Jul 28 2010 9:45 JUL-28-2618 18:36 AHCA P.@4/14 STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, PETITIONER, v. CASE NO, 2008-01358 Roy Hart, DDS, RESPONDENT. / ADMINISTRATIVE COMPLAINT COMES NOW Petitioner, Départment of Health, by and through its undersigned counsel, and files this Administrative Complaint before the Board of Dentistry against Respondent, Roy Hart, DDS, 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 14863. Jul 28 2010 9:45 JUL-28-2618 18:37 AHCA P.@5-14 3. Respondent’s address of record is 537 US Highway 1, Suite #1, North Palm Beach, FL 33408, 4. Respondent provided dental treatment to Patient MP from on or about August 28, 2006, through on or about August 29, 2006. 5. On or about August 28, 2006, Patient MP presented to the Respondent with a chief compiaint of pain in the lower left jaw. The Respondent noted that tooth number 17 was impacted. The Respondent took two periapical x-rays and treatment planned surgical extraction of tooth number 17 and a filling for tooth number 19. 5. ‘The radiographs taken on or about August 28, 2006, show that the angulation of tooth number 17 is more buccal-lingual than distal-mesial. The angulation of the third molar tooth is important since the level of bone impaction may increase the complexity of the extraction. 7. The treatment notes for August 28, 2006, do not indicate that there were any complications in the treatment the Respondent provided to Patient MP. The Respondent failed to note a diagnosis for the source of Patient MP’s pain. In addition, the Respondent failed to note the type of impaction: 8. On or about August 29, 2006, the Respondent noted that Patient TAPSU\Medical\Dentistry\Patricia Smith\AC's\Han 2008-01558.doc 22- Jul 28 2010 9:45 JUL-28-2618 18:37 AHCA P.@614 MP had called his answering service. The Respondent returned Patient MP’s call and she described feeling a shooting pain and numbness on the left hand side of the patient's face, 9. Patient MP presented to the Respondent again on or about August 29, 2006. The Respondent took a panoramic x-ray and noted in the treatment record that Patient MP's tooth number 17 area was fractured, The Respondent referred Patient MP to an oral surgeon. 10. The panoramic taken on or about August 29, 2006, revealed that tooth number 18 was severely cut into the distal root deep below the ossesous crest; the distal root was essentially amputated. 11. The panoramic x-ray also showed that apical to the extraction site of tooth number 17 excessive bone was removed. 12. The Respondent negligently fractured Patient MP’s mandible in tooth number 17 by failing to have adequate radiographs to diagnose the tooth’s relation to the inferior border of the mandible and the surrounding anatomy and failing to use due care in the Respondent’s surgical removal of the impacted tooth. 13. The subsequent treater diagnosed Patient MP with a left mandibular fracture. JAPSU\Medical\Dentistry\Paricia Smith\AC's\Han 2008-01358.doc -a- 9:45 Jul 28 2010 Paria JUL-28-2618 18:37 AHCA 14. Patient MP had three Surgeries attempting to correct the damage caused by the fracture and to restore function and sensation. Patient MP experienced pain when chewing, numbness to the left lower lip and headaches. , , 13. Patient MP filed a maipractice claim against the Respondent, The Respondent settled the claim for $590,000. 16. The standard of care for a dentist performing surgical extraction of a third molar is to review an undistorted preoperative radiograph that Captures the entire tooth structure that needs to be removed, including the apex and its relation to the inferior border of the mandible and the mandibular canal; the size and the curvature of the roots; the inferior border of the mandible; and the surrounding anatomy, including distal bone, the lingual plate and the mandibular canal, 17. Prior to initiating the surgical extraction of impacted tooth number 17, the Respondent only had two periapical x-rays of the lower left. One of the periapical x-rays failed to capture the distal of tooth number 17 or the distal root. The other periapical x-ray failed to capture the bone distal to the tooth and no detail apical to the tooth. 18. The preoperative x-rays the Respondent had were inadequate IAPSU\Medical\Dentistry\Patricia Smith\aC's\Han 2008-01558,doe -4— Jul 28 2010 9:45 JUL-28-2618 18:38 AHCA for determining the density of bone distal to tooth number 17, the thickness and size of the mandible located around tooth number 17, the length and size of the roots and the proximity to the mandibular canal. 