Apr 16 2008 15:54 APR-16-2688 16:28 AHCA P.B2 STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. a CASE NO. 2005-61984 SCOTT DUFF, D.M.D., RESPONDENT. ee 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, Scott Duff, D.M.D., 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 11441, | 3. Respondent’s address of record is 712 U.S. Highway 1, Suite 220, North Palm Beach, .Florida 33408. 3:\PSU\Medical\wayne mitchell\1-06fdntlACs\Dulf (m), (x) xtrn-parthesia05-61984,.doe ganz 8% SNV Apr 16 2008 15:54 APR-16-2688 16:28 AHCA P.@3 4. On or about May 16, 2003, Patient L.P, presented to the Respondent for the extraction of her tooth number 32. Respondent's treatment record notes reflect in part “extracted #32.” 5. The treatment record does not reflect the extraction of tooth number 32 and its potential complications were specifically discussed with Patient L. P. prior to the extraction of tooth number 32. 6. The minimum standards of performance in diagnosis and treatment when measured against generally prevailing peer performance require that a dentist performing extractions, especially those that have the potential to or actually do result in significant complications, must provide extensive notes that describe as much as possible about the extraction procedure. The notes should include (but are not limited to) the dentist's pre-operative discussion with the patient; a record of x-ray findings; a record of the proximity of the targeted extracted tooth to the sinus; the patient's behavior before and during the procedure; length of time required for the procedure; clear anatomic description of the surgery; resulting complications; discussion of the complications with the patient; elected treatment plan for the complications; the offer of a referral to a specialist and record of the patient’s election regarding a referral. 4:\PSU\Medical\wayne mitchell\1-O6fdntiAC's\Duft (m), (x) xtrn-parthesia05-61984,doc Page 2 Apr 16 2008 15:54 APR-16-2888 16:29 AHCA 7. The treatment record does not contain a signed informed _consent for the extraction of tooth number 32 executed by the patient and the Respondent. 8, The minimum standards of performance in diagnosis and treatment when measured against generally prevailing peer performance require that a dentist performing extractions obtain appropriate informed consent that among other issues clearly describes: the intended procedure and specific tooth or teeth which are to be extracted; the proposed anesthetic; the potential complications; alternatives available; and need for follow up care. The informed consent should be clear, concise and legible, and include the patient's signature and date of that signature. Extractions of impacted molars require a dentist to properly extract such an impacted tooth, or if beyond the skill of a generalist, further requires a dentist to refer the patient to a board certified oral surgeon for treatment. The Respondent failed to properly extract the impacted molar or refer Patient LP. to an oral surgeon for appropriate extraction of tooth number 32 surgically. 9. On or about May 22, 2003, Patient LP. contacted the Respondent’s office and reported her tongue was numb from the _ procedure. Three subsequent calls are recorded in the Patient treatment notes regarding similar concern. J:\PSU\Medical\wayne ritchell\1-06fdntlAC's\Duff (m), (x) xtrn-parthesle05-61984.doc Page 3 Apr 16 2008 15:55 APR-16-2688 16:29 AHCA P.@S 10. On or about August 6, 2003, the Patient treatment records reflect that Patient L.P. informed that she had a second opinion regarding the continued numbness in her tongue. The record notes the opinion included that a nerve may have been cut during the extraction procedure. COUNT I-RECORDKEEPING 11. Petitioner re-alleges the allegations contained in paragraphs one (1) through thirteen (10) as if fully incorporated herein. 12, Section 466.028(1)(m), Florida Statutes (2003), 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. Rule 64B5- 17.002, Florida Administrative Code, further provides that a dentist shall maintain written records on each patient which written records shall contain, at a minimum, the following information about the patient: (a (b) Results of clinical examination and tests conducted, including the identification, or lack thereof, of any oral pathology or diseases; — Appropriate medical history; (c) Any radiographs used for the diagnosis or treatment of the patient; e — Treatment plan proposed by the dentist; and J:\PSU\Medical\wayne mitchell\1-O6fdntiAC's\Duff (m), Ox) xtmn-parthesla05-61984,doc Page 4 Apr 16 2008 15:55 APR-16-2888 16:29 AHCA P.