Scott McAdoo, D.D.S. Charged with Unprofessional Conduct


In October 2003, the Colorado State Board of Dental Examiners charged Scott R. McAdoo, D.D.S., with unprofessional conduct. The notice he received—which is reproduced below—indicates that he worked for Hal A. Huggins, D.D.S., who advocated (a) replacing all dental amalgams, metallic crowns, and bridges, (b) extracting all teeth that had had root canal therapy, and (c) excavating "cavitations" in patients who were experiencing no problems with their dental restorations. Huggins's dental license was revoked in 1996 after an administrative law judge concluded that his treatments were "a sham, illusory and without scientific basis." The patients mentioned in the notice were seen by McAdoo after he parted company with Huggins. The charges against him included:

In August 2004, the case was settled with a consent agreement under which McAdoo agreed to immediately stop doing the challenged procedures and to permanently surrender his dental license no later than February 12, 2005.


BEFORE THE DIVISION OF ADMINISTRATIVE HEARINGS ON BEHALF OF THE STATE BOARD OF DENTAL EXAMINERS

STATE OF COLORADO

Case No. 2003-

NOTICE OF DUTY TO ANSWER, NOTICE TO SET, NOTICE OF HEARING, NOTICE OF CHARGES, AND OPTION TO ENGAGE IN ALTERNATIVE DISPUTE RESOLUTION

IN THE MATTER OF DISCIPLINARY PROCEEDINGS REGARDING THE LICENSE TO PRACTICE DENTISTRY IN THE STATE OF COLORADO OF SCOTT R. MCADOO, D.D.S., LICENSE NO. 6394.

TO: Scott R. McAdoo, D.D.S.

NOTICE OF DUTY TO ANSWER

YOU ARE HEREBY NOTIFIED that, pursuant to § 24-4-105(2)(b), C.R.S., you are hereby required to file a written answer to the attached Notice of Duty to Answer, Notice to Set, Notice of Hearing, Notice of Charges, and Option to Engage in Alternative Dispute Resolution (“Notice of Charges") with the Division of Administrative Hearings, 1120 Lincoln Street, Suite 1400, Denver, Colorado 80203, within 30 days after the mailing of this Notice of Charges. You must also mail a copy of such answer to the attorney for the State Board of Dental Examiners (“the Board"), who has signed this Notice of Charges.

If you fail to file your written answer within 30 days, an order entering a default decision maybe issued against your Colorado dental license for the relief requested in the Notice of Charges, without further notice, or such other penalties which may be provided for by law, without further notice.

NOTICE TO SET

YOU ARE HEREBY NOTIFIED that the attorney for the Board will appear at 9:00 a.m. on

Friday, November 14, 2003, in the Office of the Chief Administrative Law Judge, Department of Administration, Division of Administrative Hearings, 1120 Lincoln Street, Suite 1400, Denver, Colorado 80203, in order to set a date and obtain a location for a hearing regarding the following Notice of Hearing and Notice of Charges. You may be present in person or by counsel, or you may make prior arrangements to be reached by telephone at the time and date specified above by contacting the setting clerk prior to the day of setting at (303) 764-1400. In the event you do not appear, a date will be obtained and you will be notified in writing of the hearing date, time, and place.

NOTICE OF HEARING

YOU ARE HEREBY NOTIFIED that pursuant to § § 12-35-107, 108, and 118, C.R.S. (2002), and 24-4-104 and 105, C.R.S., a hearing will be held before an authorized administrative law judge at a time and location to be determined pursuant to the attached Notice to Set for the purpose of determining whether the dental license of Scott R. McAdoo should be revoked or suspended or other lawful discipline imposed for a violation or violations of 9 12-35-118(l)j),(k), (x), (y), and (ff), C.R.S., which provide as follows:

12-35-118 Causes for denial of issuance or renewal - suspension or revocation of licenses - other disciplinary action -unprofessional conduct defined - immunity in professional review. (1) The board may deny the issuance or renewal of, suspend for a specified time period, or revoke any license provided for by this article or may reprimand, censure, or place on probation any licensed dentist or dental hygienist after notice and hearing, which may be conducted by an administrative law judge, pursuant to the provisions of article 4 of title 24, C.R.S., or it may issue a letter of admonition without a hearing (except that any licensed dentist or dental hygienist to whom such a letter of admonition is sent may, within thirty days after the date of the mailing of such letter by the board, request in writing to the board a formal hearing thereon, and the letter of admonition shall be deemed vacated, and the board shall, upon such request, hold such a hearing) for any of the following causes:

(j) An act or omission constituting grossly negligent dental or dental hygiene practice or which fails to meet generally accepted standards of dental or dental hygiene practice;

(k) advertising which is misleading, deceptive, or false;

(x) Engaging in any of the following activities and practices: Willful and repeated ordering or performance, without clinical justification, of demonstrably unnecessary laboratory tests or studies; the administration, without clinical justification, of treatment which is demonstrably unnecessary; in addition to the provisions of paragraph (w) of this subsection (1), the failure to obtain consultations or perform referrals when failing to do so is not consistent with the standard of care for the profession; or ordering or performing, without clinical justification, any service, x-ray, or treatment which is contrary to recognized standards of practice of dentistry or dental hygiene as interpreted by the board;

(y) Falsifying or repeatedly making incorrect essential entries or repeatedly failing to make essential entries on patient records;

(ff) Practicing outside the scope of dental or dental hygiene practice.

