undersigned counsel, and files this Administrative Compla!nt before the Board of Dentistry against Respondent, Stuart Goff, DDS, and in support thereof alleges:
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.
At all times material to this Complaint, Respondent was a licensed dentist within the State of Florida, having been issued license number DN 16553.
Respondent's address of record is 2161 East Commercial Blvd., Third Floor, Fort Lauderdale, Florida 33308.
Respondent provided dental treatment to Patient R.R. from on or about February 20, 2007, through on or about May 19, 2008.
On or about February 20, 2007, Patient R.R. presented to
!,,,
Respondent for an initial implant consultation due to a history of having trouble with a loose maxillary removable partial denture.
On or about February 20, 2007, Respondent performed some sort
of dinical examination and performed a radiographic examination of the upper right anterior region. Respondent's treatment notes reflect that Respondent documented that Patient R.R. presented for an impiant consult and documented that the upper right cuspid was fractured and the maxilla was partially edentulous. It is noted that Patient R.R. was interested in an overdenture/partial.
On or about February 20, 2007, Respondent proceeded to
formulate a Proposed Treatment Plan. The treatment plan simply reflects "ext, crn, imp, ptl." The treatment plan has an associated cost of seven thousand dollars. ($7,000.00). The written treatment plan which indicates that extraction, crown, implant, and partial is inadequate as it lacks any detail as to the teeth numbers and specific procedures to be performed.
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Respondent's treatment records dated February 20, 2007, also fail to document the Patient's chief complaint. Further, the Respondent failed to document the results of the clinical and radiographic examinations to include, but not limited to, failing to chart Patient R.R.'s dentition reflecting the missing teeth, existing restorations and existing prostheses. Respondent a!so failed to document Patient's periodontal health of the remaining teeth to include pocket depths, mobility, recession, plaque, calculus and/or home care to justify his course of treatment and there was not any documentation of an oral cancer screening. Respondent also failed to document the degree of atrophy. Respondent falls to make any documentation regarding the· mandible findings or the occlusion. Without this documentation, Respondent proceeded to formulate a poorly documented treatment plan and began treatment by taking impressions. Moreover, there are not any documented
alternative treatment plans.
Respondent's treatment records dated February 20, 2007, are deficient in that they failed to comprehensively document all tests performed and the results thereof to include all oral pathology or disease present and the documentation clearly cannot support the recommended course of treatment as it is imperative before beginning or recommending any course of
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treatment involving dentures (partial, full, removable), implants, and/or i\ crowns that the periodontal status is fully examined and found to be appropriately healthy before being used as the foundation which the
restorations will be seated upon, around, or in.
From on or about February 21, 2007, through on or about May 15, 2008, Patient R.R. presented approximately twenty-four more times (2.4)1 to Respondent. The dates include on or about February 21, 2007; March 12, 2007; March 14, 2007; March 23, 2007; March 27, 2007; June 18, 2007; June 25, 2007; July 2, 2007; July 3, 2007; July 10, 2007; July 16, 2007; July 25, 2007; July 27, 2007; Ju!y 30, 2007, August 61 2007 (documented by Respondent as 8/6/8); August 8, 2007 (documented by Respondent as
8/8/8); September 17, 2007 (documented as 9/17/08); September 25, 2007;
1"
"- October 10, 1007; November 20, 2007; December 4, 2007; March 12, 2008;
April 1, 2008; and May 19, 2008. During these dates of treatment the Respondent inserted multiple implants and mini·implants, and placed abutments and mini-implant attachments, extracted multiple teeth, placed crowns, replaced failed implants; and delivered a new upper over-denture.
1 The exact dates that Patieni R.R. presemed back to Respondent are taken from Respondent's treatment records which are misdated and alternate between the year 2007 and 2008 which are incorrect. The Administrative Complaint attempts to accurately glean the we treatme111 dates and years. All errors are attr,-butable to poor record keeping by Respondent
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Respondent, during these dates of treatment, failed to continue to document a written treatment plan and/or formulate a written treatment plan even when the treatment plan was modified on or about March 12, 2007, and July
, 2, 2007, and continued to fail to document alternative treatment plans.
Moreover, Respondent continued throughout the continued course of treatment to never document/chart Patient R.R.'s dentition even as it was substantially changed, to include, but not limited to failing to document existing teeth, restorations, missing teeth, and implants. The Respondent further failed throughout the entire course to document Patient's periodontal condition to include pocket depth probing and charting.
Once an implant is inserted, it is necessary to take a radiograph for proper evaluation of the implant's health and restorability before the implant is restored with abutments in order to justify the course of treatment
;,/ of proceeding with restoration.
On or about July 25, 2007, Respondent placed two abutments on implants in site numbers 4 and 6. Respondent did not maintain or take a radiograph of the implants on this date prior to the restorations. The abutments were subsequently removed on or about August 8, 2007. Then on or about November 20, 2007, abutments were placed on implants in site
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numbers 6, 10, and 11 once they were uncovered. Respondent failed to take radiographs of the implants and/or failed to maintain the radiographs to justify his course of implant restorative treatment.
After on or about May 19, 2008, Patient R.R. was not treated by
Respondent. ·Rather, Patient R.R. was treated by another dentist not affiliated with Respondent.
On or about May 20, 2008, Patient R.R. through his subsequent
treating dentist contacted the Respondent's office and faxed over a written medical release requesting a copy of Patient R.R.'s dental records.
