STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

DEPARTMENT OF PROFESSIONAL ) REGULATION, BOARD OF DENTISTRY, )

)

Petitioner, )

)

vs. ) CASE NO. 92-6161

)

JAMES W. GIBNEY, D.M.D., )

)

Respondent. )

)

RECOMMENDED ORDER

A hearing was held in this case in Tampa, Florida on February 9, 1993 before Arnold H. Pollock, a Hearing Officer with the Division of Administrative Hearings.

APPEARANCES

For the Petitioner: Albert Peacock, Esquire

Department of Professional Regulation 1940 North Monroe Street

Tallahassee, Florida 32399-0792

For the Respondent: Louis Kwall, Esquire

133 North Ft. Harrison Avenue Clearwater, Florida 34615

STATEMENT OF THE ISSUES

Should Respondent's license as a dentist in Florida be disciplined because of the matters alleged in the Administrative Complaint filed herein?

PRELIMINARY MATTERS

By Administrative Complaint dated September 28, 1992, the Department of Professional Regulation, (Department), for the Board of Dentistry, (Board), seeks to discipline the Respondent's license as a dentist in Florida alleging that he failed to diagnose and treat conditions ultimately leading to problems with a patient's dentures; failed to properly construct and fit dentures to that patient's mouth; and failed to keep appropriate and adequate written dental records and medical history on the patient, all in violation of Section 466.028(1), Florida Statutes.

Respondent requested a formal hearing on the allegations and this hearing followed. At the hearing, Petitioner presented the testimony of Henrietta Pollio, the patient in question, and Donald I. Cadle, Jr., a dentist and expert in general dentistry, and introduced Petitioner's Exhibits 1 through 3.

Respondent testified in his own behalf and presented the testimony of Ronald E. Myers, a dentist and expert in maxillofacial prosthodontics; Jacob Eidenschink,

a dental laboratory technician; and JoAnn Marie Nolan Lawson, formerly principal dental assistant to the Respondent; and introduced Respondent's Exhibits A through E. Joint Composite Exhibits 1 and 2 were also received.

Respondent's counsel, subsequent to the hearing, filed a Motion to Strike the testimony of Petitioner's witness, Dr. Cadle, on the basis that his former position of Chairman of the Board of Dentistry created a conflict of interest affecting his ability to testify. This motion is denied.

A transcript was furnished and subsequent to the hearing, only counsel for Petitioner submitted Proposed Findings of Fact which have been ruled upon in the Appendix to this Recommended Order. Counsel for Respondent submitted a summary of testimony which does not constitute adequate Proposed Findings of Fact but which has nonetheless been carefully considered in the preparation of this Recommended Order.

FINDINGS OF FACT

1. At all times pertinent to the matter in issue herein, the Petitioner, Board, was the state agency responsible for the regulation and supervision of the dental profession and the licensing of dentists in Florida. Respondent was a licensed dentist holding license Number DN 0010500.

   
   

2. At all times pertinent to the matters in issue herein, Respondent was actively engaged in the practice of dentistry at his office located at 1429 Kass Circle, Suite A, Spring Hill, Florida.

   
   

3. In mid-January, 1990, Henrietta Pollio, then a 69 year old widow, had two teeth pulled by a Dr. Pikos, to whom she had been referred by her daughter, a patient. Dr. Pikos recommended she see Respondent for replacements for the pulled teeth, and on January 22, 1990, she saw Respondent in his office. At that time, Ms. Pollio told him she had had two teeth pulled and already wore a bridge. She initially wanted only her lower denture replaced, but Respondent suggested she replace both the lower and upper for a better fit. She agreed.

   
   

4. In March, 1990, Mrs. Pollio went to the Respondent's office for impressions for the new dentures. In the interim, she continued to wear her existing dentures which she had worn for several years. When she got her first set of dentures from Respondent that same month, she didn't like how they looked or how they fit. She told him so, and he agreed to make her another set.

   
   

5. When Respondent gave her her second set of dentures, she did not think they fit any better than the first set he had made for her. They were uncomfortable and she felt the lower denture was too loose. When she told him about this, he said that teeth were supposed to be placed on gums. She disagreed, saying she wanted them to be comfortable so she could chew. She claims he merely stated to her that this was the way they were to fit. He did, however, attempt to adjust both sets over the several times she saw him. Each time she went for an adjustment, Respondent would make some change to the dentures and allegedly said he would get them right even if it took 5 years. However, when he offered to reline the second set of dentures, as he had done to the first set, she refused because she didn't want a reline. She wanted the teeth to be made to fit properly. In all, Dr. Gibney performed 27 adjustments on Mrs. Pollio's dentures. According to Dr. Cadle, it is not routine for a dentist to provide a second set of denture for an unsatisfied patient but it is not unheard of. This fact and the numerous adjustment are, in his opinion, evidence that Respondent was trying to satisfy his patient.

