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Dental Question

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Zellie

Junior Member
Alabama
I am filing a complaint against my dental office. I feel they behaved unprofessionally by having a dental assistant deal with a dental emergency without a dentist being in the building. She rushed through the appointment because she had forgotten about it and had to come back to the dental office, leaving her kids in the car to briefly treat me. I went through excruciating pain because of her treatment and had to seek care with an emergency dentist two days later.

I am not seeking reimbursement or any type of monetary compensation. I am just angry over what happened.

I called my dentist's office and they will not give me the name of the lady who treated me (the form asks for the name) and also have refused to give me my dental records. They did confirm the lady was a dental assistant. They stated they would send my x-rays to the next dentist I go to but that any handwritten notes in my file are private and legally they don't have to allow me to view or get a copy of them.

Is this true?
 


ecmst12

Senior Member
You are entitled to a copy of your medical records. Make a proper request IN WRITING via certified mail.
 

barry1817

Senior Member
Dental

Alabama
I am filing a complaint against my dental office. I feel they behaved unprofessionally by having a dental assistant deal with a dental emergency without a dentist being in the building. She rushed through the appointment because she had forgotten about it and had to come back to the dental office, leaving her kids in the car to briefly treat me. I went through excruciating pain because of her treatment and had to seek care with an emergency dentist two days later.

I am not seeking reimbursement or any type of monetary compensation. I am just angry over what happened.

I called my dentist's office and they will not give me the name of the lady who treated me (the form asks for the name) and also have refused to give me my dental records. They did confirm the lady was a dental assistant. They stated they would send my x-rays to the next dentist I go to but that any handwritten notes in my file are private and legally they don't have to allow me to view or get a copy of them.

Is this true?
Your records are yours and you are entitled to copies.

What I would do, if in your place, is ask for a complaint form from the dental board.

file the complaint with board, explain that they won't give you the copies of the chart and I like the term, aiding and abetting the practice of dentistry without a license.

Depending what your emergency was, the treatment by an unlicensed dentist could be called practicing dentistry without a license. And a dentist that would send his assistant to to treat a patient is aiding and abetting that practice.

And then get another dentist, and have the new dentist request all records.
 
And then get another dentist, and have the new dentist request all records.
I'd do this in reverse. Get a new dentist, request all the records (he's more likely to turn over a complete set of them to another dentist than the dental board), then file your complaint.
 

ecmst12

Senior Member
The records belong to the provider. The patient is entitled to a copy, but the patient does NOT own the records. You should know that, Barry.
 

Zellie

Junior Member
Thank you for the replies. I spoke with the dental board yesterday and have the complaint form. They indicated that the turnaround on investigating complaints is between 6 - 8 months. They also indicated that if I have already complained to my dentist about my treatment (and I had left messages over the week-end regarding the pain and that I felt my treatment on Friday wasn't appropriate) that I should be prepared to not hear further from my dentist. The Board indicated that based on my statement that the dental assistant had made a huge error and the dentist would be held responsible and probably knows it.

Since they would not be able to investigate for quite a while, I wanted the name of the person treating me and my file. The dentist's office stated that they would send x-rays only on to the next dentist (no notes or other chart records - those were seen as personal notes). She said that I could pick up the x-rays if I wanted, but not the notes - only x-rays. So asking the next dentist to get them will not work.

My dental emergency is probably not as bad as what you may be imagining (although it was certainly significant to me). I had a dry socket and was concerned about the pain, the possibility that tooth shards might still be in the gum and infection. I called the office early Friday but they couldn't see me until late in the afternoon. When I arrived, nobody was there other than the office staff of the business they share space with. They are the ones who called her and she stated that she forgot. She came in, diagnosed me as a dry socket, packed the socket and sent me on my way. My biggest concerns were on how she packed the socket (she didn't explain the packing materials and I've had a reaction before to a certain type of packing - I had told her this and asked. She said that the type they were using wouldn't cause a reaction - as well, she was clumsy in how she packed it and accidentally jabbed the site with various materials in the process) and her insistence that pain medication was not necessary with a dry socket. She said ibuprofen would take care of things because the packing would take care of all the pain. She indicated that she thought I wanted the pain medication for recreational use. She came to this conclusion because I had stated that the pain medication and ibuprofen were no longer adequately covering the pain (which is how I knew I had a dry socket). She said that if the pain medication wasn't working, why did I want more of it? She said the ibuprofen alone would take care of it and wrote me a schedule on how to take the ibuprofen.

