Jul 25 2006 17:27 JUL-25-2086 17:43 AHCA P.@2/38 ; a STATE OF FLORIDA S DEPARTMENT OF HEALTH ae o —) DEPARTMENT OF HEALTH, a PETITIONER, Vv. CASE NO. 2006-08808 EDWARD WALTERS, 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, Edward Walters, 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 7036. Jul 25 2006 17:28 JUL-25-2886 17:43 AHCA P4338 3. Respondent’s address of record is 8351 West Atlantic Boulevard, Coral Springs, Florida 33071-7452. 4. At all times material to this Complaint, Respondent operated a . dental practice at 8351 West Atlantic Boulevard, Coral Springs, Florida 33071-7452. 5. At all times material to this Complaint, Respondent employed personnel to treat or assist in the treatment of patients who presented to the Respondent’s dental practice for caré and treatment. As an employer, the Respondent was responsible for the duties of an employer, an owner, a supervisor, attending dentist or senior attending dentist. 6. In his capacity of an employer, an owner, a supervisor, or a senior attending dentist, the Respondent was responsible for the treatment of patients rendered by him or by those who worked within the dental practice. 7. At all times material to this Complaint, Dr. S. was a licensed dentist within the State of Florida. 8. At all times material to this Complaint, Dr 5. was a contract dentist working within the Respondent's practice, authorized to use dental equipment, office personnel and emergency equipment. as necessary in the DOH v Edward Walters, 0.0.5. Page 2 Case no. 2006-08808 JAPSU\Medical\Brad Chrialy\Wallers (death) 2006-08808 6,15.2006\Wallers AC (#)((2)(II) 2006-08808 DRAFT 4 6,28.2006.dec Jul 25 2006 17:28 JUL-25-2886 17:43 AHCA treatment of patients presenting for dental treatment at the Respondent's dental practice. 9, Ms. M.R was an employee of the Respondent and in attendance during the care and treatment of Patient D.W. on or about March 21, 2006. 10. Ms R.C. was an employee of the Respondent and in attendance during the care and treatment of Patient D.W. on or about March 21, 2006. 11. On or about March 21, 2006, Patient D.W. was a 10 year old dental patient with an extensive medical history, to include Treacher Collins Syndrome. Treacher Collins Syndrome affects the head and face of children, causing in some cases significant deformities. In addition to the physical characteristics common to the syndrome, breathing problems and eating difficulties may commonly occur. Additionally, Patient D.W. had a tracheotomy tube placed since birth until approximately one to two months prior to the March 21, 2006, dental treatment in this case. 12. The Respondent was aware of Patient D.W’s medical history and had treated Patient D.W. on a number of occasions prior to treatment on or about March 21, 2006. DOH v Edward Walters, 0.0.5. Page 3 Case no. 2006-08808 JAPSU\Medical\Brad Chrisly\Walters (daath) 2006-08808 6.15.2006\Wallers AC (x)(Hi){z)(HI) 2006-08008 DRAFT 4 6,28.2006.doc Jul 25 2006 17:28 JUL-25-2686 17:44 AHCA P.@5/38 13. On or about March 21, 2006, Patient D.W. presented to Respondent's office for dental treatment, consisting of the extraction of her tooth number 30. Respondent either arranged for, caused to be arranged or established office procedure criteria that permitted the assignment. of Patient D.W. to Dr. S. for treatment on this date. Therefore, Patient D.W. was initially evaluated and treated by Dr S, a contract dentist working within Respondent’s practice. During that treatment, Patient D.W. experienced medical distress and subsequently died during the dental treatment procedure. 14. On or about March 21, 2006, Dr. S. commenced treatment on Patient D.W. According to a statement provided by Dr. S., Patient D.W. was not pre-medicated. Dr. S. asserts that lidocaine with epinephrine and nitrous oxide were administered to Patient D.W. in the course of preparing her for treatment. Further, Patient D.W. was restrained on a “papoose board,” A “papoose board” is considered a means of restricting the movement of a patient during dental treatment. The employment of the “papoose board” in this case permitted the moderate restriction of a patient's mobility, including movement of hands, arms and head with appropriately positioned straps and DOH v Edward Walters, D.D.5. . Page 4 Case no. 2006-08808 JAPSU\MedicalBrad Christy\Wallers (death) 2006-08808 6.15,2006Wallars AC. (x)(H)(2)(I) 2008-08808 DRAFT 4 6,28.2008.dag Jul 25 2006 17:29 JUL-25-2886 17:44 AHCA P.