6. By December, 1990, Mrs. Pollio was still complaining to Respondent about the fit of the teeth he had made for her. Respondent claims she wanted a complete partial refund of the amount she had paid. He ultimately offered her a refund of $550.00 if she would sign a release and she decided to think about the offer. When she went back the next day, she claims the office was closed. She later again went to Respondent's office where his assistant, Ginger, handed her a letter terminating the doctor/patient relationship. It was after she received that letter that she agreed to accept the money Respondent had offered but she still refused to sign a release because of the "pain and suffering he had caused her."

   
   

7. Dr. Donald I. Cadle, Jr., a dentist practicing in New Port Richey since 1971, former Chairman of the Board of Dentistry, and an expert in general dentistry, was retained by the Board to evaluate Respondent's performance in this case. He reviewed Respondent's records regarding his treatment of Mrs. Pollio including correspondence and x-rays, and the investigative report rendered herein. He also examined Mrs. Pollio on October 14, 1991 and on the basis of all the above had sufficient information on which to base an opinion of the Respondent's work.

   
   

8. His review of the lab procedure authorization forms presented to him reveals a lack of finish date on many individual forms. This date is required so that the dentist will know when to arrange for the patient to come back for the dentures. He also noted than on several forms the description of the patient and her condition was minimal but probably enough to be acceptable. On one form the Respondent failed to state how he wanted the teeth set in the mold, (occlusion, spacing, etc.). On other forms, Respondent failed to specify the material used and on some, there was no direction as to contour.

   
   

9. As to Respondent's patient records, used to keep all pertinent information regarding a patient in one area, both the statute and the rules say they should include such information as the results and findings of the doctor's initial examination of the patient; a written diagnosis; and a treatment plan. In evaluating Respondent's records relating to Mrs. Pollio, Dr. Cadle found that the treatment notes were adequate as to procedures performed, (what he did in day to day treatment) but that the examination findings and charting of existing conditions were, in his opinion, inadequate. This information would have been determined in the examination at the initial appointment. Respondent's entry is "Denture consult - advised new F/F denture because patient is unable to function with existing F/F denture."

   
   

10. In Dr. Cadle's opinion, the Respondent's entry fails to show detailed examination findings which can be found no place else. Also, he claims, the patient history and the dental history forms are inadequate. There is no evidence shown of sores, irritants or other abnormalities and there should be some explanation in the history as to why the patient checked "yes" to questions asked regarding condition. There should also be a diagnosis which relates to the dental conditions in the patient's mouth. Problems had been identified in Dr. Pikos' records, but these are not diagnoses and Dr. Cadle is of the opinion it is lax practice to accept another dentists observations. Dr. Pikos indicated to Respondent by letter that he had discussed some problems and possible alternatives with Mrs. Pollio and this letter was a part of Respondent's records. Nonetheless, Dr. Cadle felt this was not enough. Respondent also should have discussed all alternatives with her. In rebuttal, Respondent asserts that the use of the term "consult" in the records covers his discussion of implants, adhesives and surgery even though they are not specifically noted.

    He also claims he discussed her pain and other problems when he read the dental history form filled out by Mrs. Pollio's daughter. While it is found that Respondent engaged in the appropriate discussions with Mrs. Pollio, his records do not reflect that and, as such, are inadequate to clearly identify his diagnosis and treatment plan.

    
    

11. Cadle found Respondent's treatment plan acceptable as such but other options which existed should have been discussed with the patient and noted in the records. None were so noted.

    
    

12. Based on his review of all the available records, Dr. Cadle opined that Respondent's records failed to justify his treatment of Mrs. Pollio and did not meet the required standards as to examination findings and diagnosis.

    
    

13. Dr. Cadle examined Mrs. Pollio on October 14, 1991 to evaluate the treatment provided by Respondent and the conditions existing in her mouth. In his report prepared after that examination he noted that the comparison between her old dentures, those she was wearing, and the new ones prepared for her by Respondent, (second set), showed a difference which related to her complaint.

