In November 2019, an oral and maxillofacial surgeon in New Jersey had his license revoked by the New Jersey State Board of Dentistry and was ordered to pay roughly $517,000 in penalties, costs, and restitution to patients. The oral surgeon was said to have engaged in “hit and run dentistry” that had harmful consequences for many patients. The New Jersey State Board of Dentistry ordered the oral surgeon to pay civil penalties totaling $138,500; restitution totaling $75,041.22 to fifteen patients; and aggregate costs and attorneys’ fees of $303,856.22. New Jersey Attorney General Gurbir S. Grewal said
“…revolving-door dentistry that puts practitioners’ financial gain ahead of patient health and safety erodes public trust and undermines the integrity of the entire profession. That’s why it’s important for the Board to take decisive action in cases like this one, and we are pleased that the Board did so.”
The New Jersey State Board of Dentistry found that the oral surgeon took advantage of low-income, elderly, and disabled patients by practicing in such a manner that deviated from the typical standard of care. Examples of the conduct the oral surgeon engaged in included pulling teeth and replacing them with implants when the teeth pulled could have been restored, not considering the patient’s ability to pay for care when treating them, discussing treatment when patients were already sedated, not paying attention to patient’s medical histories, inflated billing for care provided, employing dentists in his practice that did not have patient’s health, safety, and welfare in mind, and pressuring eldery and Medicaid patients into implants and loans respectively.
The New Jersey State Board of Dentistry mostly agreed with the findings of an administrative law judge who heard the case in a series of hearings in early 2019. The law judge issued a decision in May 2019 and mentioned that the oral surgeon’s practice was overextended and essentially unable to provide quality care. The law judge said license removal was appropriate due to acts of negligence, professional misconduct, dishonesty and deception, and a lack of providing appropriate care for patients.
The initial decision by the State of New Jersey Office of Administrative Law is available at https://www.nj.gov/oag/newsreleases19/2019-1126_Maron_ALJ_Initial_Decision.pdf while the final decision and order by the State of New Jersey Division of Consumer Affairs and the State Board of Dentistry is available at https://www.nj.gov/oag/newsreleases19/2019-1126_Maron_Final_Decision_and_Order.pdf.
Two of the cases involved wisdom teeth extractions:
In the case known as count 16, a 17 year old male had four wisdom teeth extracted while the oral surgeon gave two doses of Versed. However in this case, the oral surgeon billed for general anesthesia even though his license to administer general anesthesia had been inactive for multiple years prior. A panorex x-ray of the man’s wisdom teeth that was used had been taken about four years prior. Further, a panorex was billed for that was not in the record. Also, there was no evidence that the patient consented to the wisdom teeth surgery in the record. An expert oral and maxillofacial surgeon who reviewed the case said that a panoramic x-ray is needed prior to wisdom teeth surgery to determine if the teeth are impacted, if there are more or less teeth than typical present, if a cyst or tumor is present, and to help determine if additional cone beam CT is needed due to possible nerve damage.
In the case known as count 17, a 25 year old pregnant patient had four wisdom teeth extracted while the oral surgeon ignored advice from her medical doctor about medications to take. A letter from the woman’s obstetrician said she may have Novocain without epinephrine and Tylenol with codeine for pain. Instead the oral surgeon gave her local anesthesia with epinephrine (Septocaine) and prescribed Vicodin for pain.
Other cases of note involved the following:
In the case known as count 6, a 26 year old woman had an upper right tooth removed (2nd bicuspid). During the tooth extraction, the oral surgeon’s eight year old son ran into the room when the oral surgeon’s assistant dropped the suction to pick it up. The oral surgeon did not have any childcare for his son (on that particular day the 26 year old woman was seen) and the office was 800 square feet.
In the case known as count 7, a 64 year old man had ten teeth removed by the oral surgeon and six implants placed. The man had to take out tens of thousands of dollars of CareCredit loans to help pay for the dental work. However, the records did not include a computed tomography scan or surgical guide to show that the man needed the work done. Further, one of the implants became displaced into his sinuses and the man was never informed of this until later being discovered by a ear, nose, and throat doctor.
Source: The State of New Jersey Office of Attorney General, “Board of Dentistry Revokes License of North Jersey Oral Surgeon and Orders Him to Pay $517,000 for ‘Hit and Run Dentistry‘,” November 26, 2019.