Oct 13 2006 11:19 OCT-13-2886 11:36 AHCA STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO. 2002-20513 GEORGE D. GREEN, D.D.S., RESPONDENT. ey / 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, GEORGE D. GREEN, D.D.S., 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 10511. Oct 13 2006 11:20 ; HCA DCT-13-2086 11:36 A 3. Respondent's address Of record is 1700 North University Drive, Suite 200, Coral Springs, Florida 33071-8966, 4. Respondent Provided dental services to Patient C.L. from on or about July 14, 2001, until on or about May 7, 2002, 5. On or about July 14, 2001, the Respondent diagnosed Patient C.L. with incipient caries for teeth numbers two (2), fourteen (14), fifteen - (15), eighteen (18), nineteen (19), thirty (30), thirty-one (31), and he billed Delta Dental for a comprehensive oral examination. A comprehensive examination would involve significant testing of the upper left area, including the use of heat and cold and electric pulp (nerve) testing to indicate possible nerve damage and Periodontal Probing to indicate any gum and bone disorder. No notes are ‘indicated in the Patient C.U’s records evidencing that any tests were done, Regarding the July 14, 2001 dental appointment, Respondent failed to make any appropriate and hecessary notations in Patient C.L’s €xamination record. The Patient C.L’s chart notes indicate caries. These catches by the explorer are subjective in determining the depth of the decay. In most cases these catches can be Closely watched and restored in the future if necessary; immediate dental treatment is unnecessary in such cases. Oct 13 2006 11:20 OCT-13-2006 11:36 AHCA 6. The Patient C.L. presented to the Respondent on July 26, 2001, for repair to the caries that the Respondent instructed needed dental » repair; the Respondent only noted caries needed repair in the Patient C.L/s dental record July 14, 2001. During Patient C.L.'s July 26, 2001 dental appointment with the Respondent, Patient C.L alleges the Respondent “sandblasted” (air abrasion) and used a drill on his teeth as part of his treatment regarding the alleged surface enamel decay to the teeth numbers stated above in paragraph five (5), The Patient C.L. stated he experienced pain during the July 26, 2001 dental treatment by the Respondent, which resulted in the Respondent administering anesthesia for the pain (a shot per the Patient C.L). With these alleged cavities not being of significant decay, the only logical conclusion is the Respondent inappropriately exposed the nerve of tooth number fifteen (15), resuiting in the minimum standards of performance of dentistry being compromised. This is confirmed by the Respondent's dental notes, which reflect he did repair a very deep decay, with vitrebond Placed, and possible pinpoint exposure to tooth number (15). The Respondent appears to have over prepared tooth number fifteen (15) resulting in the nerve exposure. 7. During the July 26, 2001 dental appointment, the Respondent Oct 13 2006 11:21 OCT-13-28M6 11:27 AHCA diagnosed Patient C.’s tooth number fifteen (15) with deep decay and a =: pinpoint exposure. An exposure into the nerve of the tooth would rarely be possible with incipient decay, The x-rays taken by a subsequent treater | (Endodontist) indicated no previous decay in Patient C.L’s tooth number . fifteen (15), The x-ray shows an abnormal white line, which is filled with an unknown material that is possibly florestore, The Operative approach by the Respondent appears to be unwarranted due to the Endodontist (Subsequent treater) preoperative x-rays. Decay usually starts out as a point on the biting surface and then travels to the mesial and distal (front ' and back of the tooth). The preoperative X-rays of the subsequent treater (Endodontist) show the preparation by the Respondent going directly to the nerve. 8. During the July 26, 2001 visit, the Respondent noted in- Patient C.L’s chart that he performed dental services for teeth numbers two (2), fourteen (14), fifteen (15), eighteen (18), nineteen (19), thirty (30), thirty- one (31), all PRR, acid etch, which is in addition to the treatment given to tooth number fifteen (15). 9. On December 28, 2001, the Patient C.L. presented to the Respondent complaining of pain to tooth #14, which the Respondent states Oct 13 2006 11:21 OCT-413-20R6 14:37 AHCA the gum was bleeding and inflamed. This is the only location in the patient . record where any probing is documented, which resulted in a diagnosis of a restoration of tooth number fourteen (14), 10. On January 3, 2002, the Respondent conducted the dental procedure on Patient C.L’s tooth number fourteen (14). 11, Patient C.L. represented to the Respondent complaining of pain in the area of tooth number fourteen (14), on May 4, 2002. 12. The Patient C.L. eventually re-presented to his pediatric dentist (treating dentist prior to the Respondent) who referred Patient C.L, to an Endodontist regarding his pain. 13, The Endodontist performed a root canal on tooth #14, COUNTI 14. The Petitioner realleges and incorporates paragraphs one (1) through thirteen (13) as if the same were stated herein. 