Dr. Roy Shelburne's Warning To Dentist After His Release From Prison

Dr. Roy Shelburne was convicted on Medicaid Fraud charges in 2008.  Here, Dr. Shelburne, released from prison in May 2010, warns dentists.(Interview by Kevin Henry)

• If you work for a dental mill, do you know exactly what was billed by the Office Manager or Corporate after that file left your hands? 
• Did they change your files, did they change your treatment plan? 
• Are the details of what you did and WHY you did it well documented? 
• Do you review your files to see that no one has altered your patients files, you should! 
• Do you use a portable voice recorder after seeing patients to keep a record of your treatment? 
• Do you think the corporate heads really have your best interest in mind? They do NOT!

Raven Marie Blanco Foundation

Raven Marie Blanco was killed by an overdose of drugs at the dental office of Dr. Michael Hechtkopf on March 7, 2007.  She left behind a grieving family who have taken their grief and are using it to awaken the dental community, who have been sleeping at the wheel.  

Children are dying, one a month since April 2010.  The RMBF is asking the ADA and other Dental Organization to take a stronger look at the reasons children are dying in droves.  The RMBF has created common sense solutions that will saves lives in the future. 

So far the American Dental Association has failed in protecting citizens, especially children, from deaths at the hands of dentists here in the United States. 

*********************

From The Raven Marie Blanco Foundation:

The recent rise in pediatric deaths due to dental visit complications is absolutely getting out of control!

RMBF needs your support now more than ever.

We are partnering with Dr. Larry Sangrik, DDS to bring a Continuing Education Memorial Lecture on the "Six Links of Survival" to the dental community in an effort to better prepare them to handle Medical Emergencies.

To honor Raven’s life and perpetuate her memory, we established RMBF. The mission of RMBF is two-fold. Financially, we seek to raise funds for causes which directly impact children.

Our 5-year plan calls for us to place 5000 automatic electronic defibrillators (AEDs) in areas of need across the country, give a grant to assist the dental health needs of underserved children and provide financial assistance for a building project to a South African orphanage.

The second mission of RMBF is to raise awareness within the dental profession about the need for medical emergency preparedness in dental offices. That objective has proved to be even more challenging than raising funds.

When RMBF began, our initial goal was to get dentists to purchase an AED for their office. As we have become more knowledgeable about medical emergency preparedness, we have learned that many of the leading authorities base dental office preparations around a concept called the Six Links of Survival. The Six Links of Survival was developed the Institute of Medical Emergency Preparedness [IMEP] as a medical emergency preparedness program and teaching tool for dentists.

RMBF partnered with Dr. Larry Sangrik to bring a Continuing Education Memorial Lecture on the Six Links of Survival to the dental community in hopes of reducing the amount of unprepared reactions to medical emergencies.

Dr. Sangrik is a nationally renowned speaker, who has lectured to over 7500 dental professionals on this topic.

Our intention is to raise awareness in the minds of dentists about the need to prepare their offices for medical emergencies. 

Six Links of Survival
-Regular dentist training
-Staff training
-Written office emergency manual
-Periodic mock emergency drills
-Proper emergency equipment
-Proper emergency medications

Since 1996 there have been 18 pediatric deaths related to dental complications. Mind you these are only the ones we know about.

That is 18 deaths in 14 years. At first glance the number is sad, but do you want to know something shocking? FOUR of the deaths occurred in the last FOUR months!

Yes, 22% of the deaths occurred in the last four months - add in Maddoux Cordova the 22-month old boy who died in December and you can clearly see that 1/3 of the deaths have happened within the last eight months!

The American Dental Association must update its medical emergency guidelines for dentists and they cannot deny our request that they hold a symposium to study the issue and the 6 Links concept in particular.

Pediatric deaths resulting from complications related to dental procedures are not a rarity people – they are an EPIDEMIC! RMBF will not take no for an answer.

RMBF sent out letters to the American Dental Association (ADA)
requesting that they pursue an update of its 2002 guidelines based on current knowledge, make the information easily accessible to dentists and to commit to regular monitoring of the recommendations to keep them timely.

