with non- mechanical hand instruments only

      2. Fabricating temporary crowns and bridges in a laboratory

      3. Cementing temporary crowns and bridges with temporary cement

      * * *

      (m) Dental assistants may perform preliminary charting of existing restorations and missing teeth and observe and record by visual assessment, using a mouth mirror only, existing oral conditions

      * * *


  22. Rule 21G-16.002, Florida Administrative Code, provides in pertinent part:


    1. The following remediable tasks may be performed only after a dental hygienist or dental assistant has satisfactorily completed formal training approved by the Board of Dentistry:

      * * *

      (c) Placing or removing temporary restorations with non-mechanical hand instruments only

      * * *

      (f) Polishing clinical crowns of the teeth, but not for the purpose of changing

      the existing contour of the tooth with instruments which shall be limited to slow speed hand pieces, rubber cup, bristle brush, porte polishers and with appropriate polishing materials

      * * *

      1. Removing excess cement from dental restorations and appliances with non- mechanical hand instruments only

      2. Cementing temporary crowns and bridges with temporary cement

      3. Taking impressions for study casts but not for the purpose of fabricating any intra-oral appliances or restorations, or orthodontic appliances

      * * *

      (q) For dental assistants, the performing of preliminary charting of

      existing restorations and missing teeth and the observation and recording by visual assessment, using a mouth mirror only, of existing oral conditions

      * * *

    2. Except for placing and exposing dental x-ray films the approved training for which is prescribed in Rule 21G-9.011, all other expanded functions of a dental hygienist or dental assistant shall be performed only after such hygienist or assistant has satisfactorily completed on- the-job training as set forth in Rule

      21G-16.002(4).

    3. Approved Formal Training.

      (a) Approved formal training required to perform any expanded function set forth in Rule 21G-16.002(1) above, shall require successful completion of an expanded function program administered or developed as a part of the regular curriculum at a school of dentistry, dental assisting or dental hygiene approved by the Board of Dentistry.

      * * *

      (f) Each dental hygienist or dental/ assistant successfully completing an approved formal training program shall be issued a certificate by the school authorizing such hygienist or assistant to perform the tasks set forth in Rule 21G- 16.002(1) and such certificates must be conspicuously displayed in the office where such hygienist or assistant practices. The school shall immediately forward to the Board a list of those hygienists and assistants who successfully completed the course.

      * * *

    4. On-the-job Training.

      1. Training by dentist currently licensed to practice and practicing in Florida which is the responsibility of the dentist training a dental hygienist or dental assistant in expanded functions, or

      2. Training in a school approved by the Board of Dentistry to provide for formal training in expanded functions.

      * * *


  23. Rule 21G-16.003, Florida Administrative Code, provides that all of the remediable expanded functions for dental assistants pertinent to this case may be performed only under direct supervision. (It provides that a dental assistant may cement temporary crowns and bridges utilizing temporary cement without pre-examination by a dentist but only when the patient is uncomfortable due to the loss of a temporary crown or bridge.)


  24. Neither Section 466.024 nor Rule 21G-16.001 make the use of a handpiece, or drill, inside a patient's mouth, the adjustment of permanent dentures (even grinding high spots and sore spots at the direction of the dentist), the packing of retraction cord, the taking of final impressions for the purpose of fabricating intra-oral restorations or appliances, or doing temporary fillings remediable tasks. They are tasks that are not delegable to a dental assistant regardless whether he or she has an expanded duties certificate. In this case the evidence proved that Craig Marcum once used a handpiece, or drill, inside a patient's mouth, and the respondent, on learning from Eugena Whitehead what Marcum was doing, did not immediately stop Marcum from continuing. The evidence also proved the allegations that: Deborah Burr, Craig Marcum, Pam Anderson, Pat Lacher and Gwen Green made adjustments on permanent dentures and packed retraction cord either for the respondent or following procedures imposed by the respondent. In addition, Pam Anderson did temporary fillings /2. These would have been violations even if these dental assistants had expanded duties certificates.