15. Section 466.028(1)(m), Florida’ Statutes (2001), states that failing to keep written dental records and medical history records justifying the course of treatment of the patient including, but not limited to, patient histories, examination results, test results, and x-rays, if taken, is grounds for disciplinary action by the Board of Dentistry. Oct 13 2006 11:21 OCT-13-2686 11:38 AHCA 16. Rule 64B5-17.002, Florida Administrative Code, requires that a dentist maintain for each patient written records that contain as a minimum - appropriate medical history; results of clinical examination and tests conducted, including the identification, or lack thereof, of any oral pathology or diseases; any radiographs used for the diagnosis or treatment of the patient; treatment plan proposed by the dentist: and treatment rendered to the patient. , 17. The Respondent failed to meet the patient records requirements in the following ways: (1) By failing to note in the record that the patient was informed of his specific problems and was given a choice of treatment or explained the risks; (2) By failing to maintain complete records regarding the procedure performed and the materials used; and (3) By failing to maintain patient records regarding treatment given to the patient. 18. Based on the foregoing, the Respondent's license is subject to discipline pursuant to Section 466.028(1)(m), Florida Statutes (2001), as implemented by Rule 64B5-17.002, Florida Administrative Code, for failing to keep written dental records and medical history records justifying the Oct 13 2006 11:22 OCT-13-2886 11:38 AHCA course of treatment of the patient including, but not limited to, patient histories, examination results, test results, and x-rays, if taken. COUNT IT 19. The Petitioner realleges and incorporates paragraphs one (1) through thirteen (13) as if the same were stated herein. 20. Section 466.028(1)(x), Florida Statutes (2001), states that » being guilty of incompetence or negligence by failing to meet the minimum standards of performance in diagnosis and treatment when measured against generally prevailing peer performance, including, but not limited to, the undertaking of diagnosis and treatment for which the dentist is not — qualified by training or experience ‘or being guilty of dental Malpractice is grounds for disciplinary action by the Board of Dentistry. 21, The Respondent failed to meet the minimum standards of performance in the treatment of Patient C.L., as follows but not limited to: (1) There is no record the patient was informed of his specific problems, given a choice of treatment or explained the risks; (2) There is no endodontic testing to create a treatment plan; (3) There is no periodontic testing to create a treatment plan; (4) There is no charting to justify and create treatment planning; (4) There are no conclusive radiographs to Oct 13 2006 11:22 OCT-13-2006 14:38 AHCA justify treatment planning; (5) The x-rays taken by a subsequent treater indicate no previous decay (6) The operative approach by the Respondent is unwarranted due to the Endodontist (subsequent treaters) preoperative x-rays; (7) The drilling of the teeth in a straight line directly to the pulp (nerve) indicates that a judgment error in the excavation of decay was performed; (8) The Respondent stated the “cavities were not that bad” regarding usage of anesthesia; if this is true, and the Respondent exposed the tooth (nerve), then the quality of care was compromised; (9) The patient was not referred to an Endodontist for consultation. 22. Based upon the foregoing, Respondent's license to practice dentistry in the State of Florida is subject to discipline pursuant to Section 466.028(1)(x), Florida Statutes (2001), for being guilty of incompetence or negligence by failing to meet the minimum standards of performance in diagnosis and treatment when measured against generally prevailing peer performance, including, but not limited to; the undertaking of diagnosis and treatment for which the dentist is not qualified by training or experience or being guilty of dental malpractice. WHEREFORE, the Petitioner respectfully requests that that the Board of Dentistry enter an order imposing one or more of the following Oct 13 2006 11:23 OCT-13-2086 11:39 AHCA P.1a vg cutee penalties: permanent revocation or suspension of practice, restriction of practice, imposition of an administrative fine, issuance of a reprimand, ' placement of the Respondent on probation, corrective action, refund of fees billed or collected, remedial education and/or any other relief that the _ Board deems appropriate. SIGNED this AnA_day of Oth 2 . 2003, John O. Agwunobi, M.D. M.B.A. Secretary, Department of Health = Samuel Dean Bunton Assistant General Counsel DOH Prosecution Services Unit 4052 Bald Cypress Way Bin C-65 Tallahassee, Florida 32399-3265 Florida Bar # 412155 (850) 487-9692 (850) 488-1855 SDB/ ; Reviewed and approved by: 30¢_. (initials) 47/03 (date) PCP: September #4, 2003 PCP Members: HH & WR & EG George D. Green, D.D.S., Case #2002-20513 Oct 13 2006 11:23 OCT-13-2086 11:39 AHCA NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section 120.569 and 120,57, Florida Statutes, to be represented by counsel or other qualified representative, to present evidence and argument, to call and cross-examine witnesses and to have subpoena and subpoena duces tecum issued on his or her behalf if a hearing is requested. NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that petitioner has incurred costs related to the investigation and prosecution of this matter. - Pursuant to Section 456.072(4), Florida Statutes, the Board shall assess costs related to the investigation and Prosecution of a disciplinary matter, which may include attorney hours and costs, on the Respondent in addition to any other discipline imposed. 10

Docket for Case No: 06-003971PL