NC Dental Board cases -

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NC Dental Board cases -

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Substance abuse issues dominate

• Three DDSs have lost their licenses in 2011 in
  connection with impairment issues.
• Another DDS failed to properly store Rx pads
  did not detect forgeries when his office mgr Rxd
  narcotics for patient. When DDS found out, he
  did not fire/discipline office mgr. Also bad
  charting on narcotic Rxs that the DDS wrote e.g.
  why giving this med?

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Dental Board Charting Issues

• Dentists disciplined for failure to chart
• 1. Amt, kind, and strength of Rx
• 2. Dated health Hx
• 3. Progress notes
• 4. Treatment provided e.g. repair of perforated
  tooth
• 5. That DDS informed pt of perforation or what
  tx options existed for that tooth

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Dental Board other cases

• Dental practice mngmnt contract illegal
• DDS planned to pull teeth, then treated them with
  scaling, root planing and Arestin, pulled them
  unnecessary tx
• DDS extruded ca hydroxide into soft tissue
• DDS rxd for non-dental conditions for self,
  family/friends e.g. viagra, estradiol,
  minocycline, simcor

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Dental Board - Medicaid fraud

• DDS miscodes billing to Medicaid 19,000 times -
  1 million collected
• Says he and staff checked with DMA as to
  appropriate code DMA denies this
• Also bills for SRP when only did regular cleaning
  this per a patient and former RDH when he
  does do SRP, only allows 45 minutes not enough
  time
• Bills for separate fillings when only did one
  filling with multiple surfaces

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Medicaid fraud - continued

• Billed for full mouth debridement but only did
  prophylaxis per his pt records
• Billed for medically unnecessary alveoloplasties
  after single tooth extractions
• Billed for surgical extraction when was simple
  extraction
• Bitewings showed decay that DDS did not note on
  chart then applied sealants to teeth with decay
  LICENSE REVOKED

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Medicaid Fraud

• Dr. Crow - 67 year old Texas DDS -70 months in
  jail, 3.2 million in fines, penalties
• Dr. Rossomando - 212,000 penalty for false
  billing
• Dr. Reed faces 5 years for billing Medicaid
  after exclusion from program
• Dr. Bramlett - 800,000 fines for billing for
  services not provided over 2 year period

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OSHA penalties

• Niles Family Dentistry allegedly forced 2 eees
  to resign when DDS thought they reported mercury
  spills at office. Allegedly, he reduced their
  hours, cursed and threatened them when they
  wouldnt clean up the spill or continue to work
  until spill was cleaned up - Litigation pending
• Dr. Domenella cited for lack of exposure control
  plan, proper vaccinations, 10k fine

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OSHA fines - continued

• Dr. Fayad allegedly ordered dental assistant to
  remove protective caps from contaminated needles
  before putting them in disposal container - OSHA
  seeking 26,400 in fines - Also DDS fired the
  assistant.

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HIPAA Update
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HIPAA Update

• U. Cal. pays 865,000 when its eees accessed
  celebrities records
• Mass General pays 1 million when eee left
  records of Infectious Disease Clinic patients on
  subway
• Cignet pays 4.3 million denied 41 pts. access
  to their records
• DDS flags outside of HIV pts charts

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HIPAA continued

• Practice provided summary of records as per
  state law - Feds say regardless of state law,
  you must provide the entire chart
• Note Dental regs only require original or
  copies of radiographs and a summary of the
  treatment record
• Lesson Provide a copy of entire record if it is
  requested

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HIPAA continued

• Practice billed 100 for records review fee and
  administrative fee. This is illegal. You can
  only charge reasonable copying fee.
• Note in NC you will lose right to collect past
  due dental charges if you bill patients personal
  injury attorney for copy of record.

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HIPAA notes

• If a patient files HIPAA complaint with you
• 1. Conduct investigation within 30 days.
• 2. If you find breach, you must mitigate.
• 3. If you find breach, you must discipline the
  employee.
• 4. Document all of the above.
• 5. If you get a letter from DHHS, hire a lawyer
  ASAP and notify malp ins co in writing. You must
  respond to DHHS within 30 days.

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Recent Cases
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Moore v. Proper NC 2011

• Pt says in 2006, DDS fxd her jaw during
  extraction says he did not tell her of the fx
  or provide tx.
• Litigation centers around qualifications of
  expert witness who was retired from full time
  dentistry in 1997.

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Brown v. Mortensen Cal. 2011

• Pt sues because DDS debt collector allegedly
  discloses confidential info of pt and his 2
  children Held patient has claim against the
  debt collector seems claim against DDS was
  settled out of court.

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Giannetto v. Knee NY 2011

• Pt says DDS cut her tooth while doing bridge
  work. Says he told her tooth just needed some
  bonding. She finds out after SOL that he had
  cut it. SOL suspended if DDS lied to her about
  what happened.

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Mara v. Otto Conn. 2011

• Pt accused DDS of sex assault while under
  nitrous. She tells police no one else. DDS
  sues her for defamation.
• Held no evidence of malice on her part. Case
  dismissed.

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• Castle doctrine extends to office and car seems
  to allow you to use gun for protection
  legislation is too vague
• Landowners owe no duty to trespassers except
  children when property has attractive nuisance
  e.g. swimming pool
• With more than 25 employees, you must use
  E-verify to be sure of citizenship of job
  applicants

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More

• Tort Reform Legis. Overrides Veto

• 1. If damage claim equals or exceeds 150,000,
  bifurcated trial required if requested by
  party
• Cap of 500,000 on noneconomic damages (pain,
  suffering, physical impairment, emotional
  distress)
• Exceptions to cap if patient suffers
  disfigurement, loss of use of part of body,
  permanent injury or death
• Also exception if defendants acts were
  reckless, fraudulent, malicious

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Even more

• Revises SOL for children
• 1. General rule if would expire before child
  reaches 10 years of age, must bring suit before
  then
• 2. If would have expired and before child is 18
  if child is abused/neglected per ct. order, may
  be extended for 3 years from order
• 3. If child is in custody of state, county, or
  agency, extended to one year after child is no
  longer in such custody.

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Finally -

• The SOL revision applies to causes of action
  arising on or after 10-1-11.

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Caveat

• This course is intended for educational purposes
  and is not individual legal advice. For specific
  issues, you should promptly consult an attorney
  for in depth review of laws and facts and for
  recommended action.

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Thanks for coming to the course.

• Patrice Walker
• Attorney at Law
• PO Box 16157
• Chapel Hill, NC 27516
• 919-933-1325
• wlkrlaw_at_gmail.com

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