STATE OF FLORIDA BOARD OF DENTISTRY PETITIONER, RESPONDENT. ADMINISTRATIVE OMPLAINT

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1 DEPARTMENT OF HEALTH, STATE OF FLORIDA BOARD OF DENTISTRY PETITIONER, v. CASE NO: JEROME IRA BISTRITZ, D.D.S., RESPONDENT. ADMINISTRATIVE OMPLAINT COMES NOW Petitioner, Department of Health, by and through its undersigned counsel, and files this Administrative Complaint before the Board of Dentistry against Respondent, Jerome Ira Bistritz, D.D.S., 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 Respondent's address of record 2332 Pine Ridge Road, Naples, Florida

2 4. An additional address for Respondent is 4544 North Jefferson Avenue, Miami Beach, Florida On or about October 2, 2013, Patient I.V. presented at Caplin & Gober D.D.S., P.A. ("Caplin & Gober"), in Hialeah, Florida for a dental exam from her general dentist, Dr. P.R. 6. Dr. P.R. and Patient I.V. agreed to have Patient I.V. referred to Palmetto Center for Dental Specialties ("Palmetto"), for a root canal treatment on Patient I.V.'s tooth #20 and an extraction of tooth # Patient I.V. was seen by two practitioners who worked for Palmetto: Dr. R.C., an endodontist and Respondent, an oral surgeon. 8. On or about October 4, 2013, Patient I.V. presented to Palmetto and was treated by Dr. R.C. for a root canal procedure on tooth #20. The root canal was performed according to plan. 9. On or about October 7, 2013, Patient I.V. presented to Respondent at Palmetto for extraction of her tooth # The Patient records for Patient I.V. from Palmetto, included a referral from her primary dentist, Dr. P.R., which stated the tooth to be extracted was Patient I.V.'s tooth # On October 7, 2013, Patient I.V. signed a consent form to have tooth #19 extracted. 2

3 12. On that date Respondent instead extracted Patient I.V.'s tooth #20 and placed an immediate implant for that tooth. 13. Respondent pulled the incorrect tooth that had received a root canal treatment just three days prior. 14. Section (1)(mm), Florida Statutes (2013), provides that "[v]iolating any provision of this chapter or chapter 456, or any rules adopted pursuant thereto[,]" is grounds for disciplinary action by the Board. 15. Section (1)(bb), Florida Statutes (2013), provides for disciplinary action for "[p]erforming or attempting to perform health care services on the wrong patient, a wrong-site procedure, a wrong procedure, or an unauthorized procedure or a procedure that is medically unnecessary or otherwise unrelated to the patient's diagnosis or medical condition." 16. Respondent violated Section (1)(mm), Florida Statutes (2013), by extracting the wrong tooth for Patient I.V., in violation of Section (1)(bb), Florida Statutes. [Signature follows on next page] 3

4 WHEREFORE, Petitioner respectfully requests that the Board of Dentistry enter an order imposing one or more of the following penalties: suspension of Respondent's license, restriction of practice, imposition of an administrative fine, issuance of a reprimand, 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 day of 1-cAttb-ex" Celeste Philip, MD, MPH Surgeo eral & Secretary FILED DEPARTMENT OF HEALTH DEPUTY CLERK CLERK Amber Greene DATE SEP arrison Assistant General Counsel DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida Florida Bar # FAX Rose.Garrison@flhealth.gov PCP: September 1, 2017 PCP: Members: Dr. Thomas, Dr. Morgan, Dr. Perdomo Prepared: July 17, 2017 DOH V. Jerome Ira Bistritz, DOH Case #

5 NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section and , 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 her behalf if a hearing is requested. A request or petition for an administrative hearing must be in writing and must be received by the Department within 21 days from the day Respondent received the Administrative Complaint, pursuant to Rule (2), Florida Administrative Code. If Respondent fails to request a hearing within 21 days of receipt of this Administrative Complaint, Respondent waives the right to request a hearing on the facts alleged in this Administrative Complaint pursuant to Rule (4), Florida Administrative Code. Any request for an administrative proceeding to challenge or contest the material facts or charges contained in the Administrative Complaint must conform to Rule (5), Florida Administrative Code. Mediation under Section , Florida Statutes, is not available to resolve this Administrative Complaint. 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 Section (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. DOH v. Jerome Ira Bistritz, DOH Case #