STATE OF FLORIDA BOARD OF DENTISTRY DEPARTMENT OF HEALTH, PETITIONER, ve CASENO: 2013-12411 STEVEN M. LONDON, D.D.S., 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 Respondent, Steven M. London, 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, having been issued license number DN 13379. 3, Respondent’s address of record is 9101 Lakeridge Boulevard, Boca Raton, Florida 33496. 4. On or about June 6, 2012, Patient I.K. presented to Respondent's practice for a consultation for Invisalign® brand orthodontic devices (Invisalign). 5. The Invisalign method of orthodontic treatment involves a series of incremental aligners to effect tooth movement. 6. The minimum standard of performance in diagnosis and treatment in the practice of dentistry requires a dentist to provide an adequate diagnosis of a patient's orthodontic condition before prescribing orthodontic devices. 7. The minimum standard of performance in diagnosis and treatment in the practice of dentistry requires a dentist to evaluate a patient's periodontal health or refer for the patient for such evaluation before commencing orthodontic treatment. 8. The minimum standard of performance in diagnosis and treatment in the practice of dentistry requires a dentist to evaluate a patient's periodontal health prior to commencing orthodontic treatment as active periodontal disease will impact the effectiveness of the treatment and may also be exacerbated by the placement of orthodontic devices. 9. The minimum standard of performance in diagnosis and treatment in the practice of dentistry requires a dentist to develop a treatment plan sufficient to address the patient’s orthodontic needs. 10. On or about June 6, 2012, Respondent noted in the clinical record that he took photographs, impressions, and a bite registration for Patient I.K. for the purpose of making a record for Invisalign treatment. Patient IK. was pregnant at the time, so Respondent reportedly did not take any radiographs on this date. 11. Respondent did not provide any diagnosis of Patient Ks orthodontic condition. 12. Patient I.K. had a recent history of periodontal disease. 13. Respondent did not provide any evaluation of Patient LKJs periodontal health or provide a referral for such evaluation. | 14. Respondent failed to provide a proposed treatment plan to Patient LK. 15. Cases are transmitted to Invisalign technicians through a software program known as “ClinCheck.” The dentist fills out the “Invisalign Prescription Form” and uploads any photographs and/or radiographs. Impressions are sent to Invisalign to be digitized. Invisalign technicians create a computerized “ClinCheck model” based on the dentist’s initial prescription, supporting photographs and/or radiographs, and the impressions. The dentist then reviews the model and makes any necessary adjustments or modifications. 16. On or about June 6, 2012, Respondent transmitted the photographs and impressions he took of Patient I.K. to Invisalign. 17. Respondent did not provide any instruction in the “Invisalign Prescription Form” specific to Patient I.K.’s orthodontic condition. 18. The Invisalign technician(s) developed the case and sent it back to Respondent for his review. 19. The proposed Invisalign treatment involved the use of eight (8) aligners, with the last four to be “passive” (non-tooth moving) in nature. 20. Each aligner was to be worn approximately two weeks. 21. Respondent did not make any adjustments to the case modeled by the Invisalign technician(s). 22. Patient I.K. had a significant occlusal (bite) issue. 23. The case modeled by Invisalign and accepted without modification from Respondent provided only four aligners to effect “active” orthodontic treatment, before Patient I.K. was to switch to the remaining four “passive” aligners. 24. The case modeled by [Invisalign without any input or modifications from Respondent was insufficient to address Patient I.K.'s orthodontic condition. 25, The Invisalign treatment package Patient LK. paid for did not involve future refinements to the treatment. Therefore, once Respondent “closed” the case and proceeded to order retainers, Patient I.K. would not receive any additional aligners to address her orthodontic condition. 26. On or about July 9, 2012, Respondent placed attachment(s) on Patient I.K.’s teeth per the Invisalign treatment plan. Respondent inserted Invisalign trays numbering one (1) through four (4) and provided Patient 1.K. with instructions. 