@6/38 similar devices. Additionally, Patient D.W. was also wearing a blood pressure cuff and a pulse oximeter. | 15. The combined statements and investigation in this case reveal that the following events occurred: a) Patient D.W. presented for a tooth extraction; b) Dr S. administered lidocaine with epinephrine, and nitrous oxide; c) During the proceeding, Patient D.W. went into meciical distress; her breathing became shallow and her oxygen saturation dropped; d) At that time, Dr. S. obtained or caused another person to obtain the Respondent’s presence and assistance within the treatment room in which Patient D.W. was being treated by Dr. S. and others; e) Subsequent to being summoned, the Respondent did enter the treatment room in which Patient D.W. was being treated. The Respondent, shortly after entering the treatment room, cid treat Patient D.W.; DOH v Edward Walters, D.D.S. Page § Case ho. 2006-08808 . JAPSU\MadicallBrad Christy\Walters (death) 2006-08808 6.15,2006\Walters AC (x)((I){z)(II) 2006-08808 DRAFT 4 6.28.2006.doc JUL-25-2686 17:44 g) h) Jul 25 2006 17:29 AHCA When the Respondent first examined Patient D.W., her breath was shallow, and her oxygen saturation was low. The Respondent completed the extraction of the tooth, which had apparently been initiated or started but not completed by Dr S., and had done so apparently to prevent aspiration of that tooth; At an unspecified point, Patient D.W. stopped breathing altogether, and had no pulse; Neither Dr. S. nor the Respondent administered Cardio Pulmonary Resuscitation (CPR) to Patient D.W. or rendered other appropriate emergency intervention to restore Patient D.W’s breathing or pulse: and During these events emergency number 911 was called, and the paramedics arrived on the scene shortly thereafter. On the paramedic’s arrival, Patient D.W, was noted to have no breath or pulse, and the attending paramedics attempted resuscitation. The paramedics noted that, on their arrival, neither the Respondent nor Dr. S. was engaged in CPR or other emergency DOH v Edward Walters, D.D.S. Case no. 2006-08808 JAPSU\MedicahBtad Christy\Walters (death) 2006-08808 6.15.2006\Wallers AC (x) (2)(t) 2006-08608 DRAFT 4 68.28.2008. doe Page 6 Jul 25 2006 17:29 JUL-25-2886 17:45 AHCA measures. Patient D.W. was transported to a hospital, where she was pronounced dead. 16. Dr S. and or other personnel attending Patient D.W. on or about March 21, 2006, may have administered medications during the course of Patient D.W.'s dental treatment, 17. Respondent lacked the appropriate training and experience to provide treatment to Patient D.W. 18. Respondent failed to render or provide appropriate emergency medical aid and/or care to Patient D.W. on or about March 21, 2006. 19. Respondent delegated treatment of Patient D.W. to Dr. 5. who - the Respondent knew or should have known was not qualified by either training and/or experience to attend to a patient with the needs demonstrated by Patient D.W. on or about and before March 21, 2006. 20, Respondent lacked the appropriate training and experience to properly operate and monitor various items of medical equipment used in the care and treatment of Patient D.W. on or about March 21, 2006 to include the criticare noninvasive monitor (to monitor blood pressure, heart rate and oxygen saturation), and the nitrous oxide analgesia system or machine (also referred to as a nitrous oxide/oxygen machine). ° DOH v Edward Walters, D.D.S. Page 7 Case no. 2006-08808 JAPSUAMadicaliBrad Christy\Waltars (death) 2008-08808 6.18.2006\Wallers AC (x)(F)(z)(N) 2006-08808 DRAFT 4 6.28.2006.doc - Jul 25 2006 17:30 JUL-25-2886 17:45 AHCA P. 8938 Be 21, Respondent failed to properly supervise and direct Dr. S. Ms, ME, Ms. RC and/or others on his staff to assure timely and effective emergency treatment was provided Patient D.W. on or about March 21, 2006. 