YOU ARE FURTHER NOTIFIED that at the hearing in this matter, you shall have the right to appear in person and/or by legal counsel, to present evidence in your own behalf, to cross-examine any witnesses presented by the Board, and to rebut any evidence presented by the Board. You may also have subpoenas issued on your behalf upon request to the administrative law judge.

NOTICE OF CHARGES

The Board charges and alleges as follows:

1. Scott R. McAdoo, hereinafter "Respondent," was licensed as a dentist in the State of Colorado on or about October 21, 1987, being issued license number 6394, and has been so licensed at all times relevant hereto.

2. The Board has jurisdiction over the person of the Respondent and the subject matter of this Notice of Charges.

3. Respondent is a past employee of the Huggins Diagnostic and Rehabilitation Center ("Huggins Center").

4. The Huggins Center accepted for treatment patients with systemic illnesses and diseases. The Huggins Center treated patients by removing all dental amalgams, metallic crowns or bridges; replacing those with composites; extracting all teeth which had root canals; and excavating cavitations. The Huggins Center provided this treatment to patients who ,were experiencing no problems with their amalgams, crowns, bridges, or root canal teeth. Hal Huggins developed a standard protocol for treatment of Huggins Center patients, including serum compatibility tests, IV-C, and electrical reading of amalgams. .

5. In 1985, Hal Huggins co-authored a book entitled It's All In Your Head, in which he espoused his theories and the treatment offered at the Huggins Center. In 1993, Hal Huggins revised this book and retitled it It's All In Your Head: The Link Between Mercury Amalgams and Illness.

6. On May 1, 1996, Hal Huggins' license to practice dentistry was revoked in Case Number DE 95-04. The Final Agency Order and Initial Decision in Case Number DE 95-04 is incorporated as though fully set forth herein. The Administrative Law Judge (“ALJ"), identified numerous violations of the Dental Practice Law of Colorado, including instances of substandard care, performing treatment and tests without clinical justification, and practicing outside the scope of dentistry.

7. Respondent advertised in a holistic magazine, Nexus, that "What a dentist places in your mouth can and does affect your overall systemic health. I feel that all patients (including parents or children) should have a say in choosing materials used for fillings. I provide information, options, and dental material testing with which to make an informed decision. . . . " The advertisement is incorporated as through fully set forth herein.

8. Respondent advocates dental material compatibility testing and ordered it for patients. The representation is that such testing, performed using the patient's blood serum, can detect allergic reactions to groups of metals and, thus, certain dental materials, and that this information can then be used to determine the "least reactive dental material" for a patient.

9. The dental material testing that Respondent "provides" is the Clifford Materials Reactivity Testing ("the Clifford test") performed by Clifford Consulting and Research, Inc. ("Clifford"); on occasion, Respondent uses an identical test done by Huggins Diagnostic Center ("Huggins"). Respondent ordered dental material compatibility testing for the following 15 patients (14 had it done at Clifford and one had it done at Huggins). The test that both Clifford and Huggins perform is a serum compatibility test wherein a patient's blood serum is mixed with a small amount of the material in question and observed for the formation of an immune complex which precipitates out of solution and collects at the bottom of the test well. The ALJ in Case Number DE 95-04 found the serum compatibility tests to be substandard and without clinical justification.

10. Upon completion of each patient's test, Clifford (and Huggins) produced a report for Respondent. The report detailed groups of materials to which the patient had a "positive" immunological reaction (meaning the patient could be allergic and that the particular materials should not be used for a dental purpose in the patient's mouth).

11. The report also listed approximately 3558 dental product which were either indicated or contraindicated for the patient, depending upon what group of materials the patient tested "positive" for.

12. Upon receipt of the test results, Respondent told these patients that he would eliminate identifiable materials that the patient was shown to react to immunologically by the compatibility test. Respondent further stated that he would restore the patients' teeth using materials that the patient did not show a reaction to in the compatibility test.

13. Respondent advocates and performs electrical conductivity testing to determine the amount, if any, of electrical current generated by the interaction of amalgam fillings with the chemical environment within the patient's mouth. Respondent uses the results to determine which fillings to begin removing and replacing first, beginning with the most "reactive."

14. Respondent also advocates intravenous vitamin C ("IVC") therapy as an adjunct to removal of amalgam dental work and surgical cavitation to help with the healing process. Respondent referred several of his patients for IVC.

15. Eight of the following patients signed an informed consent form. This form is identical for every patient, except for the procedure to be performed.

16. The second paragraph of the consent form states, in part, "….due to a combination of aesthetic, personal, and other considerations, it is my individual decision to have these procedures performed. "

17. The fourth paragraph of the consent form states, in part, "... the main objective at this time is to eliminate identifiable materials that I have been shown to react to immunologically from the serum compatibility test."

18. The final paragraph of the consent form states, "... I am here on my own behalf and not as an agent for federal, state, or local regulatory agencies and am not seeking information under cover of false identity or misrepresentation of my situation or on a mission of entrapment."

19. From approximately August 20, 1997, through June 15, 1999, Respondent provided care and treatment to Patient A, whose identity Respondent knows and is listed in the Confidential Key to Patients' Identities.