   

  Raven Marie Blanco Foundation on Facebook - Keep up with the progress

  Raven Marie Blanco Foundation Website - You can help protect pediatric dental patients.

  Raven's Memorial Website

*********************

More children have died since the government has included dental care under Medicaid/SCHIP programs.  Of course this will be explained away as due to the increase in dental care.

If we are going to have those programs, of course dental as well as vision care should be included in Medicaid/SCHIP programs.

The argument to include dental care was that one child had died due to infection.  

Take a minute and meet the children who are now dead.  Many could have been prevented had common sense precautions been taken.

The ADA has not updated their guidelines since 2002!   With the increase in pediatric treatments and skyrocketing deaths this is just unacceptable.

It is hard to believe this foundation needs to exist, but the dental community is resisting adding lifesaving equipment, as an Automatic Electronic Defibrillators (AED) to their repertoire. 

Illinois and Florida have had to pass laws requiring AED's in dental offices, which cost between $1200 - $1800.  However, many dentists are not maintaining or inspecting them on a regular basis, nor is the training in their use sufficient.  Read more here. 

As a side note here:  Papoose boards range from $300 - $500 each. 

Here is a comment from a dental forum regarding AED's:

I don't agree with making AEDs mandatory in ALL dental offices. When was the last time you went to a general practitioner MD's office and he had an AED on hand? It's ludicrous. Now, if you're doing sedation procedures, as this dentist was, then, you are a FOOL to not have such equipment, along with a pulse oximeter. I can't believe he didn't have one. He obviously didn't know how to titrate his dosage properly either, seeing that her blood levels were 3 times the level considered safe for a child her weight. Does the board in his state not regulate who can and who cannot practice sedation??? Here, in Louisiana, we can't even write for Valium for oral sedation as of a couple of years ago without first being re-certified in oral conscious sedation, regardless of how long you have been in practice and doing so.

In Illinois, the law will not apply to dentists who use only local anesthetics such as lidocaine or articaine.  The original legislation included ALL office, but thanks to the Illinois State Dental Society, it was amended.  Thank you so much ISDS. (sarcasm) Read more here.

Dental office can purchase one through the drive-thru sedation training called DOCS. 

Woman Arrested For Kool Smiles Prescription Forgery

I'm wondering a couple things here:

1. Does Bianca work for Kool Smiles

2. Why do they still use prescription "pads".  Even Small Smiles uses electronic prescriptions!  Even though they were stupid enough to put them online.

3. Wonder why it took so long for the CVS on South Cherry to get a clue that Kool Smiles dental clinics probably shouldn't/wouldn't be writing scripts for "large" amounts of Oxycodone?

Hometown Annapolis:

A woman was arrested last night after trying to pass what city police said was a fraudulent prescription for oxycodone at an Annapolis-area drugstore.

Bianca Vivian Robinson, 21, of Poplar Grove St. in Baltimore, was arrested after she tried to get 90 tablets of the painkiller from the CVS pharmacy in Hillsmere at 7:53 p.m. using a prescription from Kool Smiles of Baltimore-Westside, ostensibly for a cousin residing in Baltimore.

The dental office told police a prescription pad had recently been stolen.

The same prescription had been presented at the CVS store on South Cherry Grove Avenue 30 minutes earlier, police said. A pharmacist there said she had been getting scripts for large amounts of oxycodone from Kool Smiles recently.

Police said Robinson was arrested on prescription fraud and other charges.

Potential New Hire Asking Question On Dental Forum About Compensation Based On Production at Small Smiles Clinics

July 7 and July 8, 2010 conversation between members of a forum for new dentists.  Wonder if it was "internal and confidential" then too?  Oh, wait, that was long before I wrote anything about the bait and switch contract for Small Smiles dentists.

New Graduate asks:
Hi,
I will be interviewing for a position with Small Smiles. Here are the major pointers of the compensation and contract:
- Mon to Fri, 8 to 5
- 3 other dentists and 4 hygienists already working there.
- Production based compensation (22% of everything; xrays, hygiene exams, operative, exams, etc)
- Daily minimum $360 (but obviously this hardly happens, as I am told)
- $10k sign-on bonus.
- Average patient is billed $200 per visit, so I am told that I can see two patients at the same time, as well as hygiene exams too.
- 4 weeks paid holiday
- Did I mention this is a chain office?
Any pointers about this opportunity? Is this a good or bad deal for a new grad?

