RI dental association sues state health department

The Rhode Island Dental Association (RIDA) this week filed a complaint against the state health department alleging that state health inspectors illegally raided an oral surgeon's office as he performed surgery on a sedated patient and violated privacy laws by taking patient files.

According to the lawsuit, filed April 22 in Rhode Island Superior Court, a patient filed a complaint about her recovery from anesthesia administered by Mohammad Banki, MD, DMD. Dr. Banki and Frank Paletta, DMD, MD, are oral and maxillofacial surgeons who own an office in Warwick, RI. Dr. Banki was subsequently subpoenaed to be interviewed by the Rhode Island Board of Examiners in Dentistry on April 10.

Shortly after he was questioned, the patient's complaint was dismissed, and the board found there was no unprofessional conduct, according to the RIDA lawsuit.

Before Dr. Banki was questioned, however, investigators from the Rhode Island Department of Health conducted two unannounced inspections of the Warwick offices, on April 5 and April 9. When they arrived on April 5, Dr. Banki was not there. However, Dr. Paletta was performing surgery on a sedated patient, so his assistant asked the investigators to wait.

Instead, the investigators began opening patient files and questioning staff members "without any legitimate cause or reason," the 30-page RIDA suit stated.

The investigators acted in a "very hostile manner towards the staff and conducted what amounts to an illegal search and seizure," according to the complaint.

The investigators did not provide a copy of inspection reports and took original patient files, a violation of the Health Insurance Portability and Accountability Act (HIPAA), the complaint alleged.

Offices closed for a week

Then, on April 12, the health department issued an order to close Drs. Banki and Paletta's offices for several violations involving improper handling of controlled substances, the RIDA stated. The violations included keeping controlled substances in cabinets that were not adequately locked and having drug mixtures that were improperly labeled and had no expiration date. Also, the drug mixtures were mixed by a staffer who was not licensed to do so, the health department said.

The inspections were based on the complaint by Dr. Banki's patient, the order stated.

The offices were closed for a week, according to RIDA spokesman Bill Fischer.

But the RIDA disputes the accusation, saying the medication was still within its legal shelf life. Regarding the purchase of the drugs, the group said the health department has not published a list of registered pharmaceutical distributors, and the drugs were purchased from a facility licensed with the U.S. Drug Enforcement Administration.

The office closure was unwarranted, and conditions and procedures did not pose a danger to patient safety, the RIDA complaint stated. The association alleges that the health department and the state dental board have failed to establish proper standards and rules regarding continuing education, inspection of dental offices, and infection control, according to a statement sent to DrBicuspid.com.

"A lack of definable standards have led to illegal searches and seizures, violating federal and state laws related to healthcare patient confidentiality, and furthermore, unfairly damaging the reputation of qualified dentists," the statement reads. "Nothing is more important to the Rhode Island Dental Association than delivering the highest standards in patient care. And no Rhode Island dentist is opposed to periodic review of dental practices by the Department of Health. However, the state's investigations are being conducted improperly because they are not based on clear regulations and properly adopted procedures. The Department of Health has no clear regulations in the areas of continuing education, infection control, and dental office inspection. We are asking the Department of Health to adopt rules and procedures, as required by law, which dentists in Rhode Island can readily understand and follow."

Regulations 'vague'

Health department spokeswoman Dara Chadwick said the agency doesn't comment on pending legal matters. She referred to regulations pertaining to inspections of dental offices that simply state that dental board examiners may "conduct such inspections and investigations as deemed necessary by the board to ensure compliance with the requirements."

The complaint states the regulations are "vague and insufficient to give notice to the reasonable practitioner of what is required of him or her in order to comply with the requirements of the board."

The RIDA asserted there is a "significant lack of appropriate, properly adopted and understandable regulations relating to dentistry" and seeks a court ruling requiring the health department and dental board to put in place "appropriate regulations governing the substance and process of dentistry practice and licensing within the state of Rhode Island, as well as a declaration that such standards are binding on those who act on behalf of the state."

The complaint cites repeated attempts by the RIDA to inform health officials of the "pressing need for clear, properly adopted and publicized regulations."

"These instances of officials impugning the reputation of hardworking professionals is inappropriate and cannot continue," Fischer said

The RIDA represents 84% of the state's dentists and has more than 550 members.