STATE OF FLORIDA BOARD OF DENTISTRY DEPARTMENT OF HEALTH, Petitioner, CASE NO: 2016-00314 vs. PATRICK MICHAEL GARRETT, D.M.D. Respondent ADMINISTRATIVE COMPLAINT Petitioner Department of Health, by and through its undersigned counsel, files this Administrative Complaint against the Respondent PATRICK MICHAEL GARRE I I, D.M.D., and alleges: 1. Petitioner is the agency charged with regulating the practice of dentistry pursuant to Section 20.43, Florida Statutes; Chapter 456, Florida Statutes; and Chapter 466, Florida Statutes. 2. Respondent is, and has, been at all times material to this Complaint, a licensed dentist in the State of Florida, having been issued license numbered DN 18977.
3. Respondent's address of record with the Board of Dentistry is 116 Winchester Drive, Unit C, Palm Beach, Florida 33410. 4. On or about August 20, 2015, Patient L.K. appointed with Respondent, for an examination and consultation. Respondent proposed a treatment plan of crown placement for Patient L.K.'s tooth #3. 5. On or about September 3, 2015, Respondent placed a temporary crown on tooth #3. Patient L.K.'s tooth #3 was prepared for final impressions. Respondent recommended a root canal treatment on Patient L.K.'s tooth #2. 6. Respondent's notes and records for Patient L.K. failed to contain a diagnosis that would justify the proposed treatment plan of a root canal treatment for tooth #2. 7. Radiographs taken by a subsequent provider showed no evidence that the nerve of tooth #2 was affected by decay or that the tooth showed any evidence of periapical pathology or abscess formation. 8. On or about September 17, 2015, Patient L.K. presented for delivery of the permanent crown for tooth #3. The permanent crown was not delivered due to poor fitting buccal margins. A new crown was to be constructed.
9. On October 1, 2015, Respondent placed a permanent crown on tooth #3. 10. Minimum standards of restorative treatment require that decay be removed before restorations are seated. 11. On or about November 7, 2015, Patient L.K. appointed with Dr. L. for subsequent treatment. Dr. L. found that the crown on tooth #3 had residual decay that was not removed before Respondent placed Patient L.K.'s crown. Dr. L. also found ill-fitting margins and marginal voids on the new restoration placed by Respondent. 12. Respondent failed to meet the minimum standards of performance in diagnosis and treatment by failing to remove decay on Patient L.K.'s tooth #3 before placing the crown. 13. The minimum standard of performance in diagnosis and treatment in the practice of dentistry requires a practitioner to adequately seat and verify the fit of a restoration such as a crown or bridge so as to avoid open margins. 14. Leaving an open margin allows for bacteria and debris to access the tooth underneath, and increases the risk for developing pathologies in the periodontia and gingiva, as well as the development of dental decay. 3
15. Respondent failed to meet minimum standards of performance in diagnosis and treatment by failing to adequately seat and verify the fit of the crown so as to avoid open margins. 16. Section 466.028(1)(x), Florida Statutes, provides that "[b]eing guilty of incompetence or negligence by failing to meet the minimum standards of performance in diagnosis and treatment when measured against generally prevailing peer performance, including but not limited to, the undertaking of diagnosis and treatment for which the dentist is not qualified by training or experience or being guilty of dental malpractice [1]" shall constitute grounds for disciplinary action by the Board of Dentistry. 17. Respondent violated Section 466.028(1)(x), Florida Statutes, in one or more of the following ways: A. By failing to remove decay before placing crowns on Patient L.K.'s tooth #3; or, B. By failing to adequately seat and verify the fit of the crown so as to avoid open margins. COUNT II 18. Petitioner incorporates paragraphs one (1) through seven (7); as though fully stated herein. 4
19. Section 466.028(1)(m), Florida Statutes, provides that failing to maintain dental records justifying the course of treatment is grounds for disciplinary action by the Board of Dentistry. 20. Rule 6465-17.002(1)1 Florida Administrative Code, states that for the purpose of implementing the provisions of Section 466.028(1)(m), Florida Statutes, a dentist shall maintain written records on each patient, which records shall contain, at a minimum, the following information about each patient: A. Appropriate medical history; B. Results of clinical examinations and tests conducted, including the identification, or lack thereof, of any oral pathology or diseases; C. Any radiographs used for the diagnosis of the patient; D. Treatment plan proposed by the dentist; and E. Treatment rendered to the patient. 21. Respondent failed to maintain records in violation of section 466.028(1)(m), Florida Statutes, by failing to maintain diagnostic findings justifying the course of treatment for a root canal treatment on Patient L.K.'s tooth #2. 5
WHEREFORE, Petitioner respectfully requests that the Board of Dentistry enter an order imposing one or more of the following penalties: suspension of Respondent's licensure, or restriction of Respondent's 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 / 2017. Celeste Philip, MD, MPH Surgeon General & Secretary FILED DEPARTMENT OF HEALTH DEPUTY CLERK CLERK Amber Greene DATE MAY I 5 2017,Ros arrison Assistant General Counsel DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, Florida 32399-3265 Florida Bar # 105920 850.245.4640 FAX 850.245.4684 Email:Rose.Garrison flhealth.gov PCP: May 5, 2017 PCP Members: Dr. Fatmi, Dr. Thomas, and Dr. Britten Prepared: February 9, 2017 6
NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section 120.569 and 120.571 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 28-106.111(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 28-106.111(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 28-106.2015(5), Florida Administrative Code. Mediation under Section 120.573, 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 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. DOH v. PATRICK MICHAEL GARRETT, D.M.D., 2016-00314 7