Aug & 2007 10:48 AUG-BB-2eR7 1114 AHCA P84 STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO.: 2006-13838 NATHANIEL STALLER, DDS, RESPONDENT. —/ ADMINISTRATIVE COMPLAI COMES NOW Petitioner, Department of Health, by and through its . undersigned counsel, and files this Administrative Complaint before the Board of Dentistry against Respondent, Nathaniel Staller, DDS, and in - support thereof alleges: 1. Petitioner is the state department charged with reguiating 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 7779, Aug & 200? 10:49 AUG-@8-2087 11:14 AHCA 3. Respondent's address of record is 5869 West Atlantic Avenue, Suite 2-A, Delray Beach, Florida 33484. 4. Respondent provided dental treatment to Patient LW. from on or about November 29, 2000, through on or about September 27, 2005. 5. On or about December 20, 2000, Patient IW. presented to . Respondent who performed an intra-oral exam. Respondent's treatment notes indicate that Respondent did not note any probing depths over 4 mm, although Patient I.W. reported she had been told by a prior treater that she 7 had probing depths of 8 mm. 6. Onor about April 23, 2001, Patient 1.W. presented to Respondent who performed an intra-oral exam. Respondent’s treatment notes.for Patient LW. indicate that the Patient underwent periodontal treatment a year and a half prior. 7. On or about August 7, 2001, Patient I.W. presented to Respondent's office. Respondent’s treatment notes for Patient LW. reflect that the Patient declined an examination by Respondent. Patient I.W. received a prophylaxis. 8. On or about November 8, 2001, Patient I.W. presented to Respondent's office. Respondent's treatment notes for Patient I.W. reflect -2e 7:\PSU\Medical\Jamie Ito\Dentistry Cases\Staller, Nathaniel (x)(I) (failure to dx or examine) At\Staller AC (x) (z) (m).doc DOH v Nathaniel Staller, DDS; Case #, 2006-13838 Aug & 200? 10:49 AUG-@8-2087 11:15 AHCA P.@6 that the Patient refused an examination by Respondent. Patient I.W) received ; a prophylaxis and four (4) bitewing x-rays. ~9. On or about February 13, 2002, Patient I.W. presented to ' Respondent's office. Respondent's treatment notes for Patient I.W. reflect - that the Patient declined an examination by Respondent. Patient I.W. : received a prophylaxis. 10. On or about March 28, 2002, Patient IW. presented to Respondent's office. Respondent's treatment notes for Patient LW. reflect . that the Patient did not receive an examination by Respondent because the . Patient was ina hurry. Patient 1.W. received a prophylaxis. li. On or about September 30, 2002, Patient LW. presented to | Respondent's office. Respondent’s treatment notes for Patient LW. reflect p that the Patient did not receive an examination by Respondent because she wanted it to take place during the next visit. Patient I.W, received a : prophylaxis. ~ se 12. On or about January 10, 2003, Patient IW, presented to Respondent's office:~-Respondent’s treatment-notes for-Patient-2.W. reflect that the Patient declined an examination by Respondent because shé was in a hurry. Patient 1.W. received a prophylaxis. -3- 3:\PSU\Medical\Jamie Ito\Dentistry Cases\Staller, Nathantel (x)(i) (failure to dx or examine) AC\Staller AC: (x) (z) (m).doc DOH v Nathaniel Staller, DDS; Case # 2006-13838 Aug 8 200? 10:50 AUG-@8-2087? 14:15 AHCA Pa? 13. Onor about May 2, 2003, Patient I.W. presented to Respondent's office. Respondent's treatment notes for Patient I.W. reflect that the Patient did not receive an examination by Respondent. Patient LW. received a prophylaxis, 14, On or about August 12, 2003, Patient IW. presented to - Respondent's office. Respondent’s treatment notes for Patiént LW. reflect that the Patient received a prophylaxis only, and not an examination by Respondent “per pt.” 15. On or about December 3, 2003, Patient I.W. presented to Respondent's office. Respondent's treatment notes for Patient ILW. reflect that the Patient refused an examination by Respondent. Patient IW: received a prophylaxis