20. On August 27,1997, Patient A signed a consent form wherein the procedure to be performed was handwritten as follows: ('Replace amalgams ("silver" mercury fillings) with tooth colored fillings and/or crowns. Replace existing crowns with non heavy metal filled crowns."

21. Review of Respondent's file for Patient A reveals a report from Clifford that states, "Date Received: 8/29/97," "Date of Service: 8/29/97," and "Professional Ordering Testing: Dr. Scott McAdoo."

22. Although Respondent ordered and obtained a Clifford test on Patient A, the patient's record does not document any justification for this test or that this test was used in any way to develop the treatment plan. .

23. . Respondent performed electrical conductivity testing on Patient A, as documented on the Initial Data Base and Recommendations sheet.

24. Review of Respondent's dental treatment record for Patient A reveals that Respondent failed to document a complete dental history, a complete dental examination, a diagnosis supporting his proposed treatment, and a treatment plan. Respondent also failed to obtain an adequate panographic x-ray before beginning treatment.

25. Review of Respondent's file for Patient A also reveals that there is no documentation of a periodontal examination or an occlusal examination, despite the fact that Respondent was going to restore half of the occlusal apparatus, which included replacing 12 crowns and 3 fillings.

26. On August 20, 1997, Respondent noted in Patient A's chart, "Discussed Compat, IVC, Acup," "Compat" meaning the serum compatibility test, "IVC" meaning intravenous vitamin C, and "Acup" meaning acupressure or acupuncture. Respondent referred Patient A for all three of these treatments. Patient A's chart does not indicate follow-up for the IVC or ACUP referrals.

27. From approximately February 3, 1997, through July 21, 2000, Respondent provided care and treatment to Patient B, whose identity Respondent knows and is listed in the Confidential Key to Patients' Identities.

28. A review of Patient B's dental record reveals that Respondent failed to obtain written consent from Patient B before beginning 'any treatment. The standard regarding informed consent requires that a patient be informed of the afflicting condition, the proposed treatment for that condition, all reasonable alternative treatments including, if appropriate, doing nothing, all substantial or reasonable anticipated risks of such treatments and the anticipated outcome of such treatments.

29. Review of Respondent's file for Patient B reveals a report from Clifford that states, "Date Received: 9/11/97," "Date of Service: 9/11/97," and "Professional Ordering Testing: Dr. Scott McAdoo."..

30. Although Respondent ordered and obtained a Clifford test on Patient B, the record does not document any justification for this test or that this test was used in any way to develop the treatment plan.

31. A review of Respondent's dental treatment record for Patient B reveals that Respondent failed to document diagnoses supporting his proposed treatment plan, a description of the radiographically evident periapical pathology associated with tooth #24, a complete dental examination including a periodontal examination and charting, an occlusal examination, and radiological examination and diagnosis.

32. Respondent extracted tooth #24, but the chart does not explain why it was extracted or that alternatives and risks of extraction were explained to the patient.

33. Respondent performed "surgical cavitations" (surgical entry and debridement of "holes" left by extracted teeth) of the extraction sites for previously extracted and healed teeth #s 1, 16, 17, and 32. The documented diagnosis for teeth #s 1 and 32 was alveolar cavitational osteitis (ACO), and the documented diagnosis for teeth #s 16 and 17 was neuralgia inducing cavitational osteonecrosis (NICO).

34. On August 1, 1996, and September 23, 1997, Respondent provided care and treatment to Patient C, whose identity Respondent knows and is listed in the Confidential Key to Patients' Identities.

35. Patient C saw Respondent only for prophylaxis during orthodontic treatment.

36. A review of Patient C's dental record reveals that Respondent failed to obtain written consent from Patient C before beginning any treatment. The standard regarding informed consent requires that a patient be informed of the afflicting condition, the proposed treatment for that condition, all reasonable alternative treatments including, if appropriate, doing nothing, all substantial or reasonable anticipated risks of such treatments and the anticipated outcome of such treatments.

37. Review of Respondent' s file for Patient C reveals a report from Clifford that states, "Date Received: 10/17/97," "Date of Service: 10/17/97," and "Professional Ordering Testing: Dr. Scott McAdoo." .

38. Although Respondent ordered and obtained a Clifford test on Patient C, the record does not document any justification for this test or that this test was used in any way to develop the treatment plan.

39. A review of Respondent's dental treatment record for Patient C reveals that Respondent failed to properly document his initial examination of Patient C, and failed to obtain and document an adequate examination to reach a diagnosis to support his treatment plan.

40. From approximately September 8,1997, through April 6, 2000, Respondent provided care and treatment to Patient D, whose identity Respondent knows and is listed in the Confidential Key to Patients' Identities.

41. On October 7, 1997, Patient D signed a consent form wherein the procedure to be performed was handwritten as follows: "Replace amalgams ("silver" mercury fillings) with least reactive materials. Extract teeth # 4, 5, 6, 18, 31".

42. Review of Respondent's file for Patient D reveals a report from Clifford that states, "Date Received: 10/23/97," "Date of Service: 10/23/97," and "Professional Ordering Testing: Dr. Scott McAdoo."

43. Although Respondent ordered and obtained a Clifford test on Patient D, the record does not document any justification for this test or that this test was used in any way to develop the treatment plan.

44. A review of Respondent's dental treatment record for Patient D reveals that Respondent failed to document a complete dental examination including a periodontal examination and charting, an occlusal examination, and radiological examination and diagnosis.