    He found the maxilary portion of those done by Respondent to be inadequate as to the portion of the anterior teeth which were set differently in the old set, and this related to one of her problems. The "F" sound portion was too heavy and the "S" sound caused a slight whistle. The complaint that the anterior teeth were too long related to the way they were set - the inclination of the teeth.

    This gave her the feeling they were too big. All of this was visible in her mouth.

    
    

14. He also believed the mandibular denture was inadequate because of an over-extension of the border. The edge of the denture extended beyond where it should stop. The reason for this was that the soft tissue in the area was attached higher on the ridge than would be expected. This could have been compensated for during the patient examination and diagnosis and noted in the treatment plan. The patient should have been advised of the condition and what its consequences could be. Respondent's records failed to show this was done.

    
    

15. Taken together, Dr. Cadle was of the opinion that the dentures Respondent prepared were inadequate. There were actions he could have taken to correct this. At the initial examination and diagnosis he could have discussed the options available with the patient. Also, after construction of the dentures he could have corrected the maxilary denture by removing and resetting the six front teeth. He also could have reduced the mandibular borders. If that simple procedure had been done, according to Dr. Cadle, it might have resolved the problem. If he had contemplated doing this procedure, however, he would be required to warn Mrs. Pollio that to do it might reduce the strength of the denture and as a result, surgery might become a possibility.

    
    

16. Dr. Cadle could find no evidence in the records that any of this was done except for a discussion toward the end of the doctor/patient relationship, but there was no notation as to what action he could take to correct any but one small part of the problem. None of the previous records showed any discussion of the problem or alternatives discussed.

    
    

17. Based on the above, Dr. Cadle opined that Respondent's treatment of Mrs. Pollio failed to meet the minimum standards of performance as to both the maxillary and mandibular dentures. In that regard, the mental capacity of the patient should not enter into a determination of the standard of care to be provided.

18. Dr. Ronald E. Myers practices dentistry in Spring Hill and is considered an expert in maxillofacial prosthodontics. He, too, reviewed the Respondent's records of his treatment of Mrs. Pollio and formed an opinion of Respondent's performance quite different from that of Dr. Cadle. He agrees with Cadle that Respondent's treatment records were acceptable for the treatment given but he opined, with regard to the lab requests, that there was sufficient data contained thereon to allow the lab technician to do what was required.

    
    

19. A lab order is generally supplemented by either oral or written communications which permit the technician to know what is required. This has to be so since there is no way the dentist can write down all exact specifications on dentures. Here, the Respondent and the lab technician had an understanding of what the Respondent expected in each case as to types of acrylic, the base for the denture, and like matters, unless otherwise indicated. According to Mr. Eidenschink, the technician, he and Respondent had established certain basics as to materials and procedures to be used in all work done for Respondent. On the lab prescription, Respondent would specify what teeth he wanted, and frequently they would speak by phone about specific cases. This is, according to Myers, an accepted procedure. As to the lack of a return date, he admits they are lacking on the copies he saw. Evidence otherwise submitted indicates, however, that the slips examined by both experts, which came from the pad in the dentist's office, were duplicates whereas the original was given to the receptionist who set up a return appointment with the patient before sending that original, with a return date based on that appointment on it, to the lab. A substantial number of original lab slips, furnished by Respondent without objection by counsel for the Board subsequent to the hearing, all clearly reflected a finish date.

    
    

20. As to the Respondent's chart dealing with Mrs. Pollio's existing condition, Dr. Myers admits the notes thereon are somewhat skimpy, but since Dr. Pikos' letter to Respondent indicated he had discussed the potential for surgery with Mrs. Pollio, Gibney could have relied on that. In any event, the diagnosis is there and the treatment plan evident is to fabricate complete new dentures. In his opinion, this is sufficient and meets standards. Based on all the above, Dr. Myers is of the opinion that Respondent's records, taken together, are adequate to meet the legal standards.

    
    

21. Mrs. Pollio's undercut condition in her upper jaw did not contra- indicate full dentures. This condition does not always indicate the need for surgery. Here high tissue attachment in the front lower jaw can interfere with denture placement but a denture could be fabricated around it..

    
    

22. Psychologically, this can be a problem for denture wearers, many of whom, like Mrs. Pollio dislike wearing dentures and yearn for the days when they didn't have them. This being so, and coupled with her testy personality and her apparent inability to clearly comprehend the situation, Mrs. Pollio appears to be a difficult dental patient.