After we argued, she indicated that she would call in pain medication but that I needed to try it her way first. I asked if I could take the prescription with me (since I had a feeling she wouldn't call it in) but she said that nobody was in the building but her and she didn't have the authority to write them, only call them in. She waited six hours to call the medication in to the pharmacy (well after it closed) and the packing either fell out or wore off around 4 am. (Pharmacy didn't open until 8). I could never "catch up" and get ahead of the pain and finally the next day I went to an emergency dentist. I told him I had pain medication and didn't need any more, I just wanted the site packed again. He stated that I had an infection (dental assistant said I did not) and the packing wasn't there. He re-packed, checked for shards (it was fine) and prescribed stronger medication.

I'm still having a lot of pain but it's almost controlled. It still hurts through the pain medication but it's not anywhere as bad as this past week-end.

I didn't find out until yesterday that she shouldn't be diagnosing, treating, packing, applying medication, etc without being under the direct supervision of a dentist. I feel that if the dentist had been there (who is really a nice guy and a good dentist), things would have been done properly without argument over pain medication. I have had dry sockets in the past and my dentist knew that when he extracted the tooth, due to the difficulty, that it might develop into a dry socket. I certainly don't blame him for the dry socket. I considered my treatment appropriate until I encountered her on Friday.
 
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ecmst12

Senior Member
She was telling the truth about one thing - a dental assistant cannot write a prescription. She would have had to contact the actual dentist to call one in.

You filed your complaint, great. You will probably not find out what the outcome was, if anything.

Submit a proper request for your medical records under HIPAA IN WRITING, via certified mail. If they do not respond to your request, file a complaint with the HIPAA board.
 

Zellie

Junior Member
She was telling the truth about one thing - a dental assistant cannot write a prescription. She would have had to contact the actual dentist to call one in.

You filed your complaint, great. You will probably not find out what the outcome was, if anything.

Submit a proper request for your medical records under HIPAA IN WRITING, via certified mail. If they do not respond to your request, file a complaint with the HIPAA board.

Thank you for the reply. Incidentally, I don't think she contacted the dentist prior to her calling it in. She told me that she couldn't prescribe anything stronger than what I had already been taking (hydrocodon 5). She said she only had the authority to call in pain medication at the strength/dosage that I was currently taking. She didn't indicate that she would be contacting him at all. (If she had looked in my file she would've seen that I don't take anything stronger than hydrocodon 7.5 anyway - I tend to have reactions -rash, itching of face, neck and chest - to anything stronger. I only take hydrocodon or tramadol for pain). It is possible that she contacted him, but she gave every indication that she was the one prescribing it and she had certain rules for what she could and could not prescribe since the dentist wasn't around.

Also, I haven't sent in my complaint yet. It seemed prudent to wait a few days and try to write a thorough and non-emotional complaint. As well, I'd like to be lower on my medication to make sure I don't forget anything.

If you don't mind another question - do I have the right to know the name of the lady treating me? We live in a very small town. It will be awkward enough bumping into my dentist at church. I'd like to know her name in case I encounter her in a different setting (children's activities, etc). In my mind, she was a medical provider and I should have the right to know her name. Granted, what sounds right to me isn't what is always legally appropriate and they have indicated that they will not give me her name.
 

tranquility

Senior Member
If you don't mind another question - do I have the right to know the name of the lady treating me?
Where might we find such a right? No, you don't have that "right". You might get the name in discovery if you initiate a lawsuit.
 

Zellie

Junior Member
Tranquility - my understanding of a medical bill of rights is that a patient has the right to know the name of those providing treatment. I didn't know if dentistry had something similar and couldn't locate that information through google. As I mentioned earlier, I'm not seeking any type of monetary compensation (and my only out of pocket expense was $35 to see a different dentist - hardly worth pursuing) and I don't believe I have grounds for a lawsuit.