In the month of June, a bill from Respondent dated June 2, 2008, was received by Patient R.R. On the bill, it reads, "Your Records will Not Be Forwarded Until This is Paid." The bill was for seven hundred and twenty-thee dollars.
On or about October 6, 2008, Patient R.R.'s subsequent treating dentist followed up on their records request with Respondent's office. Respondent's office asserted that Patient R.R. still owed a balance and until it was paid off his records would not be released.
Respondent's office has failed, to date, and within less than thirty
(30) days from the initial written demand to release a copy of Patient R.R.'s
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treatment records and has made an unlawful demand for payment of an outstanding balance before they will release the treatment records.
COUNT I: RECORD KEEPING
Petitioner re-alleges and incorporates paragraphs one (1) through seventeen (17) as if fully set forth herein.
Section 466.028(1)(m), Florida Statutes (2007- 2.008), provides that "[f)ailing 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 6485-17.002, Florida Administrative Code, further provides that for purposes of implementing Section 466.028(1)(m),
a dentist shall maintain written records on each patient which written records shall contain, at a minimum, the following information about the patient:
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.
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Respondent failed to keep dental records and medical history records justifying the course of treatment of Patient R.R. in one or more of the following ways:
By failing, on or about February 20, 2007, to document an
appropriately detailed written treatment plan which identified the details of the procedures to be performed and to which teeth the procedures would be performed on;
By failing, on or about February 20, 2007, to document the Patient's chief dental complaint;
c. By failing, on or about February 20, 2007, to document the clinical examinations performed and the results thereof identifying any oral pathology and lack thereof to include, but not limited to, failing to chart the Patient's current oral
dentition reflecting the missing teeth, existing restorations,
i' and existing prostheses and/or failing to document the patient's periodontal health status, to include, periodontal pocket depth probing and charting, mobiiity, recession, plaque, and calculus and/or failing to document results of an oral cancer screening and/or the degree of Patient
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R.R.'s atrophy and/or failing to perform the preceding examinations to justify proceeding with restorativ treatment, extractions, crown restorations, implant restorations, and/or denture fabrication, delivery and insertion;
o. By failing, on or about February 20, 2007, to document the
clinical examinations performed and the results thereof identifying any oral pathology and lack thereof to include, but not limited to failing to, document anything regarding the mandible teeth and/or the occlusion of Patient R.R.;
By failing from on or about February 20, 2007, through on or about May 19, 2008, to document a detailed comprehensive treatment plan even when the Respondent made substantial changes to the treatment plan as evidenced by the changes made on or about Mach 12, 2007, and/or July 2, 2007;
By failing, from on or about February 20, 2007, through on or about May 19, 2008, to chart the patient dentition as the dentition continued to evolve and endure substantial changes and failed throughout the continued course of
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treatment to document the periodontal health status of Patient R.R.; and/or
By failing, on or about July 25, 2007, and/or November 20,
2007, to take radiographs and/or maintain radiographs utilized to justify beginning restoration of implant numbers 4, 6, 10, and/or 11.
'''
Based on the foregoing, Respondent has violated Section 466.028(1)(m), Florida Statutes (2007-2008), by failing to keep written dental records and medical history records justifying the course of trEoatment of Patient J.G.
COUNT II: Failure to Release Patient Records
Petitioner re-alleges and incorporates paragraphs one (1) through seventeen (17) as if fully set forth herein.
Section 466.028(1)(n), Florida Statutes (2007) provides that "[f]ailing to make available to a patient or client, or to her or his legal representatives or to the department if authorized in writing by the patient ,
'i'
copies of documents in the possession or under the control of the licensee which relate to the patient or client[,]"shall constitute grounds for disciplinary action by the Board of Dentistry.
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Further, a dentist shall provide a copy of the patient records in the possession or under the control of the licensee in less than 30 days of receiving a demand. Rule 64B5-17.009(2), Fla. Admin. Code.
Respondent has failed to provide a copy of Patient R.R.'s treatment records within 30 days of receiving a written request for such records on or about May 19, 2008.
Based on the foregoing, Respondent has violated Section
466.028(1)(n), Florida Statutes (2007), by failing to release and or timely release a copy of Patient R.R.'s treatment records after a written demand was submitted.
Count III: Improper Record Release Condition
Petitioner re-alleges and incorporates paragraphs one (1) through seventeen (17) as if fully set forth herein.
Section 466.028(1)(11), Florida Statutes (2007-2008), provides
that "[v]iolating any provision of [] chapter [466] or chapter 456, or rules adopted pursuant thereto[,)" constitutes grounds for discipline. Further Rule 6485-17.009(1), Florida Administrative Code, provides that furnishing of copies of patient reports or records "shall not be conditioned upon payment of an unpaid or disputed fee for services rendered."
Respondent refused to release a copy of Patient R.R.'s records without requiring payment of an outstanding balance for services rendered and communicated this condition of payment prior to release of Patient R.R.'s records through written correspondence dated June 2, 2008, and through verbal communication on or about October 6, 2008.
Based on the foregoing, Respondent has violated Section 466.028(1)(11), Florida Statutes (2007-2008), by violating Rule 6485- 17.009(1), Florida Administrative Code by conditioning the release of
;.:. patient records upon "payment of an unpaid or disputed fee for services rendered."
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Ana M. Viamonte Ros, M.D., M.P.H.
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David D. Flynn
HPSU\Meclical\Dentistry\David Fly11n\Admin Compl•ints\2009\July\Sruart Goff, DDS (x)(m)(ll).doc
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 lier behalf if a hearing is requested.
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,
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