22, Respondent failed to meet the minimum standards of performance in diagnosis and treatment when measured against generally prevailing peer performance in one or more of the following ways: Respondent failed to recognize Patient D.W. was experiencing serious, life threatening medical distress upon entering the treatment room where Patient D.W. was being treated; Respondent failed to administer CPR or render other appropriate emergency intervention to Patient D.W.; and Respondent failed to exercise his responsibility as the senior dentist in the treatment room and direct other employees and Dr S. to render appropriate emergency aid to Patient D.W. 23. The minimum standards of performance in diagnosis and treatment when measured against generally prevailing peer performance is that a dentist treating or attending a patient must assure that medical “treatment performed on a patient is appropriate for the patient’s general medical as well as dental condition. In that regard, the dentist must DOH v Edward Walters, D.D.S. Page 8 Case no. 2006-08808 JAPSU\MedicahBrad Christy\Walters (death) 2006-08808 6.15.2006\Walters AC (x)(H)(z)(II) 2006-08808 DRAFT 4 6,28.2006.doc Jul 25 2006 17:30 JUL-25-2006 17:45 AHCA Plea assure that sedation and/or local anesthetics are administered in appropriate levels and quantities so as not to complicate or contribute to the patient’s medical distress or condition, The dentist must also assure that a patient's breathing and vital signs are properly monitored and when the patient ceases breathing or indicates serious respiratory distress, the dentist must administer appropriate emergency medical treatment to include the administration of CPR at the first signs of emergency and prior to continuing any additional dental treatment. Respondent failed to meet the minimum standards of performance in diagnosis and treatment in the treatment of Patient D.W, 24. Respondent failed to meet the minimum standards of performance in operating or causing to be operated a dental office when measured against generally prevailing peer performance in one or more of the following ways: Respondent failed to assure appropriate emergency procedures were in place to provide immediate emergency aid to a patient under the dentist’s care, or the care of one for whom the dentist is responsible, when that patient is in or demonstrates signs of life threatening medical distress; Respondent's employees failed to provide appropriate emergency aid to a patient under their care when that patient DOH v Edward Walters, D.D.S, Page 9 Case no. 2006-08808 JAPSU\MadicalBrad Christy\Walters (death) 2006-08808 6.15.2006\Wallars AC (x)(I1}(z)(I) 2006-08808 DRAFT 4 6.28.2006.doc Jul 25 2006 17:30 JUL-25-2886 17:46 AHCA P.11/38 demonstrated signs of life threatening medical distress; Respondent failed to assure employees responsible for the care and treatment of patients within the Respondent's dental practice were properly skilled with the use, operation and management of life support systems employed in the care and treatment of patients; Respondent failed to establish procedures and training within his dental practice to assure that a patient’s breathing and vital signs (in this case Patient D.W.s) are properly monitored and that when a patient ceases breathing or indicates serious respiratory distress, the attending dentist and/or appropriate office personnel must administer appropriate emergency medical treatment to include the administration of CPR at the first signs of emergency and prior to continuing any additional dental treatment; and Patient D.W., a dental patient under the care of one or more persons under the Respondent's supervision, died as a result of inadequate dental, medical and emergency treatment rendered at the Respondent's practice. 25. The minimum standards of performance in diagnosis and treatment when measured against generally prevailing peer performance is that an owning or supervising dentist must supervise, and administer a dental office for which s/he is responsible in such a manner as to assure that the DOH v Edward Walters, D.D,5, Page 10 Case no. 2006-08808 JAPSU\Medical\Brad Christy\Wallers (death) 2006-08808 6.15,2006\Wallers AG (x}({i](z)(lI) 2006-08808 DRAFT 4 6.26.2006.doc Jul 25 2006 17:31 JUL-25-2886 17:46 AHCA P. 12/38 dental office procedures, all duties and responsibilities performed by employees of that office as well as the dentist’s own professional performance permits the dental office to be operated in such a manner as to result in the administration and delivery of dental treatment that meets the acceptable standards of performance in diagnosis and treatment for the community. Respondent delegated the care and treatment of Patient D.W.,, who suffered | with serious medical problems known to the Respondent, to Dr S. who was not qualified by training or experience to provide treatment to such a patient unsupervised; and Respondent delegated the emergency care and treatment - of Patient D.W., who suffered with serious medical problems known to the Respondent, to his staff who was not qualified by training or experience to provide treatment to such a patient unsupervised. 