Mar 21 2008 15:16 ver-ot-20e 14:50 AHA P2218 STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, Vv. CASE NO. 2006-26012 MOHAMED GAMAL-ELDIN, D.D.S., RESPONDENT, $e / 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, Mohamed Gamal-Eldin, 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 10222. 3. Respondent's address of record is 2525 Pasadena Ave. South, Suite E, St. Petersburg, Florida 33707. 1 é002 0 ¢ adi vpR-ot-207e ais auca Mar 21 2008 15:16 > owt 4. Respondent provided dental treatment to Patient TT. from on or about September 11, 2002, through on or about June 12, 2006. 5. On or about September 11, 2002, Patient T.T. presented to the Respondent for the first time for a comprehensive exam. It is noted in the patient progress notes that two periapical x-rays and a panoramic x-ray were taken on that date. | 6. On or about September 11, 2002, four quadrants of root planing and curettage were treatment planned by Respondent for Patient TT. | | 7. Respondent performed four quadrants of root planing and curettage on Patient T.T. on or about September 11, 2002, and on or about September 19, 2002. 8. The patient progress notes do not: indicate whether the Respondent performed any periodontal examination of or periodontal probe charting for Patient T.T. on or about September 11, 2002, nor do they reflect whether the Respondent made any periodontal diagnosis for Patient T.T. on that date. 9. Subsequently, Patient T-T. presented herself to the Respondent — and his staff for a prophylaxis on six different occasions, including on or about February 3, 2003; October 21, 2003; April 26, 2004; January 18, 2005; April 20, 2005; and April 6, 2006. J:A\PSU\Medi eal\Dentistry\Schiefelbein\Gamal-Eldin AC {m)doc., Mar 21 2008 15:16 MAR-21-2088 14:51 AHCA . P.a4718 10. There are no periodontal probing records reflected in Respondent's patient progress notes for any of the six prophylaxes performed on Patient T.T. 11. Respondent's dental records for Patient T.T. failed to justify the course of Patient T.T.’s treatment in that the Respondent did not record an | overall comprehensive written diagnosis and provided no periodontal exam results or depth charting prior to providing a periodontal course of treatment. , 12. Section 466.028(1)(m), Florida Statutes (2002-2005), 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 discipline by the Board of Dentistry. 13. Rule 64B5-17.002, Florida Administrative Code requires that a- dentist shall maintain written records on each patient which shall contain, at a minimum, appropriate medical history; results of clinical examination and tests conducted including the identification, or lack thereof, of any oral pathology or diseases; any radiographs used for the diagnosis or treatment of the patient; treatment plan proposed by the dentist; and treatment rendered to the patient. JAPSU\Medical\Dentistry\Schiefelbei\Gamal-Eldin AC (m)doc, MAR-21-2088 14:51 Mar 21 2008 15:17 AHCA P8518 14. Respondent failed to keep written dental records and medical history records justifying the course of treatment of Patient T.T. in one or more of the following ways: a. By failing to take and/or chart a periodontal examination or periodontal depth probe measurements or making any periodontal diagnosis on September 11, 2002, to allow for a full and proper diagnosis of Patient T.T’s mouth prior to root planing and curettage; By failing to take and/or chart periodontal depth probing measurements for any of the six prophylaxes performed on Patient T.T. from on.or about February 3, 2003, through April 6, 2006. 15. Based on the foregoing, Respondent has violated Section 466.028(1)(m), Florida Statutes (2002-2005) by 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; and Rule 64B5- 17.002, Florida Administrative Code, by failing to maintain written records on Patient T.7. which contain results of clinical examination and tests conducted including the identification, or lack thereof, of any oral pathology or diseases; any radiographs used for the diagnosis or treatment of the patient; treatment plan proposed by the dentist, and treatment rendered to the patient. JAPSU\Medieal\Dentistry\Schiefelbein\Gamal-Eldin AC (m).doc ‘4 Mar 21 2008 15:17 MAR-21-2088 14:51 AHCA . P.@6718 WHEREFORE, the 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 the Respondent on probation, corrective action, refund of . fees billed or collected, remedial education and/or any other relief that the Board deems appropriate, th . SIGNED this_Q7 day of Ags ¢ , 2007. Ana M. Viamonte Ros, M.D., M,P.H Secretary, Department of Health DEPARTMENT OF HEALTH DOH Prosecution Services Unit BE PUTY CLERK 4052 Bald Cypress Way, Bin C-65 " Tallahassee, FL 32399-3265 DATE Uy ROSE. Florida Bar No, 265047 850.245.4640 Ext. 8226 850.245.4683 FAX WLS PCP: 4/27/07 PCP Members: CM, BK, WR Mohamed Gamal-Eldin, DDS; DOH Case No.: 2006-26012 J\PSU\Medical\ Dentistry \Schiefelbein\Dental Cases\Gamal-Eldig\Gamal-Eldin AC (m).doe Mar 21 2008 15:17 MAR-21-2888 14:51 AHCA Paria 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. Mohamed Gamal-Eldin, DDS; DOH Case No. : 2006-26012 JAPSU\Medical\ Dentistry \Schiefelbein\Gamal-Eldin AC (m).doc 6

Docket for Case No: 08-001446PL