27. Onor about September 5, 2012, Respondent inserted Invisalign trays numbering five (5) through eight (8) (the “passive” aligners) and provided Patient I.K. with instructions. 28. On or about November 1, 2012, Respondent noted in the clinical record that the Invisalign treatment was completed and he ordered ’Vivera Retainers.” 29. Vivera® brand retainers are fabricated by Invisalign and are designed to keep the teeth in position following orthodontic treatment. 30. The minimum standard of performance in diagnosis and treatment in the practice of dentistry requires a dentist to take a panoramic radiograph following orthodontic treatment. 31. The panoramic radiograph enables the dentist to evaluate the health of the dental structures, particularly the roots of teeth, following orthodontic treatment, and to evaluate the effectiveness of the treatment and/or need for additional treatment. 32. Respondent failed to take any post-treatment radiographs. 33. On or about November 20, 2012, Respondent inserted the retainers and removed the attachments from the aligners. According to the clinical record for this date, Respondent performed “[e]sthetic recontouring [sic] lower incisors and cuspids to level them as well as gain more occlusion on post teeth.” 34. The minimum standard of performance in diagnosis and treatment in the practice of dentistry requires a dentist to develop a continuing treatment plan if the dentist determines that a course of treatment has not been effective in addressing a patient's dental condition. 35. Respondent failed to recognize that Patient I.K’s orthodontic condition had not been addressed by the Invisalign treatment. 36. The re-contouring of Patient I.K.’s lower incisors and cuspids performed by Respondent was insufficient to treat Patient I.K’s occlusal issues that remained following the Invisalign treatment. 37, The retainers Respondent provided were identical to the last series of four (4) aligners Patient I.K. received on or about September 5, 2012. 38. As such, the retainers Respondent provided only served to hold Patient I.K.’s teeth in a non-adjusted position. 39. Respondent failed to provide an adequate continuing treatment plan to effectively address Patient I.K.’s orthodontic condition. 40. Section 466.028(1)(x), Florida Statutes (2012), states that “fbJeing 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[,]” shall constitute grounds for disciplinary action by the Board of Dentistry. 41. Respondent violated Section 466.028(1)(x), Florida Statutes, in one or more of the following ways: A. By failing to provide an adequate diagnosis of Patient I.K.’s orthodontic condition prior to prescribing orthodontic devices; B. By failing to evaluate Patient I.K.’s periodontal health or refer her for such evaluation before commencing orthodontic treatment; C. By failing to provide a proposed treatment plan to Patient LK.; D. By failing to provide sufficient treatment for Patient I.K.’s orthodontic condition; E. By failing to take a post-treatment radiograph; and/or F, By failing to provide a continuing treatment plan to address Patient I.K.’s remaining orthodontic condition. WHEREFORE, Petitioner respectfully requests that the Board of Dentistry enter an order imposing one or more of the following penalties: restriction of practice, imposition of an administrative fine, issuance of a reprimand, placement of Respondent on probation, corrective action, refund of fees billed or collected, remedial education and/or any other retief that the Board deems appropriate. SIGNED this 4" day of Mat 2015. John H. Armstrong, MD, FACS Surgeon General & Secretary Bacioed Py OV chord’ C Bridget K. McDonnell Assistant General Counsel DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida 32399-3265 Florida Bar #99874 TEL: 850.245.4444, FAX: 850.245.4681 Express Mail Address: 2585 Merchants Row, Suite 105 Email: Bridget.McDonnell@fihealth.gov LED DEPARTMENT OF HEALTH DEPUTY CLERK CLERK = Angel Sanders DATE MAY_0 6 2015 _ PCP: May 1, 2015 PCP Members: C.M., T.M., R.P. DOH v, Steven M, London, D.D.S., Case # 2013-12411 9 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. DOH v. Steven M. London, D.D.S., Case # 2013-12411 10

Docket for Case No: 16-004688PL