Ecmst12 - Thank you.
 

ecmst12

Senior Member
IMO, if you didn't care enough to ask her name when she was actually sticking her fingers in your mouth, it must not have been that important to you. I'm sure she would have told you if you'd asked then.
 

tranquility

Senior Member
Tranquility - my understanding of a medical bill of rights is that a patient has the right to know the name of those providing treatment.
Since you're talking about "rights", where would I find the medical bill of rights (Generally called a paitent's bill of rights.) you refer to?

As I mentioned earlier, I'm not seeking any type of monetary compensation (and my only out of pocket expense was $35 to see a different dentist - hardly worth pursuing) and I don't believe I have grounds for a lawsuit.
Then, you have no right to the name.
 

TheGeekess

Keeper of the Kraken
Section 34-9-18
Grounds for disciplinary action.

(a) The board may invoke disciplinary action as outlined in subsection (b) hereof whenever it shall be established to the satisfaction of the board, after hearing as hereinafter provided, that any dentist or dental hygienist has been guilty of the following:

(1) Fraud, deceit, or misrepresentation in obtaining any license, license certificate, annual registration certificate, money, or other thing of value.

(2) Gross immorality.

(3) Is a menace to the public health or to patients or others by reason of a disease.

(4) Is an habitual user of intoxicants or drugs rendering him or her unfit for the practice of dentistry or dental hygiene.

(5) Has been convicted for violation of federal or state narcotics or barbiturate laws.

(6) Is guilty of negligence or gross negligence.

a. For the purposes of this subdivision, negligence is defined as the failure to do what a reasonably prudent dentist or dental hygienist would have done under the same or similar circumstances or the doing of that which a reasonably prudent practitioner would not have done under the same or similar circumstances.

b. For the purposes of this subdivision, gross negligence is defined as willful or wanton conduct with reckless, malicious, or conscious disregard for the rights or safety of others, or conduct that is so deliberate, outrageous, and callous as to display total indifference to the health or safety of a patient, that could result in serious bodily injury or death.


(7) Is guilty of employing, allowing, or permitting any unlicensed person or persons to perform any work in his or her office which, under this chapter, can only be legally done by a person or persons holding a license to practice dentistry or dental hygiene.

(8) Willfully or negligently violates the rules of the State Department of Health or of the board regarding sanitation.

(9) Is guilty of division of fees, or agreeing to split or divide the fee received for dental service with any person for bringing or referring a patient without the knowledge of the patient or his or her legal representative, except the division of fees between dentists practicing in a partnership and sharing professional fees, or in case of one licensed dentist employing another.

(10) Is guilty of professional connection or association with or lending his or her name to anyone who is engaged in the illegal practice of dentistry or dental hygiene.

(11) Conviction in any court of competent jurisdiction of a felony or a misdemeanor involving moral turpitude.

(12)a. A dental hygienist using or attempting to use in any manner whatsoever any prophylactic list, call list, records, reprints, or copies of same, or information gathered therefrom, of the names of patients whom the dental hygienist served in the office of a prior employer, unless the names appear upon the bona fide call or prophylactic list of his or her present employer and were caused to appear through the legitimate practice of dentistry or dental hygiene as provided for in this chapter.

b. A licensed dentist who aids or abets or encourages a dental hygienist employed by him or her to make use of a prophylactic list or the calling by telephone or by the use of letters transmitted through the mails to solicit patronage from patients formerly served in the office of any dentist employing the hygienist or nurse.

(13) Pertaining to licensed dentists only, the prescribing, administering or dispensing of any controlled substances enumerated in Schedules I through V contained in the Alabama Uniform Controlled Substances Act, Chapter 2 of Title 20, or any amendment or successor thereto, or any drug not prescribed for any dentally or facially related condition, and/or for any necessary medication during the course of treatment rendered directly by the dentist, for any person not under his or her treatment in the regular practice of his or her profession.