and four (4) bitewing x-rays. 16. Onor about April 7, 2004, Patient I.W., presented to Respondent's office. Respondent's treatment notes for Patient I.W, reflect that the Patient ‘declined an examination by Respondent. Patient I.W. received a prophylaxis, 17. On or about August 11, 2004, Patient LW. presented to “Respondent's ‘office, Respondent's treatment notes for Patient I.W. reflect that the Patient refused an examination by Respondent. Patient I.W.. received a prophylaxis. -4-— J:\PSU\Medical\Jamile Tto\entistry Cases\Staller, Nathaniel (x)(i) (Fallure to dx or examine) AC\Staller AC (x) (z) (m).doc DOH v Nathaniel Staller, DDS; Case\# 2006-13838 Aug & 200? 10:51 AUG-@8-2087 11:16 AHCA P.@e 18. On or about April 20, 2005, Patient IW. presented to Respondent's office. Respondent's treatment notes for Patient I.W. reflect that Respondent evaluated a fuli mouth series of x-rays taken that day. Respondent's treatment notes do not indicate that he performed an: intra-oral examination. Patient 1.W. received a prophylaxis. The radiographic examination did not disclose the presence or absence of periodontal disease in Patient I.W’s mouth, 19. On or about September 8, 2005, Patient I.W. presented to Respondent's office. Respondent’s treatment notes for Patient I.W. reflect -” . that he took an xray, performed an evaluation, and referred Patient I:W. to a Periodontist due to gingival swelling in the area of teeth numbers 14 and 15. ws. 20.: On or about-September 16, 2005, Patient LW: presented to a . periodontist. The periodontist diagnosed Patient LW. with generalized 7 pocketing of three mm and four mm throughout her mouth except. for seven ‘to.ten mm in the area of teeth numbers 14, 15, 18 and 19. 21. The periodontist recommerided guided tissue regenerative “procedures to“address the periodontal-problems: = -5- J:\PSU\Medical\Jamie Ito\Dentistry Cases\Staller, Nathaniel (x)(i) (Failure to dx or examine) AC\Staller AC;(x) (z) (m).doc DOH v Nathaniel Steller, DDS; Gase # 2006-13838 Aug & 200? 10:51 AUG-@8-2087 11:17 AHCA P.BS 22. On or about September 27, 2005, Respondent sent Patient IW, her radiographs, including the bitewing x-rays taken on or about November 8, 2001, and December 3, 2003. COUNT I 23. Petitioner realleges and incorporates paragraphs one (1) through twenty-two (22) as if fully set forth herein. 24. Section 466.028(1)(x), Florida Statutes (2000-2005), provides ’ 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 constitutes grounds for disciplinary action by the Board of Dentistry. . _. ..25. The. minimum standards. of performance -in_ diagnosis and treatment .when_measured_against generally prevailing peer performance require that a dentist perform a clinical examination at least once every 13 --Months... The_minimum..standards further require. that a’ clinical exam include an intra-oral examination of the patient, and not simply a review of the patient’s radiographs. If a patient refuses to be examined by a-dentist, -6- 3:\PsU\Medical\Jamile Ito\Dentistry Cases\staller, Nathaniel (x)() (failure to dx or examine) AC\Staller AC (x) (2) (m).doc OOH v Nathanie) Staller, DDS; Case # 2006-13838 Aug & 200? 10:52 AUG-@8-2087 11:17 AHCA P.18 than the prevailing standard of care requires that the dentist dismiss the patient from his practice. 26. The minimum standards of performance in diagnosis and treatment when measured against generally prevailing peer performance require that a dentist only delegate professional responsibilities to a person who is qualified by training, experience, or licensure to perform them. 27, Rule 64B5-16.001, Florida Administrative Code, states that “Any authorization for remediable tasks to be performed under general supervision is valid for a maximum of 13 months; after which, ne further treatment under general supervision can be performed without another clinical exam by a Florida licensed dentist.” , 28. Rule 64B5-16.007(3)(a), Florida Administrative Code, states that prophylaxis is a remediable task that may be performed under general supervision, 29. 