The Issue The issues in this case are whether the allegations set forth in the Administrative Complaint filed by the Department of Health (Petitioner) against Alexander Gaukhman, D.D.S. (Respondent), are correct, and, if so, what penalty should be imposed.
Findings Of Fact At all times material to this case, the Respondent was a licensed dentist in the State of Florida, holding license number DN 15657. The Respondent's mailing address of record was 400 Hanchey Drive, Nokomis, Florida 34275. Beginning on February 28, 2006, and continuing through January 10, 2007, the Respondent, or persons in his dental office, provided dental care and treatment to Patient S.K. (Patient), a female approximately 46 years of age. According to the Respondent's records, the woman presented to the Respondent as a new patient complaining of "severe pain" on February 28, 2006. On that date, the Respondent's records indicate that he performed a limited examination that included taking diagnostic x-rays. A limited oral examination is appropriate under emergent circumstances where the presenting complaint is severe pain. The Respondent's records contain no written documentation of the Respondent's findings based on his examination of the patient and no written diagnosis of oral pathology or disease. The Respondent performed root canal treatment on the Patient's teeth numbered 8 and 9 and placed crowns on the two teeth. The Respondent's records contain no written treatment plan related to root canal treatment provided to the patient. The Administrative Complaint alleged that the Respondent's treatment notes failed to identify the type or amount of anesthetic used during the root canal treatment. The evidence fails to establish that the Respondent administered anesthetic to the Patient during the root canal treatment. In addition to the emergency root canal treatment performed on February 28, 2006, the Respondent also placed veneers on the Patient's teeth numbered 6, 7, 10, and 11. Placement of prosthetic dental veneers is a cosmetic, not an emergent, procedure. The Respondent's records contain no written record of an examination related to placement of the cosmetic prosthetic dental veneers, no diagnosis or other information establishing the rationale for placement of the veneers, and no written follow-up plan related to the veneers. The Patient presented for prophylaxis (cleaning) on March 16, 2006, and again on October 10, 2006. The cleaning was performed by a dental hygienist working for the Respondent. According to the Respondent's records, the Respondent examined the patient on those dates. Such an examination would have included periodontal probing to determine the Patient's dental health. The Respondent's records fail to contain any record of a periodontal probing on March 16, 2006, or on October 10, 2006. Other than notation of pockets related to the root canal procedure, the Respondent's records fail to contain any indication that the Respondent performed periodontal probing on the Patient. Such probing is a basic and routine part of an examination to determine dental health. Because the Respondent was providing dental health services to the Patient, it is reasonable to presume that the Respondent performed the probing, but failed to document the process in his records. The Respondent has been previously disciplined by the Petitioner in an unrelated matter that was resolved in 2003.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Board of Dentistry enter a final order finding the Respondent in violation of section 466.028(1)(m) and imposing the following penalty: Imposition of a fine of $2,500. Successful completion of an educational course related to dental record-keeping and passage of the Florida Board of Dentistry Laws and Rules Exam. The Board of Dentistry shall designate the educational course and shall establish the deadlines related to imposition of this penalty. DONE AND ENTERED this 31st day of October, 2011, in Tallahassee, Leon County, Florida. S WILLIAM F. QUATTLEBAUM Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 Fax Filing (850) 921- 6847www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 31st day of October, 2011.
The Issue The issue in this case is whether the Board of Dentistry should discipline the Respondent, Robert John Roberts, for violating Section 466.028(1)(m) and (y), Fla. Stat. (1991), by failing to meet minimum standards of performance and by failing to keep adequate dental records, as alleged in the Administrative Complaint, DPR Case No. 91-11243.
Findings Of Fact The Respondent, Robert John Roberts, D.D.S., is a Florida licensed dentist, having been issued Board of Dentistry license number DN 0012197. A patient who will be identified by her initials, M. N., saw the Respondent on February 22, 1991, about having crowns replaced. The Respondent's dental records on the patient's medical history and his record of the clinical oral examination of the patient were inadequate. In addition, the records contained no diagnosis and treatment plan. In total, the records do not adequately explain what the Respondent planned to do, and why. There apparently was some confusion about the number of lower crowns to be replaced. The patient apparently first requested, and understood that she was having, six lower crowns replaced, three on either side (teeth 22, 23, 24, 25, 26 and 27.) But two of the six, one on either side (22 and 27), were splinted to the crown on the tooth next to it (21 and 28, respectively). At some point, the Respondent apparently decided not to attempt to split the splints, but rather decided to replace the crowns on all eight teeth. The Respondent's medical records do not adequately explain when this decision was made, or why, or whether it was explained to the patient. The patient remains confused as to why more than six lower crowns were replaced. The patient wanted the crowns replaced by June 1, 1991, so that the work would be covered by her existing insurance. The Respondent required $1,700 to begin the work. Work began on May 6, 1991. Temporary crowns were cemented on May 23, 1991. Although the patient's dental work was not unusually difficult or complicated, unusual problems developed in making and fitting the permanent crowns. Several efforts had to be made to attempt to complete the work. On occasion, the permanent crowns did not fit. On other occasions, they broke. The patient's temporary crowns had to be removed and replaced several times. Between May 6 and August 14, 1991, the patient had to be seen nine times. On August 14, 1991, a day on which the patient was scheduled to return to the Respondent's office to finally have the permanent crowns fitted and cemented, the Respondent's office called to cancel the appointment because the Respondent was not in the office. At the end of her patience, M. N. asked for her money back. The Respondent's office refused, suggesting other alternatives that were not acceptable to the patient. Instead, in September, 1991, the patient made an appointment with another dentist who had to start over at a cost of $4,000, in addition to the $1,700 the patient already had paid to the Respondent. Normally, permanent crowns are made, fitted and cemented within six weeks after the patient gets temporary crowns. Nothing in the Respondent's records explains or justifies the delay in completing the work for this patient. The evidence is that the Respondent's performance in the treatment given to the patient, M. N., failed to meet the minimum standards when measured against generally prevailing peer performance. Contrary to the Department's allegations, the X rays taken by the Respondent before treating the patient, M. N., were not of poor quality. The Department's allegation was based on the opinion of their expert, who was given poor copies of the X rays the Respondent took and who was given to understand that the copies he was sent were indicative of the quality of the X rays the Respondent took.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is recommended that the Board of Dentistry enter a final order: (1) finding the Respondent, Robert John Roberts, guilty of violating Section 466.028(1)(m) and (y), Fla. Stat. (1991); (2) reprimanding the Respondent; (3) fining the Respondent $3,000; and (4) placing the Respondent on probation for two years, conditioned upon the successful completion of thirty hours of continuing education in fixed prosthetics and fifteen hours in risk management, and upon payment of the $3,000 fine. RECOMMENDED this 29th day of April, 1993, in Tallahassee, Florida. J. LAWRENCE JOHNSTON Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 29th day of April, 1993. COPIES FURNISHED: Albert Peacock, Esquire Department of Professional Regulation Northwood Centre 1940 North Monroe Street Tallahassee, Florida 32399-0792 Robert John Roberts, D.D.S. 172 Wickford Street East Safety Harbor, Florida 34695 William Buckhalt Executive Director Board of Dentistry Northwood Centre 1940 North Monroe Street Tallahassee, Florida 32399-0792 Jack McRay, Esquire General Counsel Department of Professional Regulation Northwood Centre 1940 North Monroe Street Tallahassee, Florida 32399-0792
