Jul 2 2008 16:52 JUL-G2-2088 17:27 eHCA P.G216 STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, Vv. CASE NO. 2006-00227 MARINO FRANK VIGNA, D.D.S., RESPONDENT. z| 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, Marino Frank Vigna, 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 13239. _ 3. Respondent’s address of record is 7171 NW 126" Terrace, Parkland, Florida 33076. 2002 0 & Ud¥ Jul 2 2008 16:52 JUL-@2-2888 17:2? AHCA P.@3/16 4. The Respondent provided treatment to Patient H.A. from on or about September 26, 2000, to on or about November 4, 2004. 5. On or about September 26, 2000, Patient H.A,, then a 79 year- old female, presented to Respondent for consultation for dental treatment. She sought to have her existing lower denture supported and stabilized. Respondent presented a treatment plan to place new implants at teeth numbers twenty-two (22) and twenty-seven (27) to better achieve retention of the existing lower denture. 6. Prior to presenting to Respondent, Patient H.A. had successfully worn a lower denture, the retention of which was assisted by an anterior blade implant, with retention devices at the distal, for approximately sixteen (16) years. 7. Pre-operative x-rays taken by the Respondent on or about September 26, 2000, show that Patient H.A. was a marginal candidate for intraosseous implants due to extreme bone resorption since the original blade implants had been placed in Patient H.A.’s mouth. 8. There is no indication that Respondent made or commissioned any kind of study models of Patient H.A’s mouth and/or mounting of the existing dentures to determine the best location and optimal placement of any of the implants placed in Patient H.A.‘s mouth. JAPSU\Medieal\Dentistry\Schiefelbein\Dental Cases\Vigna, Mario\Vigna (x)(m) AC.2.0.doc 2 Jul 2 2008 16:52 JUL-@2-2888 17:2? AHCA P.a4716 9. According to the Respondent's written records for Patient H.A., on or about October 10, 2000, Respondent placed two “Branemark” implants in the tooth number 22 and 27 areas. 10. Much of the Respondent's handwritten records for Patient H.A. are illegible making it difficult to determine exactly what was done during this surgery and on subsequent visits, 11. Three unreadable post-operative x-rays were taken of the two implants placed by the Respondent on or about October 10, 2000, in Patient H.A.’s mouth. ' 42. The x-rays taken of the two implants placed by the Respondent on or about October 10, 2000, did not provide the Respondent with an acceptable representation of the position of the placement of the implants. 13. After the implants were placed in Patient H.A.°s mouth on or about October 10, 2000, Respondent failed to adjust the patient's lower anterior denture to prevent pressure on the implant sites during healing. 14. According to the Respondent’s written records for Patient H.A., the Respondent took a single x-ray on or about November 29, 2000, and concluded that the implants were healing well. JAPSU\Medical\Dentistty\Schiefelbein\Dental Cases\Vigna, Marie\Vigna (x)(m) AC.2.0.doe Jul 2 2008 16:53 JUL-@2-2888 17:28 AHCA P.@5/16 15, There is no November 29, 2000, x-ray in Respondent's records for Patient H.A. which was provided to the Department during this investigation. 16. The implants placed by Respondent on October 10, 2000, in Patient H.A’s mouth did not in fact osseointegrate into the minimal bone structure then existing in Patient H.A.’s mouth, because they were not seated properly, | 17. An xray taken by Respondent on or about February 15, 2001, shows that the implants placed on or about October 10, 2000, were lost, with considerable bone destruction around the implant sites. 18. On or about March 14, 2001, the Respondent placed two “Sendex" implants in the tooth number 23 and 26 areas. Respondent's treatment record for Patient H.A. further indicates that retentive devices were added at that time. 19. There is no x-ray record of the two implants placed by the Respondent on or about March 14, 2001, in Patient H.A.’s mouth. No post- Operative x-rays were taken by Respondent to confirm proper position of these implants. JAPSU\Medical\Dentistry\Schiefelbein\Dental Cases\Vigna, Mario\Vigna (x)(m) AC.2,0,doe 4 Jul 2 2008 16:53 JUL-#2-2688 17°28 AHCA P.