Fred:
Run for the hills

Wilma:
If it's truly a 'daily minimum,' get it in writing.  But. c'mon - a franchise just for low-income with an average per visit charge of $200, and making the offer they are making you?  If that doesn't sound fishy enough.....read this ( http://abcnews.go.com/2020/dental-chain-reaches-settlement-medical-fraud-performing-unnecessary/story?id=9615119 ) and then do as previously posted - run for the hills.

Ed:
I don't recommend franchise dental clinics for patients or people who are looking for work.  I looked at the link above and I thought it was "sensational".  Who really knows what shape the kids were in before getting in the chair.  Most of the mothers look like trailer trash and probably couldn't tell the difference between a cavity and a raisin their kid just ate that happened to get jammed into a hole in their kids "toof".   Sad that this is the only care available.  I suspect their are at least a few who work in these places that truly do care and are trying to do the best with a very bad situation and make a difference in the lives of these unfortunate kids.    
Catch a glimpse of the upper right quadrant of the kid early in this video that was not treated.  Mom says his teeth were perfect before he got in the chair.  Ignorant people see this stuff and think the dentists are evil.   Ed
http://www.youtube.com/watch?v=wdxeG6F41uc&feature=related

Gene:
Small Smile mainly takes Medicaid and Chips insurance patients. They only way to squeeze 200$ out of these low reimbursment insurances is by aggressively over-treatment planning every case ( Which of course they are notorious for) 
The worst part of working at Koolsmiles or SmallSmiles is that you will an office manager who will ensure that you meet these ridiculous production goals. If you do not produce you will called into the office and someone without a dental license will be telling you how to practice. "Dr. New Grad, Why don't start using the Papoose board. We have some Dentists producing 10,000$/ day." They don't give a crap that these kids are screaming in the back rooms and urinating on themselves out of sheer fear from the traumatic experiences they are subjected to.
The other worst part of working at the Smile Center/ Koolsmiles is that they set up the clinic so that the doctors will be fighting for production. You get a bonus if you produce X amount of dollars in operative. This will #1) lead to aggressive treatment planning #2) the doctors camp out in the operative rooms and fight over op patients.
Don't work for these guys or any smile-o-rama.
Barney:
Medicaid offices REQUIRE speed and efficiently to handle the volume of patients needed to offset the low compensation and profit margins.  Right out of school, some docs may not have the clinical skill needed.

_____________________________________

Kool Smiles, Dentist and Assistant Sued For Leaving Burn On Child's Face-Lexington, KY

Kool Smiles, a dentist and dental assistant are being sued for injuring a child in Lexington, Kentucky.  According to the complaint the child's mother was refused access to her child and was forced to stay in the waiting room.  Anyone who knows anything about these dental mill knows is this fact.

 

[June 4, 2010 review of this clinic]

When the child came out he was crying and told him mommy they hurt him.  There is no telling what all these monsters did, but one thing for sure, the left a serious burn on his cheek.  His mother took him to the University of Kentucky  medical center to have the burn examined and was told it most likely would leave a permanent scar on the little boy's face.

Currently Harris Williams & Company are bidding for the purchase of Kool Smiles.  Honestly, I look forward to this, the deeper the pockets the more the rewards for all the thousands of children lining up for compensation from the abuse of Kool Smiles creepy, slimy, dentists and their assistants.  Expect Kool Smiles  liability insurance company to drop them like hot potatoes just as two have done with Small Smiles.  Then what?

(Harris Williams & Co. appear to be negotiators for Private Equity Firms, according to their website.  Wonder which firm really wants Kool Smiles?)

I hope the dental assistants working in these places do not make the mistake they are innocent bystanders.  This is one of those cases of "if you are not part of the solution, you are part of the problem".  Personally, I would roll on these creeps.

You either have the chance to stand up and report it, or sit in the defendants chair, it is your choice, choose wisely.  Do not end up like some I know who have tried to ride it out, thinking they "company" will have their lawyers protect you.  This is not likely to happen and you will likely be told to get your own attorney, only after you meet with their attorney's and they get all the evidence they can from you to help cover their ass and lay the blame in your lap.  I've seen it happen over and over again.

