In July 2004, the Arizona State Board of Dental Examiners charged Terry J. Lee with unprofessional conduct by failing to maintain adequate records. The complaint was filed after an audit of his charts found that (a) he did not record evaluations for many patients for whom he provided periodontal (gum) treatment; (b) he administered intravenous vitamin C infusions without documenting any diagnosis or health history justifying their use; and (c) he made notions of “detox” without sufficiently identifying what it is or why he believed it was necessary. In February 2005, the board upheld the complaint, assessed a $4,000 penalty, and suspended his dental license for 45 days. Lee appealed this order, but the appeals court upheld it. The audits were part of a process that began in 1999 when the board placed him on 5 years’ probation with quarterly audits of diagnosis, treatment, planning skills, and recordkeeping.
IN THE OFFICE OF ADMINISTRATIVE HEARINGS
FOR THE ARIZONA STATE BOARD OF DENTAL EXAMINERS
IN THE MATTER OF:
Terry J. Lee, DDS
Holder of License Number D 1555
|Complaint No. 240108
- TO: Terry J. Lee, D.D.S.
- 4210 N. 32nd Strect
Phoenix, Arizona 85018
The Arizona State Board of Dental Examiners issues this Complaint and Notice of Hearing pursuant to A.R.S. §§ 32-1201, -1207, -1263, -1263.01, -1263.02, and A.R.S. §§ 41.1092 through 41-1092.1 2
II. NOTICE OF HEARING
For the reasons contained in this Complaint and Notice of Hearing, the Arizona State Board of Dental Examiners has requested that an Administrative Law Judge from the Office of Administrative Hearings conduct a formal hearing at 1400 W. Washington Avenue, Suit.e 101, Phoenix, Arizona at 9:00 a.m. on September 14, 2004 to determine whether grounds exist to take disciplinary action, including suspension or revocation, against Terry J. Lee. D.D.S., the holder of license no. D 1555 for the practice of dentistry in the State of Arizona. At the hearing, the Administrative Law Judge will hear testimony. take evidence, and produce recommended findings of fact. conclusions of law, and a recommended decision in this case.
1. The Arizona State Board of Dental Examiners (“Board”) has authority to regulate and control the practice of dentistry in the State of Arizona.
2. Terry J. Lee, D.D.S. (“Respondent”) is the holder of license no. D 1555 for the practice of dentistry in the State of Arizona.
IV. FACTUAL ALLEGATIONS
1. On February 24, 1999, the Board issued an Order in case nos. 95083.95084,95135. 95178,95312.96024,96054,96175 and 97341 (consolidated) (the “1999 Board Order”).
2. The 1999 Board Order contains a finding that Respondent engaged in unprofessional conduct by repeatedly failing to maintain adequate treatment records for his patients (as required by A.R.S. § 32-1264 and 32-1201(8)(y). Specifically, Respondent repeatedly failed to sufficiently document periodontal charting. clinical examination notes, written diagnosis and/or written treatment plans. Additionally, the 1999 Order found that Respondent failed to adequately document the administration of intravenous Vitamin C in his treatment records.
3. The 1999 Board Order censured Respondent, and placed him on probation for five (5) years, the terms of which required him to take forty-eight hours of continuing education and subjected him to peer review and quarterly audits of his diagnostic treatment planning and record keeping methods. Included in the ordered continuing education was twelve (12) hours in record keeping and twelve (12) hours in diagnosis and treatment planning. Respondent timely completed the ordered continuing education.
4. The first audit of Respondent’s records found, among other things, that Respondent continued to maintain inadequate treatment records. As a result of the audit, the Board opened ease nos. 200235 and 220306 against Respondent that included allegations of noncompliance with the 1999 Board Order and failure to maintain adequate records.
5. On or about December 9,2002 Respondent and the Board entered into a Consent Agreement and Order (the “2002 Consent Agreement”) to resolve Case Nos. 200235 and 220366. The Consent Agreement contains a Conclusion of Law that Respondent’s continued failure to record clinically acceptable justification for treatment in patients’ records and to properly chart patients’ periodontal condition constitutes unprofessional conduct.