26. The minimum standards of performance in diagnosis and treatment when measured against generally prevailing peer performance is that an owning or supervising dentist may only delegate professional responsibilities to a person who is qualified by training, experience or licensure to perform them. 27. The Respondent failed to meet the minimum standards of performance in diagnosis and treatment when measured against generally DOH v Edward Walters, D.0.5. Page 11 Case no. 2006-08808 JAPSU\MedicaBrad Chrisly\Waltars (dealh) 2006-08808 6.15.2006\Wallers AC (x)(#)(z){II) 2006-08808 DRAFT 4 8.28.2006.doc Jul 25 2006 17:31 JUL-25-2886 17:47 AHCA P.13/38 prevailing peer performance, by 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; being guilty of dental malpractice in that Respondent failed to recognize the need for and render emergency aid to Patient D.W. when treating Patient DW; delegating professional responsibilities for treatment and care of Patient D.W. to Dr. S. who the Respondent should have known was not qualified by training or experience to perform these responsibilities. Specifically permitting Dr S. to administer anesthesia and similar substances to Patient D.W. who suffered with serious medical problems known to the Respondent; and Respondent failed to properly exercise his responsibility and his duty of an employer, an owner, supervisor or attending dentist to assure that Patient D.W. received dental treatment meeting the minimum acceptable standards of performance in the community. 28. The minimum standards of performance in diagnosis and treatment when measured against generally prevailing peer performance is that a dentist must conduct his/her treatment and the treatment of those for whom he is responsible in such a manner as not to violate any DOH v Edward Walters, D.D,S. Page 12 Case no. 2006-08808 JAPSU\Madicallerad Christy\Walters (dealh) 2006-08808 6,15.2006\Wallers AC (xH)(z)(ll) 2006-08808 DRAFT 4 6.28.2006.doc Jul 25 2006 17:31 JUL-25-2686 17:4? AHCA P.14/38 provision of Chapters 466, or 456, Florida Statutes or any rules adopted pursuant thereto. 29, The Respondent failed to assure or establish office procedures to assure that written dental records and required medical history records justifying the course of treatment of Patient D.W. were appropriately observed and entered in Patient D.W.s record by failing to meet one or more of the following requirements: a) By failing to include the patient's current written medical history, including known allergies, history of previous surgery and anesthesia, and the patient’s age, weight, and calculation of maximum allowable local anesthesia; b) By failing to include physical and risk assessment (e.g., ASA classification); c) By failing to include a signed informed consent for the use of the “papoose board” during treatment of Patient D.W.; and/or DOH v Edward Walters, D.D.5. Page 13 Case no. 2006-08808 \PSUAMedicalBrad Christy\Walters (death) 2006-08808 6,15.2006\Wallers AC (x)(If)(z)(Il) 2006-08808 DAAFT 4 6.28.2006.doc Jul 25 2006 17:32 JUL-25-2886 17:4? AHCA P.15/38 d) By failing to include a signed informed consent for the use of nitrous oxide/oxygen in treatment. of Patient D.W. 30. The minimum standards of performance in diagnosis and treatment when measured against generally prevailing peer performance require that a dentist maintain the following information in the patient's treatment records: a) The patient’s current written medical history, including ‘known allergies, history of previous surgery and anesthesia, and the patient's age, weight, and calculation of maximum allowable local anesthesia; and b) Physical and risk assessment (e.g., ASA classification). Additionally, appropriate signed and dated informed consents are required for procedures regarding treatment to include the administration of nitrous oxide/oxygen and the employment of a “papoose board” in treatment of the patient. DOH v Edward Walters, D.D.S. Page 14 Case no, 2006-08808 JAPSUMedicalBrad Christy\Walters (death) 2006-08808 6.15.2006\Walters AC (x)(H)(z){Il) 2006-08808 DRAFT 4 6.28.2006.doe Jul 25 2006 17:32 JUL-25-2886 17:48 AHCA P.16/38 COUNTI 31. Petitioner realleges and incorporates paragraphs one (1) through thirty (30) as if fully set forth herein. 