NC Dental Board cases -

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Substance abuse issues dominate

Three DDS’s 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 Rx’d narcotics for patient. When DDS found out, he did not fire/discipline office mgr. Also bad charting on narcotic Rx’s 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 rx’d 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 e’ees to resign when DDS thought they reported mercury spills at office. Allegedly, he reduced their hours, cursed and threatened them when they wouldn’t 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 e’ees accessed celebrities’ records

Mass General pays $1 million when e’ee 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 reg’s 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 patient’s 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 fx’d 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

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1. If damage claim equals or exceeds $150,000, bifurcated trial required if requested by party2.Cap of $500,000 on noneconomic damages (pain, suffering, physical impairment, emotional distress)3.Exceptions to cap – if patient suffers disfigurement, loss of use of part of body, permanent injury or death4.Also – exception if defendant’s acts were reckless, fraudulent, malicious

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@gmail.com

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