6. The 2002 Consent Agreement placed Respondent’s license on probation for three (3) years, ordered him to take eight (8) hours of continuing education in risk management and subjected him to semi-annual audits of his patient records.
7. The 2002 Consent Agreement also ordered Respondent’s treatment records to contain “a recognizable, legitimate diagnostic method, within the standard of care, that support his diagnosis and treatment of a patient.” Additionally, the 2002 Consent Agreement ordered Respondent to maintain treatment records that comply with A.R.S. § 32-1264 and contain clinical and treatment information that is within the standard of care.
8. An audit of fifty of Respondent’s patient records was commenced in October 2003. The audit resulted in findings that some of Respondent’s treatment records did not contain written diagnoses or support for treatment rendered and that Respondent failed to properly document periodontal conditions and charting.
9. For the following patients, Respondent’s treatment records contain none or insufficient periodontal charting: M.D. – record contains no current periodontal charting; J.H. I record contains no updated periodontal charting; MJ. – record contains no written periodontal evaluation of teeth treated and no charting of any teeth; M.K., T.M., S.M., M.N. – no periodontal charting present in records.
10. For the following patients, Respondent’s treatment records indicate Respondent administered an intravenous Vitamin C drip: M.D.; L.E., B.G., P.G., L.G., and LT. Respondent’s treatment records do not contain a documented diagnosis or health history notation justifying the use of a Vitamin C drip. Additionally, Respondents’ treatment records do not contain documentation regarding the dosage of Vitamin C administered, the length of the administration or the administration site.
11. For the following patients, Respondent’s treatment records contain the notation “detox” but fail to sufficiently identify what “detox” is or explain the necessity for the detox: J.A.; J.B.; M.D.; L.B.; and S.M.
12. For the following patients, Respondent’s treatment records contain inadequate and/or undiagnostic radiographs: E.A – record contains undiagnostic digital radiograph; J.B. record does not contain current radiographs supporting treatment rendered on May 27, 2003; M.N. – record contains undiagnostic panorex; L.S.B. – record contains two undiagnostic bitewing radiographs.
1. The conduct and circumstances described in the above factual allegations constitute unprofessional conduct as defined in A.R.S. § 32-1201(18)(w), failure to comply with a Board Order, and are grounds for discipline, including suspension or revocation, pursuant to AR.S. § 32-1263(1) and -1263.01(C). Respondent’s treatment records, described in paragraphs 9 through 12 do not include a recognizable diagnosis supporting his treatment and/or fail to include the information required by A.R.S. § 32-1264(A), in violation of the 2002 Consent Agreement.
2. Respondent’s treatment records, as described in paragraphs 9 through 12 fail to include the information required by A.R.S. § 32-1264 and Respondent’s failure to maintain adequate treatment records constitutes unprofessional conduct as defined in A.R.S. § 32 -1201(l8)(t) and (y) and is grounds for discipline under A.R.S. § 32-1263(1) and (4).
RESPONDENT IS HEREBY NOTIFIED that pursuant to A.R.S. § 32-1263.01(G) he shall submit a written answer to the allegations and charges contained herein within twenty (20) days of receipt of the Complaint and Notice of Hearing. Failure to submit a written answer within twenty days shall be deemed an admission of the acts charged herein and the Board may revoke or suspend Respondent’s license without proceeding to hearing.
RESPONDENT IS FURTHER NOTlFlED that he may appear with or without the assistance of an attorney, on the date and at the place specified in this Complaint and Notice of Hearing, and may present testimony and argument in his defense with respect to the alleged violation contained in this Complaint and Notice of Hearing. The written report of the Administrative Law Judge’s findings of fact, conclusions of law and recommended decision will be submitted to the Arizona State Board of Dental Examiners for its consideration in determining an appropriate disposition.
RESPONDENT IS FURTHER NOTIF1ED that if he fails to appear at the hearing, the Arizona Board of Dental Examiners may proceed and determine this matter in her absence.
Dated this 26th of July, 2004
Julie N. Chapko