@6/16 20. Respondent failed to align the two implants placed in Patient H.A.'s mouth on or about March 14, 2001, with each other or to a common path. 21, Respondent did not create any holes in the denture base behind Patient H.A.’s anterior teeth when the implants were placed on or about March 14, 2001. Appropriately placed holes would have allowed Patient H.A.s denture to be seated completely and the attachments aligned with the denture in a seated position, without the denture base touching, disturbing, torquing, or otherwise engaging the implants in any way, Proper technique would have further involved attaching the retentive devices on Patient H.A’s implants to the denture base with plastic. This would allow the old denture to be tissue-supported and implant-assisted:. Instead, the Respondent tried to make the old denture implant-supported and tissue-assisted. This gave the posterior occlusion a two to three inch cantilever for stress magnification which acted on the lower anterior implants and caused implant failure. 22. After the implants were placed by Respondent on or about March 14, 2001, the posterior occlusion of Patient H.A’s denture was very high. 23. Two weeks later, on or about March 28, 2001, Patient H.A. returned to the Respondent, who determined that one of the Sendex JAPSU\Medical\Dentistry\Schiefelbein\Dental Cases\Vigna, Mario\Vigna (x)(m) AC.2.0.doc 5 Jul 2 2008 16:53 JUL-@2-2888 17:28 AHCA P.ar/i6 implants was loose and not implanted deeply enough into the bone to establish adequate retention, and the other implant was lost. 24. On or about December 12, 2001, the Respondent piaced three (3) more Sendex implants in Patient H.A.’s mouth. 25, The x-ray taken by Respondent on or about December 12, 2001, shows the implants in Patient H.A’s mouth placed on that date were either barely in the bone or badly aligned. 26. Respondent failed to align the three implants placed in Patient ~ H.A.‘s mouth on or about December 12, 2001, with each other or with a | common path. 27. Respondent failed to create any holes in the denture base — behind Patient H.A.'s anterior teeth when the implants were placed on or about December 12, 2001. Appropriately placed holes would have allowed the denture to be seated on the posterior tissue before picking up the relation of the implants to the denture, 28. After the implants were placed by Respondent in Patient H.A.‘s mouth on or about December 12, 2001, the posterior occlusion of the denture was very high. J:\PSU\Medical\Dentistey\Schiefelbcin\Dental Cases\Vigna, Mario\Vigna (x)n) AC.2.0.doe JUL-#2-2688 17°29 AHCA TAN 2 200g 188 P8616 29. By February 1, 2002, Patient H.A. had lost the three implants placed by Respondent on or about December 12, 2001. — 30. On or about December 3, 2002, the Respondent performed a chairside relining of Patient H.A’s denture as she did not want to leave it for the lab. 31. On or about November 4, 2004, Patient H.A. returned to the Respondent with complaints regarding the denture re-lining and contending that the Respondent should have used blade implants. The Respondent referred Patient H.A. to another dentist. 32. The acceptable standard of care in placing implants requires a © dentist to ensure that implants are properly aligned and that good tissue supports the occlusion. Proper placement requires due consideration of a patient's anatomy. Further, post operative X-rays performed immediately after the surgery are essential to ensure that placement is correct in relation to angulation and depths, and to ensure that no anatomic structures are improperly involved. , COUNT ONE 33. Petitioner realleges and incorporates paragraphs one (1) through thirty two (32) as if fully set forth herein. JAPSU\Medical\ Dentistry\Schiefelbein\Dental Cases\Vigna, Mario\Vigna (x)(m) AC.2.0.doe 7 JUL-@2-2088 17:29 Jul 2 2008 16:54 AHCA P9716 34, Section 466.028(1)(x), Florida Statutes (1999-2001) 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. 