    
    

23. Dr. Myers examined Mrs. Pollio on February 5, 1993. She brought both sets of dentures made for her by Respondent to the examination and was wearing her old dentures. He had her insert both sets of dentures made for her by Respondent and did speech tests and measurements with both. Then he mixed uppers and lowers from the sets in different combinations and when he asked her to give him the first set Respondent made, she gave him the lowers from both sets. Obviously, she was confused and she could not tell which was which from the feel in her mouth.

24. Dr. Myers found the dentures to be made of high quality materials and fabricated to the "pleasure curve" Mrs. Pollio had developed in the old teeth. He did not care for the fit of the first set but this may have been due to the appearance instructions Mrs. Pollio gave to Respondent at that time. He found the second set to be "fine", however - fitting even better than her old set. As to the lower, the anterior flange was overextended into the mouth. This, however, could have been corrected by a minor procedure. Generally, this type of problem can be corrected if the patient and the dentist work together. Here, Myers feels Mrs. Pollio's frustration with the situation precluded this. The teeth were in the proper place, however, and with a possible realignments, they would have fit. Had Mrs. Pollio worked more with Respondent, he could have made them fit.

    
    

25. The fact that Mrs. Pollio would go back to her old dentures from time to time could materially effect the fit of the new dentures because such a practice inhibits tissue adaptation. The current looseness of the dentures is due to tissue damage occurring during the past two years since Mrs. Pollio last saw Respondent.

    
    

26. Dr. Myers is of the opinion that Respondent did all he could to help Mrs. Pollio accommodate to her new dentures. Unfortunately, it appears, she manipulated him. From all the evidence he observed, Dr. Myers also concluded that Respondent treated the patient properly. He is of the opinion that Respondent met community standards in both his dental records and history and the treatment given.

    
    

    CONCLUSIONS OF LAW

    
    

27. The Division of Administrative Hearings has jurisdiction over the parties and the subject matter in this case. Section 120.57(1), Florida Statutes.

    
    

28. In the Administrative Complaint, the Department has alleged that the Respondent has both failed to meet the minimum standards of diagnosis and treatment in his treatment of Mrs. Pollio, in violation of Section 466.028(1)(y), Florida Statutes, and failed to keep written dental records and history justifying the course of treatment he performed on her, in violation of Section 466.028(1)(m).

    
    

29. The statutory provisions cited above outline the statutory grounds for which disciplinary action may be taken against a licensee. Subsection (y) authorizes disciplinary action when a licensee has been 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. Subsection (m) authorizes disciplinary action when a licensee has been guilty of 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.

    
    

30. Petitioner has the burden of proving its allegations of misconduct herein by clear and convincing evidence. Ferris v. Turlington, 510 So.2d 292 (Fla. 1987).

    
    

31. With regard to the allegation of incompetence or negligence, the evidence shows that Mrs. Pollio came to see Respondent for the fabrication of a

    new pair of dentures after several extractions by another dentist, on the recommendation of that dentist. An elderly woman, Mrs. Pollio clearly appeared to be hard to please and the Respondent obviously expended herculean effort in an attempt to satisfy her changing requirements. He made two separate sets of dentures for her and adjusted those he made at least 27 times. She was never satisfied. Though Dr. Cadle was of the opinion the dentures Respondent made were not correct and his efforts were below peer standard, Dr. Myers, a highly skilled and experienced specialist in the area of maxilofacial prosthodontics, who examined the dentures and Mrs. Pollio, opined that Respondent's work was satisfactory and any minor defects could be cured through minimal modifications. Taken together, the evidence fails to clearly and convincing demonstrate that Respondent's treatment of Mrs. Pollio was either incompetent or negligent when measured against generally prevailing peer performance.

    
    

32. The records issue is somewhat different, however. The thrust of Petitioner's argument regarding the inadequacy of Respondent's records of his treatment of Mrs. Pollio relates to three areas: the alleged failure to properly complete the lab slips by which the laboratory technician prepared the appliance ordered; the lack of examination findings and a charting of existing conditions; and the lack of a written diagnosis and treatment plan.

    
    

33. It is clear that the lab slips were properly prepared. The copies made available to the investigator and the Department's experts, which frequently failed to include a finish date, as well as other pertinent matters, were inadequate for the purpose. However, the original copies which were completed before being forwarded to the lab, but which were no longer in Respondent's records, were shown, for overwhelmingly the most part, to have been complete and were acceptable. No violation has been shown.