45. From approximately January 28,1997, through February 8, 1998, Respondent provided care and treatment to Patient E, whose identity Respondent knows and is listed in the Confidential Key to Patients' Identities.

46. A review of Patient E's dental record reveals that Respondent failed to obtain written consent from Patient E before beginning any treatment. The standard regarding informed consent requires that a patient be informed of the afflicting condition, the proposed treatment for that condition, all reasonable alternative treatments including, if appropriate, doing nothing, all substantial or reasonable anticipated risks of such treatments and the anticipated outcome of such treatments.

47. Review of Respondent's file for Patient E reveals a report from Clifford that states, "Date Received: 2/4/97," "Date of Service: -2/4/97," and "Professional Ordering Testing: Dr. Scott McAdoo."

48. Although Respondent ordered and obtained a Clifford test on Patient E, the record does not document any justification for this test or that this test was used in any way to develop the treatment plan.

49. Respondent provided electrical conductivity testing on Patient E, as documented on the Initial Data Base and Recommendations sheet.

50. A review of Respondent's dental treatment record for Patient E reveals that Respondent failed to document a complete dental examination including a periodontal examination and charting.

51. From approximately November 8, 1996, through September 18,2000, Respondent provided care and treatment to Patient F, whose identity Respondent knows and is listed in the Confidential Key to Patients' Identities.

52. On March 31, 1997, Patient F signed a consent form wherein the procedure to be performed was handwritten as follows: "Replace amalgams ("silver" mercury fillings) with tooth colored fillings and/or crowns."

53. Review of Respondent's file for Patient F reveals a report from Clifford that states, "Date Received: 4/3/97," "Date of Service: 4/3/97," and "Professional Ordering Testing: Dr. Scott McAdoo."

54. Although Respondent ordered and obtained a Clifford test on Patient F, the record does not document any justification for this test or that this test was used in any way to develop the treatment plan.

55. Respondent performed electrical conductivity testing on Patient F, as documented on the Initial Data Base and Recommendations sheet.

56. A review of Respondent's dental treatment record for Patient F reveals that Respondent failed to document a complete dental examination, an occlusal examination, and sufficient diagnostic documentation to support the treatment plan presented.

57. From approximately January 22, 1997, through June 1,2000, Respondent provided care and treatment to: Patient G, whose identity Respondent knows and is listed in the Confidential Key to Patients' Identities.

58. On February 5,11997, Patient G signed a consent form wherein the procedure to be performed was handwritten as follows: "Replace amalgams ("silver" mercury fillings) with least reactive tooth colored fillings and crown's."

59. Review of Respondent's file for Patient G reveals a report from Clifford that states, "Date Received: 1/28/97," "Date of Service: 1/28/97," and "Professional Ordering Testing: Dr. Scott McAdoo." This date is before the date the consent form was signed by Patient G.

60. Although Respondent ordered and obtained a Clifford test on Patient G, the record does not document any justification for this test or that this test was listed in any way to develop the treatment plan.

61. Respondent performed electrical conductivity testing on Patient G, as documented on the Initial Data Base and Recommendations sheet.

62. A review of Respondent's dental treatment record for Patient G reveals that Respondent failed to document a complete dental examination including a periodontal examination and charting. Respondent also failed to obtain any radiographs before beginning treatment.

63. Respondent's dental record for Patient G does not contain an occlusal examination despite the fact that Respondent's treatment plan included 14 restorations and two crowns.

64. Respondent performed 14 restorations and two crowns without radiological evidence of necessity.

65. An entry made in Patient G's dental record for January 22, 1997, reveals the following notation: "Disc. Compat, IVC, Acup."

66. From approximately June 12,1997, through June 10, 1999, Respondent provided care and treatment to Patient H, whose identity Respondent knows and is listed in the Confidential Key to Patients' Identities.

67. On June 26, 1997, Patient H signed a consent form wherein the procedure to be performed was handwritten as follows: "Replace amalgams ("silver" mercury fillings) with least reactive tooth colored materials. Replace crowns with least reactive materials."

68. Review of Respondent's file for Patient H reveals a report from Clifford that states, "Date Received: 6/17/97," "Date of Service: 6/17/97," and "Professional Ordering Testing: Dr. Scott McAdoo." This date is prior to the date Patient H signed the consent form.

69. Although Respondent ordered and obtained a Clifford test on Patient H, the record does not document any justification for this test or that this test was used in any way to develop the treatment plan.

70. Respondent performed electrical conductivity testing on Patient H, as documented on the Initial Data Base and Recommendations sheet.

71. A review of Respondent's dental treatment record for Patient H reveals that Respondent failed to document a complete dental examination including a periodontal examination and charting, and occlusal examination.

72. Respondent failed to obtain a complete set of radiographs before beginning treatment.

73. A review of Patient H's dental record also reveals no documentation of a condition or a diagnosis that would support Respondent's treatment of the removal and replacement of crowns on teeth #s 7, 30 and 14, the removal and replacement of the bridge on teeth #s 2-4, or the alloys in teeth #s 28, 29 and 31. The pre-treatment radiographs show well-done and functioning crowns.

74. From approximately August 28, 1997, through September 12, 2000, Respondent provided care and treatment td Patient I, whose identity Respondent knows and is listed in the Confidential Key to Patients' Identities.

