STATE ¢ % Z DEPARTMENT OF s | | %y% 2 %D ee EEE, % . OG "t, ects hE ake SET La t Picks 2 I DEPARTMENT OF HEALTH, “toe @ IL Petitioner, 0O-/S/l < Vs. CASE NO. 1998-11737 IRWIN BERGMAN, Respondent. / ADMINISTRATIVE ‘COMPLAINT COMES NOW, the Petitioner, Department of Health, hereinafter referred to as "Petitioner," and files this Administrative .Complaint before the Board of Dentistry against Irwin Bergman, hereinafter referred to as "Respondent," and alleges: 1. Petitioner is the state agency charged with regulating the practice of dentistry pursuant to Section: 20.43, Florida Statutes; Chapter 455, Plorida Statutes; and “Chapter 466, Florida Statutes. 2. Pursuant to the authority of Section 20.43(3) (9), ‘Florida Statutes, the Petitioner has contracted with the Agency for Health Care Administration, hereinafter referred to as the "Agency," to provide consumer complaint, investigative, and prosecutorial services required by the EXHIBIT _A_ we v) Division of Medical Quality Assurance, councils or board, as appropriate, including the issuance of emergency orders of suspension or restriction. 3. Respondent is, and has been at all times material hereto, a licensed dentist in the State of Florida, having been issued license number DN 0007539. Respondent’s last known address is 957 Southeast Mayo Drive, Crystal River, Florida 34429, 4. In or around April 1997, the Board of Dentistry entered a Final Order in case number 93-20548 against the license to practice dentistry of the Respondent. 5. The Final Order entered in or around April, 1997, required the Respondent to submit to a psychiatric evaluation as recommended by the Physician’s Recovery Network (hereinafter referred to as “PRN”) and comply with any recommended treatment. . 6. In or around September 1997, the Director of PRN, Dr. Roger A. Goetz, M.D., opined in a letter to the Board of Dentistry that based upon the psychiatric evaluations obtained, he “recommended that. the “Board require br. Bergman to enter into a PRN Psychiatric Monitoring Contract.” 7. Subsequently, a Psychiatric Monitoring Contract was forwarded to the Respondent by PRN. wo 8. The Respondent failed to respond to the i Psychiatric Monitoring Contract or subsequent telephone calls and letters of PRN. 9, As of April 15, 1999, the Respondent has failed to comply with the Final Order of the Board of Dentistry entered on April 1, 1997 and enter into a Psychiatric Monitoring Contract with PRN. 10. Based on the foregoing, the Respondent's license to Practice dentistry in the State of Florida is subject to discipline for violating Section 466. 028 (1) (aa), Florida Statutes, for the violation or the repeated violation of Chapter 466, Florida Statutes, Chapter 455, Florida Statues, or any rule promulgated pursuant to Chapter 455 or 466, Florida Statutes, 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. ewrrerirsene one WY WHEREFORE, Petitioner respectfully requests the Board of Dentistry enter an Order imposing one or more of the following penalties: revocation or suspension of the Respondent’ s license, restriction of the Respondent‘ s practice, imposition of an administrative fine, issuance of a reprimand, placement of the Respondent on probation, and/or any other relief that the Board deems appropriate. SIGNED this)(chiay of YOY , 1999, Robert G. Brooks, M.D. Secretary, Department of Health : Nancy M. Snurkowski Chief Attorney FILED DEPARTMENT OF KEALTH .COUNSEL FOR AGENCY: EPUTY CLERK gory W. Files Lo CLERK Q. a Contract Counsel DATE “27°59 Agency for Health Care ‘Administration ’. General Counsel's Office - MQA “Allied Health P.O. Box 14229 ‘Tallahassee, — Florida 323174229 (850) 414 1981 -— GWE/ pcr: FG, CR, PP “DATE: va is -Qq cee ce aprcmmeneme se ee aes es SO OC MMR eRe ewe SF rmRMIE Pa ore =

Docket for Case No: 00-001516