    
    

34. With regard to the examination findings and charting of existing conditions, or the lack thereof, the situation is not so clear. Dr. Cadle concluded that Respondent's records of examination findings and charting of existing conditions were inadequate. Dr. Myers, on the other hand, opined that the collateral information contained in the letters from Dr. Pikos, his records, and his x-rays, all of which were forwarded to Respondent were part of his records. The records also disclose the existence of certain of Mrs. Pollio's dental complaints and conditions and the medications she was taking. In this regard, it is concluded that again, the evidence does not clearly show a failure to meet standards.

    
    

35. As to the alleged lack of written diagnosis and treatment plan, however, a review of the records clearly shows a paucity of required information. No doubt Respondent knew what he was doing and what had to be done. However, his records do not adequately define with sufficient specificity what he found and what he proposed to do to treat the patient's condition. Even when reviewing the entire chart, the notations as to conditions found and proposed treatment are minimal and inadequate.

    
    

36. In its Proposed Recommended Order, by which Petitioner urges Respondent be found guilty of all alleged misconduct, it seeks to impose an administrative fine of $4,000.00 and a reprimand. Clearly this is excessive in light of the findings and conclusions herein. By this Recommended Order, Respondent has been shown to have been guilty only of a failure to keep proper records as they relate to one of three specified areas and not guilty of incompetence or negligence in treatment. The initiation of this disciplinary action and the convening of this hearing serves to bring to Respondent's attention the requirement to keep and maintain proper records. Little further

    benefit to either the Respondent by way of rehabilitation, or to the Board, would be served by additional severe discipline.

    
    

    RECOMMENDATION

    
    

    Based on the foregoing Findings of Fact and Conclusions of Law, it is, therefore, recommended that a Final Order be entered by the Board of Dentistry finding Respondent, James W. Gibney, D.M.D., not guilty of incompetence or negligence and not guilty of both preparing inadequate work orders and failing to list examination findings and to chart existing conditions in his records, but guilty only of failing to include an adequate written diagnosis and treatment plan in his records, in violation of Section 466.028(1)(m), Florida Statutes. It is further recommended that Respondent be reprimanded.

    
    

    RECOMMENDED this 19th day of April, 1993, in Tallahassee, Florida.

    
    

    
    

    ARNOLD H. POLLOCK

    Hearing Officer

    Division of Administrative Hearings The DeSoto Building

    1230 Apalachee Parkway

    Tallahassee, Florida 32399-1550

    (904) 488-9675

    
    

    Filed with the Clerk of the Division of Administrative Hearings this 19th day of April, 1993.

    
    

    APPENDIX TO RECOMMENDED ORDER

    
    

    The following constitutes my specific rulings pursuant to Section 120.59(2), Florida Statutes, on all of the Proposed Findings of Fact submitted by the parties to this case.

    
    

    FOR THE PETITIONER:

    
    

    1. Accepted and incorporated herein.

    2. & 3. Accepted and incorporated herein.

1. & 5. Accepted and incorporated herein.

   1. Accepted but dissatisfaction basis is as alleged by Mrs. Pollio.

   2. Accepted and incorporated herein.

   3. Accepted as claimed by Mrs. Pollio.

   4. Accepted.

   5. Accepted.

   6. Rejected as not proven by clear and convincing evidence.

   7. Accepted and incorporated herein.

   8. Rejected as not proven by clear and convincing evidence.

   9. Accepted in part and rejected in part.

FOR THE RESPONDENT:

No Proposed Findings of Fact submitted by Respondent.

COPIES FURNISHED:

Albert Peacock, Esquire Department of Professional

Regulation

1940 North Monroe Street Tallahassee, Florida 32399-0792

Louis Kwall, Esquire

133 N. Ft. Harrison Avenue Clearwater, Florida 34615

Jack McRay General Counsel

Department of Professional Regulation

1940 North Monroe Street Tallahassee, Florida 32399-0792

William Buckhalt Executive Director Board of Dentistry

1940 North Monroe Street Tallahassee, Florida 32399-0792

NOTICE OF RIGHT TO SUBMIT EXCEPTIONS

All parties have the right to submit written exceptions to this Recommended Order. All agencies allow each party at least 10 days in which to submit written exceptions. Some agencies allow a larger period within which to submit written exceptions. You should consult with the agency which will issue the Final Order in this case concerning its rules on the deadline for filing exceptions to this Recommended Order. Any exceptions to this Recommended Order should be filed with the agency which will issue the Final Order in this case.