75. A review of Patient I's dental record reveals that Respondent failed to obtain written consent from Patient Il before beginning any treatment. The standard regarding informed consent requires that a patient. be informed of the afflicting condition, the proposed treatment for that condition, all reasonable alternative treatments including, if appropriate, doing nothing, all substantial or reasonable anticipated risks of such treatments and the anticipated outcome of such treatments.

76. Review of Respondent's file for Patient I reveals a report from Clifford that states, "Date Received: 9/21/97," "Date of Service: 9/21/97," and "Professional Ordering Testing: Dr. Scott McAdoo."

77. Although Respondent ordered and obtained a Clifford test on Patient I, the record does not document any justification for this test or that this test was used in any way to develop the treatment plan.

78. It is believed that Respondent performed electrical conductivity testing on Patient I and documented it on an old periodontal examination from, from a previous dentist, dated 4/17/91.

79. A review of Respondent's dental treatment record for Patient I reveals that Respondent failed to document a complete dental examination including an occlusal examination.

80. Respondent performed a periodontal examination on September 12, 2000, well after his restoration of tooth # 4 and extraction of teeth #s 15, and 19 and the last day Respondent saw the patient.

81. From approximately March 6, 1997, through April 30, 1997, Respondent provided care and treatment to Patient J, whose identity Respondent knows and is listed in the Confidential Key to Patients’ Identities.

82. A review of Patient J's dental record reveals that Respondent failed to obtain written consent from Patient IJ before beginning any treatment. The standard regarding informed consent requires that a patient be informed of the afflicting condition, the proposed treatment for that condition, all reasonable alternative treatments including, if appropriate, doing nothing, all substantial or reasonable anticipated risks of such treatments and the anticipated outcome of such treatments.

83. An entry made in Patient J's dental record for March 6, 1997, reveals the following notation: "Discussed Compat (had blood drawn), IVC, Acup."

84. Review of Respondent's file for Patient J reveals a report from Clifford that states, "Date Received: 3/11/97," "Date of Service: 3/11/97," and "Profession~ Ordering Testing: Dr. Scott McAdoo."

85. Although Respondent ordered and obtained a Clifford test on Patient J, the record\ does not document any justification for this test or that this test was used in any way to develop the treatment plan.

86. Respondent performed electrical conductivity testing on Patient J, as documented on the Initial Data Base and Recommendations sheet.

87. A review of Respondent' s dental treatment record for Patient J reveals that Respondent failed to document a complete dental examination including a periodontal examination and charting and occlusal examination.

88. Further review of Patient J's dental record reveals inadequate documentation supporting the extensive treatment plan. A review of the March 6, 1997 panograph reveals missing teeth wherein the bony extraction sites appear radiographically nominal; however, Respondent diagnosed these sites with ACOo presumably requiring invasive surgical cavitation.

89. On April 9, 1997, arid April 29, 1997, Respondent provided care and treatment to Patient K, whose identity Respbndent knows and is listed in the Confidential Key to Patients' Identities.

90. A review of Patient K's dental record reveals that Respondent failed to obtain written consent from Patient KI before beginning any treatment. The standard regarding informed consent requires that a patient be informed of the afflicting condition, the proposed treatment for that condition, all reasonable alternative treatments including, if appropriate, doing nothing, all substantial or reasonable anticipated risks of such treatments and the anticipated outcome of such treatments.

91. Review of Respondent's file for Patient K reveals a report from Clifford that states, "Date Received: 4/15/97," "Date of Service: 4/15/97," and "Professional Ordering Testing: Dr. Scott McAdoo."

92. Although Respondent ordered and obtained a Clifford test on Patient K, the record does not document any justification for this test or that this test was used in any way to develop the treatment plan.

93. A review of Respondent's dental treatment record for Patient K reveals that Respondent failed to document a complete dental examination including a periodontal examination and charting and occlusal examination. There is inadequate documentation to support the treatment plan described on the Initial Data Base Sheet.

94. Respondent obtained one radiograph of tooth #4 and failed to obtain any further radiographs before setting forth his extensive treatment plan, which included 8 crowns and 9 fillings.

95. From approximately June 30, 1997, through September 19,2000, Respondent provided care and treatment t6 Patient L, whose identity Respondent knows and is listed in the Confidential Key to Patients' Identities. '

96. On July 10, 1997, Patient L signed a consent form wherein the procedure to be performed was handwritten as follows: "Replace amalgams ("silver" mercury fillings) with least reactive tooth colored fillings~ Extract root canal teeth."

97. Review of Respondent's file for Patient L reveals a report from Clifford that states, "Date Received: 7/2/97," "Date of Service: 7/2/97," and "Professional Ordering Testing: Dr. Scott McAdoo." This date is before the consent form was signed by the patient.

98. Although Respondent ordered and obtained a Clifford test on Patient L, the record does not document any justification for this test or that this test was used in any way to develop the treatment plan.

99. A review of Respondent's dental treatment record for Patient L reveals that Respondent failed to document an occlusal examination. There is a periodontal examination record but it is dated September 19, 2000, the last day the patient was seen by Respondent and after Respondent performed 2 fillings, one crown, one extraction, and replaced two bridges. There is inadequate documentation to support the treatment plan described on the Initial Data Base Sheet.

100. Respondent referred Patient L to a periodontist but failed to properly document the referral.

101. From approximately April 2, 1997, through July 24, 2000, Respondent provided care and treatment to Patient M, whose identity Respondent knows and is listed in the Confidential Key to Patients' Identities.