32. Section 466.028(1)(x), Florida Statutes (2005), provides that being quilty 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 constitutes grounds for disciplinary action by the Board of Dentistry. 33. Respondent failed to meet the minimum standards of performance in diagnosis and treatment when measured against generally prevailing peer performance in one or more of the following ways: a) Respondent failed to recognize Patient D.W. was experiencing serious, life threatening medical distress upon entering the treatment room where Patient D.W, was being treated; DOH v Edward Walters, D.D.S. Page 15 Case no. 2006-08808 JAPSU\MedicahBrad Chrisly\Walters (death) 2006-08808 6.15.2006\Walters AC (x)(f1)(z)(II) 2006-08808 DRAFT 4 6.28.2008.doc Jul 25 2006 17:33 JUL-25-2886 17:48 AHCA P. 17/38 b) Respondent failed to administer CPR or render other appropriate emergency intervention to Patient D.W.; and c) Respondent failed to exercise his responsibility as the senior dentist in the treatment room and direct other employees and Dr. S. to render appropriate emergency aid to Patient D.W. 34. Based on the foregoing, Respondent has violated Section 466.028(1)(x), Florida Statutes (2005), by 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, COUNT II 35. Petitioner realleges and incorporates paragraphs one (1) through thirty (30) as if fully set forth herein. 36. Section 466.028(1)(ff), Florida Statutes (2005), provides that being guilty of operating or causing to be operated a dental office in such a manner as to result in dental treatment that is below minimum acceptable standards of performance for the community. This includes, DOH v Edward Walters, D.D,S, Page 16 Case no. 2006-08808 JAPSU\Madiealrad Christy\Walters (death) 2006-08808 6,15.2006\Walters AC (x)(FA(2)() 2006-08808 DRAFT 4 6.28 2008.doe JUL-25-2886 17:48 but is not limited to, the use of substandard materials or equipment, the imposition of time limitations within which dental procedures are to be performed, or the failure to maintain patient records as required by Chapter 466, Florida Statutes constitutes grounds for disciplinary action by Jul 25 2006 17:33 AHCA the Board of Dentistry. 37. Respondent failed to meet the minimum standards of performance in operating or causing to be operated a dental office when measured against generally prevailing peer performance in one or more of the following ways: a) b) Respondent failed to assure appropriate emergency procedures were in place to provide immediate emergency aid to a patient under the dentist's care or the care of one for whom the dentist is responsible, when that patient is in or demonstrates signs of life threatening medical distress; Respondent's employees failed to provide appropriate emergency aid to a patient under their care when that patient demonstrated signs of life threatening medical distress; DOH v Edward Walters, D.D.S. Case no. 2006-08808 JAPSU\MedicahBrad Chilsty\Walters (death) 2006-08808 6.15.2006\Wallers AC (x)(fiX2){lI) 2008-08808 DRAFT 4 6.28.2008.doc P.18/38 Page 17 Jul 25 2006 17:33 JUL-25-2686 17:49 AHCA P.19/38 c) Respondent failed to assure employees responsible for the care and treatment of patients within the Respondent's dental practice were properly skilled with the use, operation and management of life support systems employed in the care and treatment of patients; d) Respondent failed to establish procedures and training within his dental practice to assure that a patient’s breathing and vital signs (in this case Patient D.W’s) are properly monitored and that when a patient ceases breathing or indicates serious respiratory distress, the attending dentist and/or appropriate office personnel must administer appropriate emergency medical treatment to include the administration of CPR at the first signs of emergency and prior fo continuing any additional dental treatment; and e) Patient D.W., a dental patient under the care of one or more persons under the Respondent’s supervision, DOH v Edward Watters, D.D.S. Case no. 2006-08808 JAPSU\Medical\Brad Christy\Walters (dealh) 2006-08808 6.15.200G\Walters AC (x)(f1)(z)(Il) 20068-08808 DRAFT 4 6.28.2008.do0 Page 18 Jul 25 2006 17:34 JUL-25-2886 17:49 AHCA P. 28/34 died as a result of inadequate dental, medical and emergency treatment rendered at the Respondent's practice. 