(14) Irregularities in billing an insurance company or other third party payer for services rendered to a patient. For the purposes of this section irregularities in billing shall include: Reporting charges for the purpose of obtaining a total payment in excess of that usually received by the dentist for the services rendered; falsely reporting treatment dates for the purpose of obtaining payment; falsely reporting charges for services not rendered; falsely reporting services rendered for the purpose of obtaining payment; or failing to advise any third party payer that the copayment provisions of a contract have been abrogated by accepting the payment received from the third party payer as full payment.

(15) Violating any rule adopted by the board.

(16) Has had his or her license to practice dentistry or dental hygiene from another state suspended or revoked based upon acts similar to those described in this section. A certified copy of the record of suspension or revocation of the state making the suspension or revocation shall be conclusive evidence thereof.

(17) Violating any provision of this chapter.

(b) When the board finds any dentist or dental hygienist guilty of any of the grounds set forth in subsection (a), it may enter an order imposing one or more of the following penalties:

(1) Refuse to issue the dentist or dental hygienist license or permit provided for in this chapter.

(2) With the exception of negligence as defined in paragraph (a)(6)a. revoke the license or permit of any dentist or dental hygienist.

(3) Suspend the license or permit of any dentist or dental hygienist.

(4) Enter a censure.

(5) Issue an order fixing a period and terms of probation best adapted to protect the public health and safety and to rehabilitate the dentist or dental hygienist.

(6) Impose an administrative fine not to exceed five thousand dollars ($5,000) for each count or separate offense.

(7) Impose restrictions on the scope of practice.

(8) Impose peer review or professional education requirements.

(9) Assess the costs of the disciplinary proceedings.

(c) Failure to comply with any final order of the board, including, but not limited to, an order of censure or probation, is cause for suspension or revocation of a license.

(d) No disciplinary action as outlined in subsection (b) or (c) hereof shall be invoked or entered except after hearing by the board as provided in this chapter, and such order is subject to judicial review as provided by this chapter.

No order of suspension or revocation provided in this section shall be made or entered except after hearing by the board as provided in this chapter, and the order shall be subject to judicial review as provided by this chapter.

(e) The board may temporarily suspend a special purpose license to practice dentistry across state lines without a hearing on either of the following grounds:

(1) The failure of the licensee to appear or produce records or materials as requested by the board.

(2) The initiation of a disciplinary action against the licensee by any state or territorial licensing jurisdiction in which the licensee holds a license to practice dentistry.

Notwithstanding any other provision of law, including the Alabama Administrative Procedure Act, the temporary suspension provided herein shall remain in effect until either the licensee has complied with the request of the board or the disciplinary action pending against the licensee has been terminated in favor of the licensee and the temporary suspension has been terminated by a written order of the board. A special purpose license to practice dentistry across state lines is subject to each of the grounds for disciplinary action provided in this section in accordance with the procedures of Section 34-9-24 and the Alabama Administrative Procedure Act.

(f) Members of the board, any agent, employee, consultant, or attorney for the board, and the members of any committee of dentists or dental hygienists impaneled by the board, shall be immune from suits for any conduct in the course of their official duties with respect to investigations or hearings; provided, that the persons act without malice and in good faith that such investigations or hearings are warranted by the facts, known to them after diligent effort to obtain the facts of the matter relative to the investigations or hearings.

(g) Nothing in this chapter shall be interpreted to limit or restrict the authority of the board to discipline any dentist licensed to practice in this state who violates this chapter while engaging in the practice of dentistry within this or any other state.

(h) The board shall have the authority to adopt rules imposing a non-disciplinary administrative penalty for designated violations of this chapter.
(Acts 1959, No. 100, p. 569, §22; Acts 1981, No. 81-372, p. 540, §3; Acts 1985, No. 85-697, p. 1120, §1; Acts 1986, No. 86-498, p. 950, §1; Act 99-402, p. 669, §1; Act 2005-73, p. 106, §3; Act 2009-18, p. 43, §5; Act 2011-571, §1.)
http://alisondb.legislature.state.al.us/acas/CodeOfAlabama/1975/34-9-18.htm
http://alisondb.legislature.state.al.us/acas/CodeOfAlabama/1975/150534.htm
 

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