102. A review of Patient M's dental record reveals that Respondent failed to obtain written consent from Patient M before beginning any treatment. The standard regarding informed consent requires that a patient be informed of the afflicting condition, the proposed treatment for that condition, all reasonable alternative treatments including, if appropriate, doing nothing, all substantial or reasonable anticipated risks of such treatments and the anticipated outcome of such treatments. I ;.

103. Review of Respondent's file for Patient M reveals a report from Clifford that states, "Date Received: 4/14/97," "Date of Service: 4/14/97," and "Professional Ordering Testing: Dr. Scott McAdoo."

104. Although Respondent ordered and obtained a Clifford test on Patient M, the record does not document any justification for this test or that this test was used in any way to develop the treatment plan.

105. A review of Respondent' s dental treatment record for Patient M reveals that Respondent failed to document! a periodontal examination or charting until June 2, 1998, 14 months and 12 office visits after Patient M's initial examination. Respondent also failed to document an occlusal examination. There is inadequate documentation to support the treatment plan described on the Initial Data base Sheet.

106. Respondent also failed to obtain a complete set of radiographs before beginning extensive restoration. There is no pre-operative extraction radiograph of tooth # 19.

107. From approximately April 8, 1997, through July 24,2000, Respondent provided care and treatment to Patient N, whose identity Respondent knows and is listed in the Confidential Key to Patients' Identities.

108. On May 15, 1997, Patient N signed a consent form wherein the procedure to be performed was handwritten as follows: "Replace amalgams ("silver" mercury fillings) with least reactive tooth colored fillings and/or crowns based on compatibility test."

109. Review of Respondent's file for Patient N reveals a report from Clifford that states, "Date Received: 4/14/97," "Date of Service: 4/14/97," and "Professional Ordering Testing: Dr. Scott McAdoo." This date is before the patient signed the consent form.

110. Although Respondent ordered and obtained a Clifford test on Patient N, the record does not document any justification for this test or that this test was used in any way to develop the treatment plan.

111. Respondent performed electrical conductivity testing on Patient N, as documented on the Initial Date Base Sheet.

112. A review of Respondent's dental treatment record for Patient N reveals that Respondent failed to document a complete dental examination including a periodontal examination and charting and occlusal examination. There is inadequate documentation to support the treatment plan described on the Initial Data Base Sheet.

113. Respondent referred Patient N for IVC and Acup but failed to properly document these referrals.

114. From approximately January 12, 1995, through July 28, 1995, Respondent provided care and treatment to Patient O, whose identity Respondent knows and is listed in the Confidential Key to Patients' I Identities. According to Respondent's records, Patient O had numerous systemic complaints. "

115. On January Id. 1995, Patient O signed a consent form wherein the procedure to be performed was handwritten as follows: "Replace amalgams with least reactive tooth colored materials. Extract root canal teeth. Clean out cavitations (holes in bone)." Respondent failed to diagnose any endodontic condition that would justify the recommended extractions. .

116. Review of Repondent's file for Patient 0 reveals a report from Huggins that states, "Doctor: McAdoo, Scott," "Date received: 1/13/95," and "Date reported: 1/16/95."

117. Although Respondent ordered and/or obtained a compatibility test on Patient O, the record does not document any justification for this test or that this test was used in any way to develop the treatment plan.

118. Respondent performed electrical conductivity testing on Patient O, as documented on the Initial !?ate Base Sheet.

119. A review of Respondent's dental treatment record for Patient O reveals that Respondent failed to document complete dental examination including a periodontal examination and charting, soft tissue examination and occlusal examination. Respondent failed to document a definitive diagnosis. There is inadequate documentation to support the treatment plan described on the Initial Data Base Sheet.

120. Respondent extracted asymptomatic, endodontically treated teeth #s 9, 29 and 30. Respondent failed to document any pain, discomfort, infection, or swelling associated with these teeth nor any diagnosis of any endodontic condition that might justify these extractions.

121. Respondent diagnosed ACO of the surgical extraction sites of previously-extracted teeth #s 1, 16, 17, and 32. Respondent performed “surgical cavitations" on all four extraction sites.

122. Respondent failed to document any complaints of pain, infection or swelling associated with these extraction sites to justify invasive surgical cavitation. Respondent also failed to adequately document the surgical procedures performed.

123. Respondent replaced 11 fillings and 6 crowns without radiological indication.

124. The crowns on teeth #s 24 and 25 that Respondent unnecessarily replaced in March 1995 were ultimately replaced again by a subsequent treating dentist in May 1999.

125. Respondent routinely removed otherwise asymptomatic fillings, crowns, and endodontically treated teeth. There was often no legitimate dental reason for the restorative work.

126. Mercury toxicity is a medical condition, requiring treatment by a medical doctor.

127. Respondent diagnosed ACO, NICO, and focal infection in several of his patients for whom he removed dental work.

128. ACO, NICO, and the focal theory of infection are not generally recognized diagnoses or theories by the scientific medical/dental community.

129. Respondent performs "surgical cavitation" as a treatment for NICO, often on asymptomatic endodontically treated teeth that he has extracted, and on healed asymptomatic extraction sites of previously extracted teeth.