  25. The evidence proved that Marcum and Lacher took "opposing impressions" for the respondent and at his direction. The evidence did not prove that these were irremediable final impressions for purposes of fabricating restorations or appliances. But, under Rule 21G-16.002, Florida Administrative Code, a dental assistant must have formal training and an expanded duties certificate and must be under dentist's direct supervision to take impressions for study casts. Therefore, the delegation of those duties to Lacher and Marcum constituted violations.


  26. Under Section 466.024, Florida Statutes, and Rules 21G-16.002 and 21G- 16.003, Florida Administrative Code, no formal training is required to enable a dental assistant to remove sutures or make temporary crowns and bridges in a laboratory. These are remediable tasks for which on-the-job training and general supervision is sufficient. It was not a violation for Burr, Marcum, Anderson, Lacher and Green to fabricate temporary crowns and bridges according to the specifications of the dentists whom they served, as the evidence proved happened. Likewise, it was not a violation for the respondent to have Lacher remove sutures.


  27. The other functions performed by Burr, Marcum, Lacher, Anderson and Green for the respondent and under procedures he imposed--cementing and removing temporary crowns and bridges--were remediable functions that required an

    expanded duties certificate and direct supervision, according to Section 466.024, Florida Statutes, and Rules 21G-16.002 and 21G-16.003, Florida Administrative Code. None of these individuals had an expanded duties certificate, and they performed these tasks without direct supervision.


  28. Section 466.028, Florida Statutes (1983), also provides in pertinent part:


    1. When the board finds any applicant or licensee guilty of any of the grounds set forth in subsection (1), it may enter an order imposing one or more of the following penalties:

      1. Denial of an application for licensure.

      2. Revocation or suspension of a license.

      3. Imposition of an administrative fine not to exceed $1,000 for each count or separate offense.

      4. Issuance of a reprimand.

      5. Placement of the licensee on probation for a period of time and subject to such conditions as the board may specify, including requiring the licensee to attend continuing education courses or demonstrate his competency through a written or practical examination or to work under the supervision of another licensee.

      6. Restricting the authorized scope of practice.

    2. There shall be a minimum 6-month suspension of the license of a dentist who is convicted of a violation of paragraph (1)(aa).

    3. The department shall reissue the license of a disciplined licensee upon certification by the board that the disciplined licensee has complied with all of the terms and conditions set forth in the final order.


  29. Rule 21G-13.005, Florida Administrative Code, provides in pertinent part:


    21G-13.005 Disciplinary Guidelines.

    1. Unless relevant mitigating factors are demonstrated the Board shall always impose a reprimand and an administrative fine not to exceed $3,000.00 per count or offense when disciplining a licensee for any of the disciplinary grounds listed in subsection (2) or (3) of this rule. The reprimand and administrative fine is in addition to the penalties specified in subsections (2) and (3) for each disciplinary ground.

    2. When the Board finds an applicant or licensee whom it regulates under Chapter 466, Florida Statutes, has committed any of the acts set forth in Section 466.026, Florida Statutes, it shall issue a final order imposing appropriate penalties within the ranges recommended in the following disciplinary guidelines.

      * * *

      (c) Knowingly employing any person to perform duties outside the scope allowed such person under Chapter 466, F. S., or the rules of the Board. The usual action of the Board shall be to impose a period of probation, restriction of practice, and/or suspension. In the case of an applicant for licensure, the Board shall deny the application.

      * * *

    3. When the Board finds an applicant or licensee whom it regulates under Chapter 466, Florida Statutes, has committed any of the acts set forth in Section 466.028, Florida Statutes, it shall issue a Final Order imposing appropriate penalties within the ranges recommended in the following disciplinary guidelines:

      * * *

      1. Failing to report to the Department any person the licensee knows or has reason to believe, is clearly in violation of Chapter 466, Florida Statutes, or the rules of the Board or Department. The usual action of the Board shall be to impose a period of probation.

      2. Aiding, assisting, procuring, or advising any unlicensed person to practice dentistry or dental hygiene contrary to Chapter 466, F. S., or the rules of the Board or Department. The usual action of the Board shall be to impose a period of probation, restriction of practice and/or suspension. In the case of an applicant, the Board shall deny the application.