35. The Respondent was negligent and failed to meet the minimum standards of dental performance in his treatment of Patient H.A. in one or more of the following ways: By failing to take adequate post-operative X-rays showing proper placement of the implants during his first two attempts to surgically place implants in Patient H.A.'s mouth; By failing to ensure that there was good tissue support for the occlusion when installing implants; By failing to ensure that Patient H.A.’s denture was seated completely and the attachments aligned with the denture in a seated position, without the denture base touching, disturbing, torquing, or otherwise engaging the implants in any way; By failing to properly place or align the implants with each other or with a common path, during any of his three (3) attempts to surgically place implants in Patient H.A.'s mouth; JAPSU\Medical\Dentistry\Schiefelbein\Dental Cases\Vigna, Mario\Vigna (x)(m) AC.2.0.doc Jul 2 2008 16:54 JUL-@2-2088 17:29 AHCA P.14/16 e. By failing to adjust the lower anterior denture after the implants placed on or about October 10, 2000, to prevent pressure on the implant sites during healing; and/or f. By failing to make or commission study models of Patient H.A.’s mouth and/or mounting of the existing dentures to determine the best location and optimal placement of the implants. 36. Based on the foregoing, Respondent has violated Section 466.028(1)(x), Florida Statutes (1999-2001), 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 malpractice. COUNT TWO 37. - Petitioner realleges and incorporates paragraphs one (1) through twelve (12), fourteen (14), fifteen (15), and seventeen (17) through nineteen (19), as if fully set forth herein. 38, Section 466.028(1)(m), Florida Statutes (1999-2001) provides that failing to keep written dental records and medical history records justifying the course of treatment of the patient including, but not J:\PSU\Medical\Dentistry\Schiefelbein\Dental Cases\Vigna, Mario\Vigna (x)(m) AC.2.0.doc 9 Jul 2 2008 16:55 JUL-@2-2088 17:29 AHCA P.11/16 limited to, patient histories, examination results, test results, and X rays, if taken, constitutes grounds for disciplinary action by the Board of Dentistry. 39, The Respondent failed to keep written dental records justifying the course of his treatment of Patient H.A. in one or more of the following ways: a. __ By failing to take and/or retain readable x-rays of the implants placed on or about October 10, 2000; b. By failing to take and/or retain any x-rays of the implants on November 29, 2000, when the Respondent concluded that the implants placed on or about October 10, 2000, were healing well; C. By failing to take and/or retain any x-rays of the implants placed on or about March 14, 2001; and/or d. _—_—By failing to prepare handwritten records sufficiently legible to determine exactly what was done on various visits by Patient H.A. 40. Based on the foregoing, Respondent has violated Section 466.028(1}(m), Florida Statutes (1999-2001) by failing to keep written dental records and medical history records justifying the course of treatment of Patient H.A. 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 IAPSU\Medical\ Dentistry Schiefelbsin\Dental Cases\Vigtra, Mario\Vigna (x)(m) AC.2.0.doce Jul 2 2008 16:55 JUL-#2-2688 17°38 AHCA P.i2/16 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. SIGNED this 7 day of pil , 2007. Ana M. Viamonte Ros, M.D., M.P.H. Secretary, Department of Health im) fen Mont x. slat hr ayne L. Schiefelbein Assistant General Counsel DOH Prosecution Services Unit DEPARTMENT OF HEALTH 4052 Bald Cypress Way, Bin C-65 CLERK Tallahassee, FL 32399-3265 pDATE__ ‘SX "BO Ot Florida Bar No. 265047 (850) 245.4640 Ext. 8226 (850) 245.4683 FAX WLS . PCP: 4/34/07 PCP Members: CM, Bx WE DOH v Marino Frank Vigna, D.D.S., Case No. 2006-00227 JAPSU\Medical\Dentistry\Schiefelbcin\Dental Cases\Vigna, Mario\Vigna (x)(m) AC.2.0.doc , 1l Jul 2 2008 16:55 JUL-@2-28688 17:38 AHCA P.13/16 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 MARINO FRANK VIGNA, D.D.S., Case No. 2006-00227 JA\PSU\Medical\Dentistry\Schiefelbein\Dental Cases\Vigna, Mario\Vigna (x)(m) AC.2.0.doc 12

Docket for Case No: 08-003211PL