13 O. Respondent' s performance of "surgical cavitation" for the treatment of ACO and NICO is below the standard of practice for dentists within the state of Colorado.

131. Respondent's serum compatibility testing has no scientific basis to determine which materials will react with the immune system and which will not. Respondent's serum compatibility testing is without clinical justification.

132. The need to test for dental materials reactivity, as an accepted or routine component of a comprehensive dental examination or as an accepted or routine component of determining a dental diagnosis or treatment plan, is not included in any accredited dental curriculum.

133. When an allergic reaction to a dental material is suspected or a systemic medical manifestation due to use of a dental material is suspected, the standard of care is to refer the patient for a medical consultation. Such testing and interpretation is the practice of medicine. Respondent failed to refer any of these patients for a medical consultation and/or interpretation of the test results.

134. Regardless of the actual compatibility test results for Patients A through O, Respondent used the same dental material to restore their teeth.

135. Respondent's treatment objective, as stated in the consent form signed by eight of the above-referenced 15 patients (". . . the main objective at this time is to eliminate identifiable materials that I have been shown to react to immunologically from the Serum Compatibility Test") is mlsleading and false. This treatment is below the standard of practice for dentlsts within the State of Colorado. .

136. Electrical conductivity testing such as that performed by Respondent is not recognized in the general practice of dentistry. .

137. Intravenous vitamin C therapy is not a recognized adjunct for any dental procedure and is not recognized in the general practice of dentistry. Furthermore, Respondent is not a medical doctor and cannot discuss the pros and cons of medical procedures.

138. Because the treatment referenced above is without clinical justification, patients cannot consent to it.

139. The final paragraph of Respondent's standard informed consent form is irrelevant to the practice of dentistry and serves only to protect Respondent against dental practices that he knows or suspects are negligent and/or below the standard of care for dentists in Colorado.

COUNT I
(Substandard Care)

140. Paragraphs 1 through 139 are incorporated herein by reference as if fully set forth.

141. The above stated conduct is in violation of § 12-35-118(l)G), C.R.S., an act or omission constituting grossly negligent dental practice or which fails to meet generally accepted standards of dental practice, more fully set forth in paragraphs 3 through 139 above.

COUNT II
(Failure to refer)

142. Paragraphs 1 through 141 are incorporated herein by reference as if fully set forth.

143. The above stated conduct is in violation of § 12-35-118(l)(x), C.R.S., engaging in any of the following activities and practices: Willful and repeated ordering or performance, without clinical justification, of demonstrably unnecessary laboratory tests or studies; the administration, without clinical justification, of treatment which is demonstrably unnecessary; in addition to the provisions of paragraph (w) of this subsection (1), the failure to obtain consultations or perform referrals when failing to do so is not consistent with the standard of care for the profession; or ordering or performing, without clinical justification, any service, x-ray, or treatment which is contrary to recognized standards of practice of dentistry or dental hygiene as interpreted by the board, more fully set forth in paragraphs 3 through 139 above.

COUNT III
(Willful and Repeatedly Ordering Clinical Tests Without Justification)

144. Paragraphs through 143 are incorporated herein by reference as if fully set forth.

145. By ordering dental patients to undergo the compatibility test without clinical justification, Respondent's conduct is in violation of § 12-35-118(1 )(x), C.R.S., engaging in any of the following activities and practices: Willful and repeated ordering or performance, without clinical justification of demonstrably unnecessary laboratory tests or studies; the administration, without clinical justification, of treatment which is demonstrably unnecessary; in addition to the provisions of paragraph (w) of this subsection (1), the failure to obtain consultations or perform referrals when failing to do so is not consistent with the standard of care for the profession; or ordering or performing, without clinical justification, any service, x-ray, or treatment which is contrary to recognized standards of practice of dentistry or dental hygiene as interpreted by the board, mo e fully set forth in paragraphs 3 through 139 above.

COUNT IV
(Substandard Care)

146. Paragraphs 1 through 145 are incorporated herein by reference as if fully set forth.

147. By ordering his patients to undergo the compatibility test and/or regardless of the reactivity results, using the same dental materials for all patients, Respondent's conduct is in violation of § 12-35-118(l)d), C.R.S., an act or omission constituting grossly negligent dental practice or which fails to meet generally accepted standards of dental practice, more fully set forth in paragraphs 3 through 139 above.

COUNT V
(Consent to Negligent/Substandard Treatment - Substandard Care)

148. Paragraphs 1 through 147 are incorporated herein by reference as if fully set forth.

149. By having patients A, D, F, G, H, L, N, and O sign a consent form wherein they consent to negligent treatment pr treatment which fails to meet generally accepted standards of dental practice, Respondent's conduct is in violation of § 12-35-118(l)0), C.R.S., an act or omission constituting grossly negligent dental practice or which fails to meet generally accepted standards of dental practice, more fully set forth in paragraphs 3 through 139 above. .

COUNT VI
(Lack of Informed Consent - Substandard Care)

150. Paragraphs 1 rough 149 are incorporated herein by reference as if fully set forth

151. By NOT having patients B, C, E, I, J, K., and M sign a consent form at all, Respondent's conduct is a violation of § 12-35-118(l)0), C.RS., an act or omission constituting grossly negligent dental practice or which fails to meet generally accepted standards of dental practice, more fully set forth in paragraphs 3 through 139 above.