@6 (e) Treatment rendered to the patient. 13. Respondent failed to keep written dental records and medical history records justifying the course of treatment of the patient in one or more of the following ways: (a) Respondent failed to record pre-operative discussion with the patient; (b) Respondent failed to obtain a signed informed consent for the procedure and record the patient’s assent to the procedure and election of treatment; (c) Respondent failed to create a record of x-ray findings; (d) Respondent failed to create a record of the proximity of the targeted extracted tooth to the sinus; (e) Respondent failed to record the patient's behavior before and during the procedure; (f) Respondent failed to record the length, of time required for the extraction procedure; (g) Respondent failed to record clear anatomic description of the surgery; (h) Respondent failed to record the resulting complications;. (i) Respondent failed to record the discussion of the complications with the patient; (j) Respondent failed to record the patient’s elected treatment plan for the complications; and/or (k) Respondent failed to record the offer of a referral to a specialist and record of the patient’s election regarding a referral. oO 3:\PSU\Medical\wayne mitchell\1-06fdntiAC's\Duff (m), (x) xtrn-parthesia05-61984,doc Page 5 Apr 16 2008 15:55 APR-16-2888 16:38 AHCA Pa? 14. Based on the foregoing, Respondent has violated Section 466.028(1)(m), Florida Statutes (2003), by failing to keep written dental records and medical history records justifying the course of treatment of the patient. COUNT [I-STANDARD OF CARE 15. The Petitioner re-alleges the allegations contained in paragraphs one (1) through thirteen (10) as if fully incorporated herein. 16, Section 466,028(1)(x), Florida Statutes (2003), states 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, shall constitute grounds for disciplinary action by the Board of Dentistry. 17. The Respondent was negligent and failed to meet minimum standards of dental performance in diagnosing and treating Patient L.P. in one or more of the following ways: | a) The Respondent failed to provide a comprehensive diagnosis with adequate radiographs, teeth charting, and a comprehensive treatment plan prior to initiating the extraction of tooth number 32 in Patient L.P’s mouth; J:\PSU\Medical\wayne mitchell\1-O6fantlAC’s\Duff (m), (x) xtrn-parthesia05-61984.doe Page 6 Apr 16 2008 15:56 APR-16-2888 16:38 AHCA P.@8 b) The Respondent failed to properly extract tooth number 32, an impacted molar without causing complications, and/or failed to refer Patient L.P. to an oral surgeon for appropriate extraction of tooth number 32 surgically; and/or c) The Respondent proposed and tried to perform a major extraction without presenting a comprehensive treatment plan to Patient L.P. outlining all the proposed therapy and explaining any possible options to include benefits and risks for the patient's acknowledgement and informed consent. 18. Based on the foregoing, the Respondent has violated Section 466.028(1)(x), Florida Statutes (2003), 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. 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 jicense, 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 deéms appropriate. J:\PSU\Medical\wayne mitchell\1-O6fdntlAC's\Duff (m), (x) xtm-parthesia05-61984.doc Page 7 Apr 16 2008 15:56 APR-16-2888 16:38 AHCA J 5) SIGNED this day of 4 V BUS J , 2006. M. Rony Francois, M.D., M.S.P.H., Ph.D. Secretary, Department of Health ws Wayne Mitchell Assistant General Counsel DOH Prosecution Services Unit CLERK 4052 Bald Cypress Way, Bin C-65 DATE. i Tallahassee, FL 32399-3265 Florida Bar No. 179590 850.245.4640 850.245.4683 FAX nepal muNG HEALTH PCP: 8-25-06 PCP Members: 6M, WR, JT DOH v Scott Duff, D.M.D., Case No. 2005-61984 J:\PSU\Medical\wayne mitchell\1-O6fdatlAC's\Duff (m), (x) xtrn-parthesia05-61984.doc ; Page 8 Apr 16 2008 15:5 APR-16-2888 16:41 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 Scott Duff, D.M.D., Case No, 2005-61984 J:\PSU\Medical\wayne mitchell\1-06fdntlAC’s\Duff (m), (x) xtrn-parthesia05-61984,doc Page 9

Docket for Case No: 08-001950PL