19. To embark upon surgical extraction with radiographs that do not show the roots, the surrounding bone and/or the surrounding nerve canals shows a disregard for the patient’s Safety. COUNT I 20. Petitioner realleges and incorporates paragraphs one (1) through 19 (nineteen) as if fully set forth herein. 21. Section 466.028(1)(m), Florida Statutes (2006), 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, 22. Rule 64B5-17,002(1), Florida Administrative Code requires that: for the purpose of implementing the provisions of subsection 466.028(1)(m), Florida Statutes, a dentist shall maintain written records on each patient which written records shall contain, at a minimum, the following information about the patient: IAPSU\Medieal\Dentisiry\Paricia Smith\aC's\Hart 2008-01358.doc -E- P8714 Jul 28 2010 9:45 P8914 JUL-28-2618 18:38 AHCA a. Appropriate medical history; b. Results of clinical examination and tests conducted, including the identification, or lack thereof, of any oral pathology or diseases; c, Any radiographs used for the diagnosis or treatment of the patient; d. Treatment plan proposed by the dentist; and é. Treatment rendered to the patient. 23. Respondent failed to keep written dental records and medical history records justifying the course of treatment of the Patient MP in one Or more of the following ways: a. By failing to document a diagnosis for the source of Patient MP's pain; b. By failing to record the type of impaction; and/or c. By failing to record the type of anesthetic used during the surgical extraction of tooth number 17. 24. Based on the foregoing, Respondent has violated Section 466.028(1)(m), Florida Statutes (2006), by failing to keep written dental records and medical history records justifying the course of treatment of Patient MP. COUNT II 25. Petitioner realleges and incorporates Paragraphs one (1) JAPSU\Medical\Dentistry\Patricia Smith\AC's\Hart 2008-01358,doe +6- Jul 28 2010 9:47 P. 18/14 JUL-28-2618 18:38 AHCA through 19 (nineteen) as if fully set forth herein, 26, Section 466.028(1)(x), Florida Statutes (2006), 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 jimited 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. 27. Pursuant to Section 466.028(1)(x), Florida Statutes (2006) “dental malpractice” includes, but is not limited to, three or more claims within the previous -5 year period which resulted in indemnity being paid, or any single indemnity paid in excess of $25,000 in a judgment or settlement, as a result of negligent conduct on the part of the dentist, 28. 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. By performing the surgical extraction of tooth number 17 without adequate pre-operative radiographs; b. By unnecessarily cutting adjacent tooth number 18 with a dental bur the Respondent was using J:\PSU\M edical\Dentistry\Patricia Smith\AC's\Hart 2008-01356.dac -7- O10 9:4 Jul 28 2 P.1i/14 JUL-28-2618 18:38 AHCA to section bone and/or the roots of tooth number 17; c. By failing to recognize that the Respondent had destroyed tooth number 18; d. By negligently fracturing the mandible of tooth number 17; €. By failing to diagnose the mandible fracture and releasing Patient MP after the surgical removal of tooth number 17; and/or f. By having a single indemnity paid in excess of $25,000, ($590,000 paid), in a judgment or settlement, as a result of negligent conduct on the part of the Respondent. 29. Based on the foregoing, Respondent has violated Section 466.028(1)(x), Florida Statutes (2006), 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 €xperience 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 license, restriction of practice, imposition of an administrative fine, issuance of a reprimand, JAPSU\Medical\Dentistry\Pairicig Smith\AC's\Han 2008-01358. doe -8- Jul 28 2010 9:47 12/14 JUL-28-2618 18:39 AHCA P 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. SIGNED this 15th day of May , 2009, Ania M. Viamonte Ros, M.D., M.RH State Surgeon General a) iy Ota brit Patricia Smith 7 Assistant General Counsel DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65. Tallahassee, FL 32399-3265 Florida Bar No, 78120 Fd Og 850.245.4640 850.245.4683 FAX PCP: 5/15/09 PCP Members: CM, JT, WR DOH v Roy Hart, D.D.S., Case No, 2008-01358 FAPSU\M edical\Dentistry\Patricia Smith\AC's\Hart 2008-01358.doc -Ge Jul 28 2010 9:47 P1314 AHCA JUL-28-2018 16:39 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 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 DOH v Roy Hart; Case # 2008-01358 JAPSU Medical Demtismy\Parieis Smith\aC's\Hart 2008-01358. doc -10—

Docket for Case No: 10-006401PL