COUNT VII
(Substandard Care)

152. Paragraphs 1 through 151 are incorporated herein by reference as if fully set forth.

153. By ordering compatibility testing prior to the date a patient signs an informed consent form, Respondent's conduct is in violation of § 12-35-118(100), ,C.R.S., an act or omission constituting grossly negligent dental practice or which fails to meet generally accepted standards of dental practice, more fully set forth in paragraphs 3 through 139 above.

COUNT VIII
(Unnecessary procedures - Substandard Care)

154. Paragraphs 1 through 153 are incorporated herein by reference as if fully set forth.

155. By removing aymptomatic endodontically treated teeth, replacing asymptomatic fillings and crowns, and by performing "surgical cavitations" without clinical justification, Respondent's conduct is in violation of 9 12-35-1l8(1)G), C.R.S., an act or omission constituting grossly negligent dental practice or which fails to meet generally accepted standards of dental practice, more fully set forth r paragraphs 3 through 139 above.

COUNT IX
(Unnecessary procedures)

156. Paragraphs 1 through 155 are incorporated herein by reference as if fully set forth.

157. By removing aymptomatic endodontically treated teeth, replacing asymptomatic fillings and crowns, and by performing "surgical cavitations" without clinical justification, Respondent's conduct is in violation of ~ 12-35-118(l)(x), C.R.S., engaging in any of the following activities and practices: Willful and repeated ordering or performance, without clinical justification, of demonstrably unnecessary laboratory tests or studies; the administration, without clinical justification, of treatment which is demonstrably unnecessary; in addition to the provisions of paragraph (w) of this subsection (1), the failure to obtain consultations or perform referrals when failing to do so is not consistent with the standard of care for the profession; or ordering or performing, without clinical justification, any service, x-ray, or treatment which is contrary to recognized standards of practice of dentistry or dental hygiene as interpreted by the board, more fully set forth in paragraphs 3 through 139 above.

COUNT X
("Surgical cavitations" and electrical conductivity testing - Substandard Care)

158. Paragraphs 1 through 157 are incorporated herein by reference as if fully set forth.

159. By performing "surgical cavitations" and electrical conductivity testing, procedures that are not recognized by the general practice of dentistry, Respondent's conduct is a violation of § 12-35-118(l)0), C.R.S., an act or omission constituting grossly negligent dental practice or which fails to meet generally accepted standards of dental practice, more fully set forth in paragraphs 3 through 139 above.

COUNT XI
(Unrecognized treatment)

160. Paragraphs 1 through 159 are incorporated herein by reference as if fully set forth.

161. By ordering patients to undergo the compatibility test and/or by performing electrical conductivity testing, by removing asymptomatic amalgam fillings, endodontically treated teeth, and crowns, and by performing "surgical cavitations," Respondent's conduct is in violation of § 12-35-118(1 )(x), C.R.S., engaging in any of the following activities and practices: Willful and repeated ordering or performance, without clinical justification, of demonstrably unnecessary laboratory test or studies; the administration, without clinical justification, of treatment which is demonstrably unnecessary; in addition to the provisions of paragraph (w) of this subsection (1), the failure to obtain consultations or perform referrals when failing to do so is not consistent with the standard of care for the profession; or ordering or performing, without clinical justification, any service, x-ray, or treatment which is contrary to recognized standards of practice of dentistry or dental hygiene as interpreted by the board, more fully set forth in paragraphs 3 through 139 above.

COUNT XII
(Recordkeeping)

162. Paragraphs 1 through 161 are incorporated herein by reference as if fully set forth.

163. By failing to document complete initial examinations, periodontal examinations, occlusal examinations, diagnoses, referrals and follow up of referrals, and numerous other essential entries, Respondent's conduct is a violation of § 12-35-118(l)(y), C.RS., falsifying or repeatedly making incorrect essential entries or repeatedly failing to make essential entries on patient records, more fully set forth in paragraph 3 through 139 above.

COUNT XIII
(Practice outside the scope of dentistry)

164. Paragraphs 1 through 163 are incorporated herein by reference as if fully set forth.

165. By discussing and/or referring patients for compatibility testing and intravenous vitamin C therapy, by removing asymptomatic amalgam fillings, endodontically treated teeth, and crowns, by performing "surgical cavitations" without clinical justification, and by performing electrical conductivity testing, the Respondent practiced outside the scope of dentistry, in violation of § 12-35-118(l)(ff), C.RS., more fully set forth in paragaphs 3 through 139 above.

COUNT XIV
(Misleading, deceptive, or false advertising)

166. Paragraphs through 165 are incorporated herein by reference as if fully set forth.

167. Respondent's advertisement in Nexus constitutes advertising that is misleading, deceptive, or false, in violation of § 12-35-118(l)(k), C.R.S., more fully set forth in paragraphs 3 through 139 above.

WHEREFORE the Board prays for an Order revoking, suspending, or otherwise appropriately disciplining Respondent's dental license, and for such other relief as deemed proper and just.

Respectfully submitted this 3rd day of October, 2003.

KEN SALAZAR
Attorney General

__________________________
BARBARA EZYK, 26031*
SUSAN MACHMER, 14657*
Assistant Attorney Generals Business and Licensing Section

Attorneys for State Board of Dental Examiners

1525 Sherman Street, 5th Floor
Denver, CO 80203
Telephone: (303) 866-5919

* Counsel of Record

This page was posted on September 18, 2004.

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