38. Based on the foregoing, Respondent has violated Section 466.028(1)(ff), Florida Statutes (2005), by being guilty of Operating or causing to be operated a dental office in such a manner as to result in dental treatment that is below minimum acceptable standards of performance for the community. COUNT II 39. Petitioner realleges and incorporates paragraphs one (1) through thirty (30) as if fully set forth herein. 40. Section 466.028(1)(z), Florida Statutes (2005), provides that being guilty of delegating professional responsibilities to a person who is not qualified by training, experience, or licensure to perform them constitutes grounds for disciplinary action by the Board of Dentistry. 41. Section 466.024(5), Florida Statutes (2005), provides that — notwithstanding any other provision of law, a dentist is primarily responsible for all procedures delegated by her or him. DOH v Edward Walters, D.D.S. Page 19 Case no. 2006-08808 JAPSUMedical\Brad Chrisly\Walters (daath) 2006-08808 6.15.2006\Walters AC: (x}({1)(z)(II) 2006-08808 DRAFT 4 6.28.2006.doc JUL-25-2886 17:49 42. Respondent failed to meet the minimum standards of performance in delegating professional responsibilities in one or more of Jul 25 2006 17:34 AHCA the following ways: a) b) 43. Based on the foregoing, Respondent has violated Section 466.028(1)(z), Florida Statutes (2005), by being guilty of delegating professional responsibilities to a person who is not qualified by training, Respondent delegated the care and treatment of Patient D.W., who suffered with serious medical problems known to the Respondent, to Dr S. who was not qualified by training or experience to provide treatment to such a patient unsupervised; and Respondent delegated the emergency care and treatment of Patient D.W., who suffered with serious medical problems known to the Respondent, to his staff who was not qualified by training or experience to provide treatment to such a patient unsupervised. experience, or licensure to perform them. DOH v Edward Walters, D.D.5. Case na. 2006-08808 JAPSU\Medical\Brad Ghristy\Walters (dealh) 2006-8808 6,15.2006\Waltars AC (x)(If){z\(ll) 2008-08808 DAAFT 4 6.28.2006.doc Page 20 P.2i/38 Jul 25 2006 17:34 JUL-25-2886 17:58 AHCA P2273 COUNT IV 44, Petitioner realleges and incorporates paragraphs one (1) through thirty (30) as if fully set forth herein. 45. Section 466.028(1}(Il), Florida Statutes (2005), provides that being guilty of violating any provision of Chapters 466 or 456, Florida Statutes or any rules adopted pursuant thereto constitutes grounds for disciplinary action by the Board of Dentistry. 46. Respondent violated provisions of Chapters 466 or 456, Florida Statutes or any rules adopted pursuant thereto in one or more of the following ways: a) 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: DOH v Edward Walters, D.D,5, Page 21 Case no. 2006-08808 JAPSU\MedicaliBrad Christy\Walters (death) 2006-08808 6.15.2006\Walters AC (x)(lt)(z)(ll) 2006-08808 DRAFT 4 6.28.2006.oc Jul 25 2006 17:35 JUL-25-2886 17:58 AHCA P.23/34 b) Being guilty of dental malpractice in that Respondent failed to recognize the need for and render emergency aid to Patient D.W. when treating Patient D.W.; c) Delegating professional responsibilities for treatment and care of Patient D.W. to Dr. S. who the Respondent should have known was not qualified by training or experience to perform these responsibilities. Specifically permitting Dr S. to administer anesthesia and similar substances to Patient D.W. who suffered with serious medical problems known to the Respondent; and d) Respondent failed to properly exercise his responsibility and his duty of an employer, an owner, supervisor or attending dentist to’ assure that Patient D.W. received dental treatment meeting the minimum acceptable standards of performance in the community. DOH v Edward Walters, D,D.S, Page 22 Case no. 2006-08808 JAPSU\MedicahBred Christy\Walters (daath) 2006-08808 6.15.2006\Wallers AC (x)(If\(z\(II) 2006-03408 DRAFT 4 6.28.2006.dac Jul 25 2006 17:35 JUL-25-2886 17:58 AHCA P.24/34 COUNT V 47, Petitioner realleges and incorporates paragraphs one (1) . through thirty (30) as if fully set forth herein. 