 

Kool Smiles defense to this action - "it was the child's fault."

Corporate Dental A Good Investment? Not for the patients!

I hope you don't want your dentist to have your best interest in mind, those who work for these places only need answer to shareholders and keep the bottom line in the black.  Know what that means, swift, cheap and low quality care and being sold crap you don't need. 

The New York Post

The private-equity barbarians may soon be running a dental office near you.
In recent weeks private-equity firms have been bidding for two of the largest national chains of dentists' offices as they drill further into the space.

In fact, a PE firm is close to winning the auction for Syracuse-based Aspen Dental with a winning bid likely to stretch past $500 million. A separate auction for the slightly larger Kool Smiles chain is well underway, sources said.

Aspen, with its nearly 300 branches, is working with investment bank Moelis & Co. to sell itself. Kool Smiles, which generates $80 million in EBITDA (earnings before interest, taxes, depreciation and amortization), has hired investment bank Harris Williams, The Post has learned.


Financially, dental is the old-fashioned piece of the healthcare industry. Most practitioners still work outside a management practice and more than 80 percent work with, at most, one other dentist. Most importantly to private-equity firms, it is one of healthcare's last bastions of fee-based services, according to the American Dental Association.

 Financial consultant Tom Climo said 89 percent of dental services, including preventative care, are covered by insurance, with patients only paying for oral and cosmetic surgery. Healthcare reform that is cutting into reimbursement for medical doctors is not affecting dentists, he said.

An investment banker said private-equity firms like dental offices because they sell for low valuations and one can borrow a fair amount of money against them because of reliable cash flow.

The downside, Climo said, is private-equity firms are likely to work dentists longer once they take over practices to boost profits and that could lead to worse service.

[COULD!?  It has! They also failed to mention in most states they operate Illegally!]

Private equity firms already own the Forba and Bright Now! dental chains. Kool Smiles did not return calls for comment.

[Kool Smiles didn't return phone calls, well hell no, they didn't!]

Read more: http://www.nypost.com/p/news/business/private_equity_firms_ink_teeth_into_5HBGAj0ju7eQM0bIPPhCaJ#ixzz0xoHrpM8E

Things FORBA Small Smiles Don't Want You To Know

In the past two weeks FORBA, for some reason,  after 2 years has decided they don't want anyone to see information or opinions of two subjects.  I received a letter last week asking two be removed and this week they've added a new one to the list.  Until it can be further investigated I will remove them, in accordance to the consent injunction I signed.  However, 2 years ago, I filed a Compliance agreement saying I had removed reference to documents they were stupid enough to post openly on the Internet.  Being they accepted that Compliance statement with no objections, seems to me I had satisfied their request, right?

However, they have decided to pick on me again, I guess I'm the only case in the courts they feel they can truly get a bit of satisfaction beating upon.  I find it amazing in so many ways. 

Here is a quote from their Cease and Desist Letter:

"…a review of recent postings on your website dentistthemenace.com which is directed to debbiehagan.blogspot.com, reveals that you are engaging in clear contempt of the Court's permanent injunction by publishing confidential and internal information about FORBA's contracts with its dentists.  Without limitations, we direct you to your entries dated July 13 … and 20… 2010…" 

I'm not sure how they consider their new deals with the dentists "confidential and internal" since there are ads out the waazoo on the Internet advertising they are hiring and dentists will be paid a commission.  But we know how they operate, put it on the Internet, and cry like a baby if someone who does not like them reads it!

Clearly their standard of "Confidential and Internal" differs greatly from what is normal, instead meaning anything they themselves post on the Internet.  With that being the stick by which they measure, how in the hell would anyone know what they consider "Confidential and Internal"!!??

As for all other lawsuits involving them, I actually have lost count! 

Ohio – 2, or three I think

Virginia – 3, I believe

Tennessee- 1

Oklahoma – 1

New York – Hundreds maybe, who knows

Colorado – untold number but at least 1 or 2 this year

South Carolina – 1, but I think it's settled

Anyway, you get the point…they have mucho legal proceedings going on and mucho legal fees.