=================================================================

AGENCY FINAL ORDER

=================================================================

STATE OF FLORIDA

DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION

BOARD OF DENTISTRY

DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION,

Petitioner,

DBPR CASE NO. 91-05315

vs. DOAH CASE NO. 92-6161

LICENSE NO. DN0010500

JAMES W. GIBNEY, D.M.D.

Respondent.

/

FINAL ORDER

THIS MATTER was heard by the Board of Dentistry (hereinafter Board) pursuant to Section 120.57(1)(b)10., Florida Statutes, on June 18, 1993, in Naples, Florida, for consideration of the Hearing Officer's Recommended Order (a copy of which is attached) in the case of Department of Business and Professional Regulation v. James W. Gibney, D.M.D. At the hearing before the Board, Petitioner was represented by Nancy M. Snurkowski, Chief Attorney.

Respondent appeared before the Board and was represented by Louis Kwall, Attorney at Lab. Upon consideration of the Hearing Officer's Recommended Order after review of the complete record and having been otherwise fully advised in its Premises the Board makes the following rulings, findings and conclusions:

RULINGS ON EXCEPTIONS

Pursuant to Rules 21G-1.026 and 28-5.404, Florida Administrative Code, Petitioner timely filed exception to the Hearing Officer's Recommended Order. Although these exceptions were individually numbered 1-14, they were each directed at the Hearing Officer's recommendation that the Findings of Fact clearly and convincingly establish a violation of Section 466.028(1)(m), Florida Statutes. After receiving the arguments of the parties, the Board voted to accept Petitioner's exception and to reject paragraph 35 of the Hearing Officer's Recommended Order. In so doing, the Board does not reject any recommended findings of fact determined by the Hearing Officer. The-Board merely finds that as viewed with its expertise in the area of dental records and practice, these findings do not clearly and convincingly establish a violation of Section 466.028(1)(m), Florida Statutes.

FINDINGS OF FACT

1. The Hearing Officer's Recommended Findings of Fact are approved and adopted and are incorporated herein by reference without exception.

2. There is competent, substantial evidence to support the Boards findings herein.

CONCLUSIONS OF LAW

1. The Board has jurisdiction over the parties and subject matter of this case pursuant to Section 120.57 and Chapter 466, Florida Statutes.

   
   

2. The findings of fact set forth above do not establish that Respondent has violated Section 466.028(1)(in) or (y), Florida Statutes, as charged in the administrative complaint.

DISPOSITION

In light of the foregoing Findings of Fact and Conclusions of Law the Board hereby determines that pursuant to Rule 2IG- 13.005(3), Florida Administrative Code, the penalty recommended by the Hearing Officer is not appropriate as set forth in the Recommended Order.

WHEREFORE, it is found, ordered, and adjudged that the Respondent has not violated Section 466.028(1)(m) or (y), Florida Statutes and Respondent shall have this matter DISMISSED.

This Final Order becomes effective upon its filing with the Clerk of the Department of Business and Professional Regulation.

NOTICE

The parties are hereby notified pursuant to Section 120.59(4), Florida Statutes, that an appeal of this Final Order may be taken pursuant to Section 120.68, Florida Statutes, by filing one copy of a Notice of Appeal with the Clerk of the Department of Business and Professional Regulation and one copy of a Notice of Appeal with the required filing fee with the District Court of Appeal within thirty (30) days of the date this Final Order is filed.

DONE and ORDERED this 11th day of August, 1993.

BOARD OF DENTISTRY

EDWARD R. SCOTT, III, D.M.D. CHAIRMAN

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of the foregoing Final Order and its attachments have been forwarded by U.S. Mail to Edward R. Scott, III,

D.M.D. and to James W. Gibney, D.M.D. c/o Louis Kwall) 133 North Fort Harrison Avenue, Clearwater, Florida 34615, Hearing Officer, Division of Administrative Hearings, The DeSoto Building, 1230 Apalachee Parkway, Tallahassee, Florida 32399-1550, and by hand delivery to Arnold H. Pollock, Nancy M. Snurkowski, Chief Attorney, Department of Business and Professional Regulation, 1940 North Monroe Street, Tallahassee, Florida 32399-0792 on this 11th day of August, 1993.

Docket for Case No: 92-006161

Orders for Case No: 92-006161