48. Section 466.028(1)(ff), Florida Statutes (2005), provides being guilty of operating or causing to be operated a dental office in such a manner as to result in dental treatment that is below minimum acceptable standards of performance for the community. This includes, but is not limited to, the use of substandard materials or equipment, the imposition of time limitations within which dental procedures are to be performed, or the failure to maintain patient records as required by Chapter 466, Florida Statutes constitutes grounds for disciplinary action by the Board of Dentistry. 49. Section 466.028(1)(m), Florida Statutes (2005), provides 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, constitutes grounds for disciplinary action by the Board of Dentistry. DOH v Edward Walters, D.D.S. Page 23 Case no. 2006-08808 J\PSU\Medical\Brad Christy\Wallers (death) 2006-08808 6.15.2006\Walters AC (x)(H)(z)\{l) 2006-08808 DRAFT 4 6.28,2006.doe Jul 25 2006 17:35 JUL-25-2886 17:51 AHCA P.2538 50. Rule 64B5-17.002(b), Florida Administrative Code, provides that for the purpose of implementing the provisions of Section 466.028(1)(m), Florida Statutes, a dentist shall maintain written records on each patient which written records shall contain the results of clinical examination of the _patient and tests conducted, including the identification, or lack thereof, of any oral pathology or diseases. 51. Respondent failed to assure or establish office procedures to assure that written dental records and required medical history records justifying the course of treatment of Patient D.W. were kept in that one or more of the following requirements was not appropriately observed and entered in Patient D.W.’s record: a) The patient's current written medical history, including known allergies, history of previous surgery and anesthesia, and the patient's age, weight, and calculation of maximum allowable local anesthesia; b) Physical and risk assessment (eg. ASA classification); DOH v Edward Walters, D.D.S. Page 24 Case no. 2006-08808 JAPSU\MadicalBrad Christy\walters (death) 2006-08808 6,15.2006\Wallars AC (x)(M)(z)(II) 2006-08808 DRAFT 4 6.28,2006.doc Jul 25 2006 17:36 JUL-25-2686 17:51 AHCA P. 2638 c) Signed informed consent for the use of the “papoose board” during treatment of Patient D.W.; and d) Signed informed consent for the use of nitrous oxide/oxygen in treatment of Patient D.W. 52. Based on the foregoing, Respondent has violated) Section 466.028(1)(ff), Florida Statutes (2005), by being guilty of Operating or causing to be operated a dental office in such a manner as to result in dental treatment that is below minimum acceptable standards of performance for the community. WHEREFORE, Petitioner respectfully requests that the Board of Dentistry enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent's license, 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 relief that the Board deems appropriate, DOH v Edward Walters, D.D.S. Page 25 Case no. 2006-08808 JAPSU\MedicalBrad Christy\Walters (death) 2006-08808 6.15.2006\Waltars AC (x)(I(2)(Il) 2006-08808 DRAFT 4 6.28.2006,doc Jul 25 2006 17:36 JUL-25-2686 17°51 AHCA P.27/a St / SIGNED this <> 7 day of © Agere , 2006. M. Rony Francois, M.D., M.S.P.H,, Ph.D Secretany Ds Department of Health PELs Lo ORPARTMWENT GF HEALTH. DEPUTY CLERK cue Aion. Mel paTE __(e-30- 06 . EBC Pcp: 6/2 4/16 PCP Members: ¢ 47 WA TT DOH v. Edward Walters, D.D.S, Case No. 2006-08808 DOH v Edward Walters, 2.D.S. Case no. 2006-08808 JAPSUMadical\Bread Chiisty\Walters (death) 2006-08808. 6,15.2006\Wallers AC (x)(I)(Z)(H) 2006-08808 DAAFT 4 6.28.2006.doc ea B, Gis 3 | Assistant General Counsel DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265 Florida Bar No. 179590 (850) 922-6579 (850) 488-1855 FAX ae 5 ee Page 26 Jul 25 2006 17:36 JUL-25-2886 17:52 AHCA P.28 38 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. Edward Walters, D.D.5, Case No. 2006-08808 DOH v Edward Walters, D.D.S. Page 27 Case no. 2006-08808 4APSU\Medical\Brad Christy\Wallers (death) 2006-08808 6.15,2006\Wellers AC (x)(fi)(z)(lI} 2006-08808 DRAFT 4 6,28.2006.doc

Docket for Case No: 06-002694PL