Sep 6 2006 17:14 SEP-G6-2606 17:29 AHCA Pa STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, Vv. CASE NO. 2003-22625 JEFFREY BAKER, D.M.D., RESPONDENT. ; ADMINISTRATIVE COMPLAINT COMES NOW, Petitioner, Department of Health, by and through its — undersigned counsel, and files this Administrative Complaint before the Board of Dentistry against the Respondent, Jeffrey Baker, D.M.D., and in support thereof alleges: , 1. Petitioner is the state department charged with regulating the practice of Dentistry pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 466, Florida Statutes. 2. At all times material to this Complaint, Respondent was a licensed dentist within the State of Florida and was issued license number * DN 10245. JAPSU\Medical\Bunton\AC\Baker, Jeffrey - AC 03-22625(x)(m) 6-9-05.doc Sep 6 2006 17:14 SEP-G6-2806 17:38 AHCA Pa 3. Respondent's address of record is 1626 South Conway Road, Orlando, Florida 32812. 4. Respondent provided dental care to Patient A.K. from on or about August 24, 2001, until on or about August 5, 2003. 5. Onor about July 29, 2003, the Respondent's treatment records for Patient A.K. indicate a prophylaxis, examination, and two bitewing radiographs. The unsigned entry on that date was apparently made by an auxiliary presumably a dental hygienist. The bitewing radiographs taken on July 29, 2003, included the majority of the crown of tooth number 27, which exhibited a pre-existing composite restoration that appears to be on the labial surface of the tooth and a large radiolucency involving the distal . lingual surfaces that would represent either a carious lesion or a missing » restoration. 6. On or about August 5, 2003, Patient A.K. presented to the © Respondent for dental treatment. The dental record for Patient A.K. was unsigned by the Respondent on August 5, 2003. The dental record of - Patient A.K. for August 5, 2003, states 1 carpule 2% lidocaine with 1:100,000 epinephrine was injected followed by an amalgam restoration placed in the lingual surface of tooth number 27. During this same dental 2 JAPSU\Medical\Bunton\AC\Baker, Jeffrey - AC 03-22625(x)(m) 6-9-05.doc Sep 6 2006 17:14 SEP-@6-2086 17:38 AHCA P.a4 treatment by the Respondent a copalite cavity varnish was placed in the cavity preparation but no liner or base was placed prior to condensing the amalgam.