      * * * (dd) Delegating professional

      responsibilities to a person who is not qualified by training, experience or licensure to perform them. The usual action of the Board is to impose a six month suspension and/or period of probation. In the case of an applicant, the Board shall deny the application.

      (ee) Violations or repeated violations of Chapter 466 or 455, F. S., or the rules promulgated thereunder. The usual action

      of the Board shall be to impose a period of

      probation, restriction of practice, suspension and/or revocation. In the case of an applicant, the Board shall deny the application.

      * * *

    4. Based upon consideration of aggravating or mitigating factors, present in an individual case, the Board may deviate from the penalties recommended in subsections (2) and (3) above. The Board shall consider as aggravating or mitigating factors the following:

  1. The severity of the offense;

  2. The danger to the public;

  3. The number of repetitions of offenses or number of patients involved;

  4. The length of time since the violation;

  5. The number of times the licensee has been previously disciplined by the Board;

  6. The length of time the licensee has practiced;

  7. The actual damage, physical or otherwise, caused by the violation and the reversibility of the damage;

  8. The deterrent effect of the penalty imposed;

  9. The effect of the penalty upon the licensee's livelihood;

  10. Any efforts of rehabilitation by the licensee;

  11. The actual knowledge of the licensee pertaining to the violation;

    1. Attempts by the licensee to correct or stop the violation or refusal by the licensee to correct or stop violation;

  1. Related violations against the licensee in another state including findings of guilt or innocence, penalties imposed and penalties served;

  2. Penalties imposed for related offenses under sections (2) and (3) above;

  3. Any other relevant mitigating or aggravating factor under the circumstances.

(5) Penalties imposed by the Board pursuant to sections (2) and (3) above may be imposed in combination or individually, and are as follows:

  1. issuance of a reprimand;

  2. imposition of an administrative fine not to exceed $3,000.00 for each count or separate offense;

  3. restriction of the authorized scope of practice;

  4. placement of the licensee on probation for a period of time and subject to such conditions as the Board may

    specify, including requiring the licensee to attend continuing education courses, to submit to reexamination, or to work under the supervision of another licensee;

  5. suspension or revocation of a license; and

  6. denial of an application for licensure.


RECOMMENDATION


Based on the foregoing Findings Of Fact and Conclusions Of Law, it is recommended that the Board of Dentistry enter a final order:


  1. holding the respondent, Peter Kurachek, D.D.S.: (a) guilty as charged of five counts of violating Section 466.028(1)(g) and (aa) (1983), one for each of the dental assistants Burr, Marcum, Lacher, Anderson and Green; and (b) guilty of a sixth count, as charged, for violating Section 466.028(1)(bb) (1983);


  2. imposing a $5,000 fine payable within 30 days;


  3. suspending the respondent's license for a period of six months; and


  4. placing the respondent on probation for one year after reinstatement of his license.


RECOMMENDED this 15th day of March, 1988, in Tallahassee, Florida.


J. LAWRENCE JOHNSTON Hearing Officer

Division of Administrative Hearings The Oakland Building

2009 Apalachee Parkway

Tallahassee, Florida 32399-1550

(904) 488-9675


Filed with the Clerk of the Division of Administrative Hearings this 15th day of March, 1988.


ENDNOTES


1/ While the Respondent represented himself at the final hearing he now has retained an attorney, Salvatore A. Carpino, Esquire, of Freeman & Lopez, P.A., of Tampa, who filed Respondent's Proposed Recommended Order.


2/ Eugena Whitehead, a receptionist, once packed retraction cord and on other occasions was asked by the respondent to pack retraction cord and to adjust a permanent partial (although she did not comply with his request on these other occasions.) But the petitioner never charged the respondent with this conduct as part of the violation, and it therefore cannot be concluded that this is a separate violation.

APPENDIX TO RECOMMENDED ORDER, CASE NO. 87-3291


To comply with Section 120.59(2), Florida Statutes (1987), the following explicit rulings are made on the parties' proposed findings of fact:


  1. Petitioner's Proposed Findings of Fact.


    1.-2. Accepted and incorporated.

    3. Last sentence, irrelevant and unnecessary; rest, accepted and incorporated, except proposed finding of no indirect supervision rejected as contrary to facts found.