Here is the response received from them yesterday.  Yesterday they added a new post they want removed.  I guess I could get one of their letters everyday seeing how they gauge "Confidential and Internal".  Looks like someone has a full time job and the postal service is going to love them!  However, I highly doubt they get another wish list filled.

Back to what they don't want you to know:

1.  Warnings and Pitfalls For Dentists - A post about problems working strictly on commission – After I reviewed this post in full I remembered this wasn't written by me but someone who saw several problems.  So I highly disagree that this information/opinion is or was "Confidential and Internal" to FORBA's business operations. 

2.  Small Smiles Dentists Pay To Be Production Based Only By January 2011-No Vacation-No Holidays-No Paid Time Off – Since this information are in ads Jenna Kochenberger has posted on the Internet, I highly disagree that this is "Confidential and Internal" either and believe they would have a hard time holding this argument. 

3. 126- The Number of Children Herded Through One Small Smiles Office in Just One Day – they don't want you to read this either. 

Anyway, we all know FORBA by now, whether it's being run by the DeRose bunch or the Arab bunch and their cronies they try to bully their way through, so bully it is.

They manhandle and bully the innocent children, they bully and imprison their employees, in my opinion of course,  so what else does one expect from the famous Bully Dental Company.

And by doing this, they just keep stuff that would have gotten lost in the mix, back to the top. 

GO FORBA! 

4 Year Old Tulsa Child Dead After Sedation At Pediatric Dental Group, Tulsa, Oklahoma – Charles Keithline, DDS! 4 Dead Children In 4 Months!

Is anyone paying attention to this issue. 

I'm thinking no. 

I hope someone takes this up and does NOT leave it to the Oklahoma Board of Dentistry,  they let citizens down every day!  Dental Boards fall far short on protecting the citizens of Oklahoma, but it's not just Oklahoma!

Dr. Charles Russell Keithline III's dental licenses ( # 3942) shows he has been disciplined before!  Why is that not in the report?  Call the  Board of Dentistry (405) 524-9037 for more information.

Here is what I found:

Dr. Charles Keithline # 3942
Charges: practiced dentistry in an incompetent and/or negligent manner.
Action: 6 month suspension  and 5 yrs. probation. 

(I'm told it was due to drug addiction, but can not verify)
 

This death happened on August 14, 2010.  The earliest reports I can find are from yesterday, August 20, 2010, and  only from one source.  Why?

***********

Tulsa, OK
By KIM ARCHER World Staff Writer
Published: 8/20/2010  11:00 PM
Last Modified: 8/20/2010  11:00 PM

The Tulsa Police Department and the Oklahoma Dentistry Board are investigating the death of a 4-year-old girl who had been put under sedation for a dental procedure at a Tulsa pediatric dental clinic.

Akasmse Rose Tecumseh of Morris died Aug. 14 after leaving Pediatric Dental Group, 602 S. Utica Ave.

“I can tell you we are working constantly on this,” said Linda Campbell, executive director of the Oklahoma Board of Dentistry. “We are working on the timeline.”

She said investigators have been at the clinic going through records this week to find out how long the sedative was administered and whether proper protocol was followed.

Campbell said the Tulsa Police Department is working with the board’s investigators on the case.
“Certainly one death is too many, but we are looking at this to ensure there is clear and convincing evidence” regarding any potential wrongdoing, she said.

The primary dentist at the clinic is listed on the group’s website as Dr. Charles Keithline, a fellow of the American Academy of Pediatric Dentistry and a diplomate of the board.

Keithline’s attorney, Keith Sweet of Oklahoma City, said the dentist could not comment about the patient, citing patient privacy laws. Campbell said an associate of Keithline’s performed the procedure.

Only seven people in Oklahoma are known to have died after being sedated at a dentist’s office, she said. Many were ruled natural deaths after investigations because the patients were found to have had pre-existing medical conditions, such as heart disease or asthma.

Before Akasmse’s death, the last death linked to sedation at a dental office was that of a 6-year-old boy in Muskogee six years ago, Campbell said.