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 delegated prophylaxis treatments for Patient I.W. on or about September 30, 2002; January 10, 2003; May 2, 2003; August 12, 2003; December 3, 2003; April 7, 2004; August -7- J:\PSU\Medical\Jamie Ito\Dentistry Cases\Staller, Nathaniel (x){i) (failure to dx or examine) AC\Stailer AC (x) (z) (m).doc DOH v Nathaniel Steller, DDS; Case # 2006-13838 Aug & 200? 10:53 AUG-@8-2087 11:18 AHCA 11, 2004; April 20, 2005; and September 8, 2005. All of these dates fell more than 13 months after Respondent performed a clinical examination of Patient I.W.; and/or b. Respondent failed to perform a_ clinical examination of Patient I.W. between on or about August 7, 2001, and September 8, 2005. 30. Based on the foregoing, Respondent has violated: Section . 466.028(1)(x), Florida Statutes (2000-2005), 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, 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. COUNT II 31. Petitioner “realleges and incorporates paragraphs one (1) through twenty-two (22) as if fully set forth herein. “~~ 32. 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 patientincluding; 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. -H=- 3:\PSU\Medical\Jamie Ito\Dentistry Cases\Staller, Nathaniel (*){i) (failure to dx or examine) AC\Stalter AC (x) {z) (m).doc DOH v Nathaniel Staller, DDS; Case # 2006-13836 Aug & 200? 10:53 AUG-@8-2087 11:19 AHCA 33. Rule 64B5-17.002(1)(f), Florida Administrative Code, provides. that “whenever patient records are released or transferred, the dentist: releasing or transferring the records shall maintain either the original records or copies thereof and a notation shall be made in: the retained: records indicating to whom the records were released or transferred.” 34. Respondent failed to keep written dental records and medical history records justifying the course of treatment of Patient’ 1.W. by failing to maintain the originals or copies of the bitewing radiographs taken on or about November 8, 2001, and December 3, 2003, when he released them _ ta the Patient on or about September 27, 2008. 35. Based on the foregoing, Respondent has violated Section: 466.028(1)(m), Florida Statutes (2005), by failing to keep written dental. records and medical history records justifying the course of treatment of Patient 1.W. 7 WHEREEORE,_ Petitioner respectfully. requests.that the..Board of Dentistry enter an order imposing one or more of the following penalties: —Peérmanent 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 . . : 79H TAPSU\Madical\lamle Ito\Dentistry Cases\Staller, Nathanlet (x)(7) (fallure to dx or examine) AC\staller, AC (x) (2) (m),doc DOH v Nathanle! Stalier, DDS: Case # 2006-13838 Aug & 200? 10:54 AUG-@8-2087 11:19 AHCA P.13 billed or collected, remedial education and/or any other relief that the: Board deems appropriate. SIGNED this _//”*_ day of Tx compa , 2006, M. Rony Francois, M.D., M.S.P.H., Ph.D, Secretary, Department of Health Jem K folate, = lm amie Ito Assistant General Counsel ED DOH Prosecution Services Unit DEPARTMENT OF H 4052 Bald Cypress Way, Bin C-65 i Tallahassee, FL 32399-3265 aenchting f Florida Bar No. 13553 DATE... 850.245.4640 Ext. 8178 850.245.4683 FAX PCP: 12/¢/6 6 PCP Members: @ A/, T7, HH DOH V Nathaniel Staller, DDS: Case # 2006- 13838 *10- J:\PSU\Medical\Jamie Ito\Dentistry Cases\Stalier, Nathaniel (x)(i) (failure to dx or examine). AC\Staller AC (x) (m).dac - DOH v Nathaniel Staller, DDS; Case # 2006-13838 iene taht teammate Ihe ed toaaed meine oR ee Oe DOH v Nathaniel Staller, DDS; Case # 2006-13838 Aug 8 200? 10:55 AUG-@8-2087 11:28 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. DOH v Nathaniel Staller, DDS; Case # 2006-13838 -i- 2:\PSU\Medicalamnie fto\Dentistry Cases\Staller, Nathaniel (%)(i) (Failure to dx or examine) AC\Staller AC (¥} (2) (m).doe DOH v Nathaniel Staller, DDS; Case #, 2006-13838 TOTAL P.15

Docket for Case No: 07-003590PL