    4.-5. Accepted and incorporated, except proposed finding of no indirect supervision in 5 rejected as contrary to facts found.

    6. First sentence, accepted and incorporated; second sentence, rejected as contrary to facts found and not proven by the evidence.

    7.-9. Accepted and incorporated.

    1. Rejected, as not proven by the evidence, that Anderson made adjustments on permanent crowns inside the mouth; otherwise, accepted and incorporated, except proposed finding of no indirect supervision rejected as contrary to facts found.

    2. Rejected as entirely outside the charges and irrelevant. 12.-13. Accepted and incorporated, except proposed finding of no indirect supervision in

    13 and 15 rejected as contrary to facts found.

    16.-17. Accepted but subordinate to facts found and unnecessary. (The Administrative Complaint did not allege violations involving Whitehead, but the facts are relevant on the issue of the respondent's knowledge of the similar charged violations.)

    1. Rejected as irrelevant.

    2. First sentence, subordinate, cumulative and unnecessary; second sentence, accepted and incorporated; third sentence, subordinate and unnecessary.

    3. Rejected as outside the charges and irrelevant. 21.-25. Rejected as conclusions of law.

    1. Subordinate and unnecessary.

    2. Subordinate in part to facts found and in part to facts contrary to those found.


  2. Respondent's Proposed Findings of Fact.


1.-2. Accepted and incorporated.

  1. Penultimate sentence, rejected as contrary to facts found; rest, accepted but subordinate to facts found.

  2. Fourth sentence and first clause of the last sentence, rejected as contrary to facts found; rest accepted but subordinate.

  3. Except that it was implicit and is inferred that the dentures were "permanent," accepted but subordinate to facts found.

  4. Third from the last sentence, rejected as contrary to facts found (although it was not proven that the respondent had knowledge of this); rest, accepted but subordinate to facts found. Accepted but subordinate to facts found.

  1. Implication of the last sentence, rejected as contrary to facts found. (Dr. Anisz said that he and the other dentists, as well as the dental assistants, were required to follow the procedures imposed by the respondent.)

  2. First sentence, rejected as contrary to facts found. (Some of the illegal conduct was in accordance with procedures imposed by the respondent. In addition, Whitehead once told the respondent that Marcum was using a handpiece,

    or drill, inside a patient's mouth.) Fourth sentence, rejected as an incorrect conclusion of law. Rest, accepted but subordinate to facts found.

  3. Accepted but only marginally relevant and unnecessary.

  4. Second sentence, rejected as not proven by the evidence. (Mrs. Rovac said it was "dental floss.") Rest, accepted but subordinate and unnecessary.

  5. Accepted but subordinate to facts found.

  6. First clause of third sentence, rejected as not proven by the evidence; last clause of the last sentence, rejected as contrary to facts found (the respondent imposed the procedures being followed); rest subordinate in part to facts contrary to those found and in part to facts found.

  7. Penultimate sentence, rejected as contrary to facts found. Many of the violations did occur when the respondent was not present, but many occurred when he was present and many were done in accordance with procedures he imposed. Rest, subordinate to facts contrary to those found.


COPIES FURNISHED:


Theodore C. Eastmoore, Esquire 1550 Ringling Boulevard

Sarasota, Florida 34236


Salvatore A. Carpino, Esquire 4600 W. Cypress Avenue

Suite 410

Tampa, Florida 33607


William O'Neil General Counsel

Department of Professional Regulation

130 North Monroe Street Tallahassee, Florida 32399-0750


Pat Guilford Executive Director Board of Dentistry

Department of Professional Regulation

130 North Monroe Street Tallahassee, Florida 32399-0750


Docket for Case No: 87-003291
Issue Date Proceedings
Mar. 15, 1988 Recommended Order (hearing held , 2013). CASE CLOSED.

Orders for Case No: 87-003291
Issue Date Document Summary
Oct. 21, 1988 Agency Final Order
Mar. 15, 1988 Recommended Order Dentist had assistant perform nondelegable, irremediable tasks. Uncertified assistant performed expanded duties. No violation for other remediable tasks
Source:  Florida - Division of Administrative Hearings

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