In that case, the investigation found that a pharmacy erred by providing the patient a lethal dose of methadone instead of the prescribed sedative, she said. The dentist was exonerated.
According to the American Dental Association, the use of sedation and general anesthesia has been an integral part of dental practice since the 1840s.

If properly administered by trained personnel, sedation and general anesthesia are safe and effective, allowing millions of people access to comprehensive dental care who otherwise would not get it, the ADA says.

The ADA sets guidelines for the industry regarding the use of sedation and offers continuing education on proper monitoring and airway management during the use of general anesthesia.
Officials with the Oklahoma Dental Association would not comment.

Read more from this Tulsa World article at http://www.tulsaworld.com/news/article.aspx?subjectid=17&articleid=20100820_11_0_TheTul956938

The child was having some restorations done and crowns put on her deciduous teeth, according to Linda Campbell, executive director of the Oklahoma Board of Dentistry.
**********

Update Sept. 2, 2010

One story coming from the community is that Dr. Charles Keithline is charging the child's stepmother with causing the death of this child.  He is saying she left his office and drove the child around in a hot car for three house.  Of course Dr. Charles Keithline isn't planning on taking any responsibility. 
Just because a child has an underlying medical condition does NOT mean the child died of "Natural Causes" and the dentist is off the hook.

It's clear this is what has happened as the article mentions the number of deaths in Oklahoma and all were ruled "natural deaths" because of other health issues. How in the hell does this let the dentist off the hook?

And screw the AAPD or ADA guidelines and comments.  Remember they are the ones who sent out the "talking points" memo after deaths earlier this year to cover their (and their colleagues) asses!

I'm having big issues with this DOCS (Dental Organization For Conscious Sedation) Company, based in Seattle who delivering these "drive-thru" classes for dentists.  They advertise and have testimonials from dentists who talk about how offering Conscious Sedation is another tool to increase their profits! 

Related Articles:

Five Year Old David Liddell Death July 12, 2010

Deaths In Dental Chair On The Rise

Hey Kool Smiles - Time For The Assistant With The Long Green Fingernails To Go! YUK!

Hopewell, VA 

Kool Smiles Complaint:

Me and my 6 yr old went to Kool Smiles because i was looking for a place to take us both for the convience. It was horrible for me and her. She had a dental assistant with 2+ inch fake green nails that she kept stabbing into my daughters mouth.

My experience left me with a sore mouth and a assembly line experience. Now I can't get them to stop calling me to schedule another appointment and sending me post cards. I have called and called and requested they remove all my information and told them the unpleasant experience we had and they are still calling my work and sending things.

 ATTN:  NCDR, LLC (Kool Smiles)

Clean Up Your Act! 

(I know, a pipe dream) 

Stop Calling People At Their Place of Employment! 

(I get this complaint a lot!)

New York Ocean Dental Complaint

This was posted in the comment section but thought it deserved some front page space.  Mr. Hoecker, do you have an comments on this! 

I took my daughter to Ocean Dental as it was difficult to find someone close to where I live that would accept medicaid.  They wanted me to watch through a window while they cleaned her teeth and did not let me go back for X-rays or the exam....then I was told after not being explained anything, showed x-rays, etc, that my daughter needed two fillings and a cap, she is 3 and a half, so I made an appt for the first filling, they kept pushing me to sign a waiver for laughing gas but didn't even give me time to read what I was signing, as there were so many people there I just did and that was a mistake, then I wasn't even allowed to stand in the hallway while they filled the cavity, after that someone did talk to me for about two minutes and said that I needed to make sure she brushed I said she does brush and I supervise, then the person said, "well you wouldn't let your three year old wash your dishes so why would you let her brush her own teeth," when that was over I took her out to the car where she proceeded to barf in the backseat and lean her whole body over to the side and said she didn't feel good.  I was so mad that I called there and complained, and decided not to go back, I took her to a far away dentist from my house and to my surprise they went over x-rays and showed me her teeth and proceeded to tell me that she had no cavities, I said well they said she needed another filling and cap and they looked again...same results....I am furious that this is how people are being treated just because they have medicaid..your not entitled a decent dentist unless you drive for at least 45 minutes?  These people need to be investigated in my opinion.....