I believe Inside Edition will be airing a program tomorrow, September 11, 2012 about mobile dental clinics, specifically ReachOut Healthcare America.

Deaths and dental care, could this be one of the problems?

Dennis Yamashita DDS, Chairman and Director of Oral and Maxillofacial Surgery at Los Angeles County/USC, Ostrow School of Dentistry at USC, and Children's Hospital Los Angeles, is charged with incompetence, gross negligence, and multiple counts of negligence for his treatment of a 44 year old who died under general anesthesia that he administered while performing a biopsy in his office in 2009. Dr Yamashita has been involved in the training of dental oral surgery residents for many years in Los Angeles and currently remains at this position as the Program Chairman and Residency Director at USC and affiliated hospitals.


The California State Dental Board, according to an online public record released a few months ago on its website (http://www.dbc.ca.gov/) is moving to revoke his license to practice and general anesthesia privileges for incompetence -- presumably for treating this patient without prior consultation or consideration of her extremely high blood pressure and other medical problems that resulted in her having suffering a stroke under his care, failing to do a proper medical examination prior to anesthesia, failure to control the patient's high blood pressure on two occasions (she had had a prior surgery at his office a year before), failure to keep proper records during the surgery and anesthesia, and failure to call emergency services until 7 hours after the surgery and anesthesia were completed.


Is this the role model of the standard of care representing our current crop of dental trainees?

Child dies while being sedated at the office of Dr. Juan D. Villareal, Harlingen, Texas

While being sedated at this man’s office -  Dr. Juan D. Villarreal…

 

 

 

 

…this 10 year old boy, Marcos Tirado…died…basically euthanized.

 

 

 

 

…at this place, Harlingen Family Dentistry, Harlingen, Texas

 

 

 

Read more: Local, News, Boy in Coma, Boy Dies, Tooth Filling, Dental Procedure, Marcos Tirado, Anesthesia, Trinity Baptist Hospital, Loss of a Child, Harlingen, Cameron County, Harlingen Family Dentistry, Treacher Collins Syndrome, Valley Baptist Medical Center, Death of Marcos Tirado, 10 Year Old Dies, Federal Patient Privacy Laws, Lamar Elementary School Third Grader, Lamar Elementary School, Dixieland Road

Just minutes after 10-year-old Marcos Tirado received anesthesia at a local dental office, he was rushed to the hospital.

The Lamar Elementary School fifth-grader died two days later. 

It’s a pain no parent wants to endure. 

The loss of a child, that’s too young to be gone.  It’s a hard reality for the Tirado family in Harlingen. 

He was undergoing a  tooth filling at Harlingen Family Dentistry off Dixieland Road.

"Every time there was a procedure there was a lot of precautions that had to be done, the time we took him to the dentist, the doctor said it was a simple procedure, but obviously is wasn't." said Marcos Tirado, Sr.

Marcos had a medical condition called Treacher-Collins syndrome; and certain precautions need to be followed. 

The family said they made doctors and nurses aware before the procedure. 

When they were told Marcos would need to use a gas to keep him calm. 

His father showed concern but says the staff assured him it was perfectly safe and routine. 

But 10 minutes into the procedure, something went terribly wrong.

"I thought he was in just a little pain, but obviously he was unable to breathe, he just stopped," the grieving father said.

Marcos was rushed to the Valley Baptist Medical Center in Harlingen where doctors were able to revive him.

He stayed in a coma as his parents prayed for a miracle. 

But by Wednesday evening, Marcos passed away leaving his family heartbroken.

"He was with us for 10 years and even though he went thru a lot medically he was a happy boy,” the boy’s father recalled. “He surprised us many times but when it’s time to go God gives the call..that's what it is, we'll respect that."

Action 4 News contacted the Harlingen Family Dentistry for comment.

They said they were deeply saddened to learn of the death of Marcos Tirado, Jr. but due to federal patient privacy laws, they said limited information could be given. 

“Our thoughts and prayers are with the parents and their family at this difficult time,” they said in a statement.

Is Rick Workman trying to dump his baby - Heartland Dental - before its value is zero?

Many in the industry don’t see it.  Even more are in denial about it. But it’s happening, non-the-less. Corporate Dentistry is under attack. Federal, state and local governing boards as well as law enforcement agencies are making bold moves to clean up what has been left to run amok for years. This “clean up” may be fatal. Which is fantastic for every person in America, because everyone sees the dentist at some point.

Though it may be slow and painful. Has Rick Workman finally come to gripes with that reality? I think this is a HUGE signal to all “corporate dental chains” out there. When one of the first, largest and most influential entities in the industry is ready to tuck it’s tail and run, you know it’s bad.

 

Heartland Dental Care, Inc. Sale
September 6, 2012
Heartland Dental Care Inc., one of the largest dental practice management companies in the United States, is exploring a sale that could fetch as much as $1.4 billion, according to two people familiar with the matter, Reuters wrote Thursday. The company, in which Chicago-based private equity firm CHS Capital Partners has a stake, has hired investment banks Jefferies and Moelis to find a buyer and has drawn interest mostly from other buyout firms, the people said.
(Reuters) – Heartland Dental Care Inc, one of the largest dental practice management companies in the United States, is exploring a sale that could fetch as much as $1.4 billion, according to two people familiar with the matter.

The company, in which Chicago-based private equity firm CHS Capital Partners has a stake, has hired investment banks Jefferies and Moelis to find a buyer and has drawn interest mostly from other buyout firms, the people said.

The sources asked not to be identified because the process is not public.
Heartland Dental has about $120 million in annual earnings before interest, tax, depreciation and amortization (EBITDA) and could be sold for 10 to 12 times EBITDA, they added.

The auction is early in the second round and final bids are expected about a month from now, according to the people. Jefferies has offered to provide financing for potential buyers, they added.

Representatives for Heartland Dental, CHS Capital, Jefferies and Moelis did not immediately respond to requests for comment.

 

Private practice to corporate takeover of your dental practice

If you’ve not been approached by one of the Private Equity dental companies, then this will be a treat.

Great Expressions Acquisition Solicitation Package

WSJ- Texas has eye on Xerox in Texas Dental Medicaid Fraud

 

By NATHAN KOPPEL

Texas authorities are investigating whether Xerox Corp. played a role in allowing dentists to allegedly overbill the state's Medicaid system by millions of dollars.

Like many states, Texas contracts with Xerox to process forms submitted by dentists, who seek a determination about whether procedures they intend to perform are covered by Medicaid, a federal-state program that insures lower-income people. The company evaluates whether the planned procedures are medically necessary.

The Texas Health and Human Services Commission says it is concerned that Affiliated Computer Services Inc., which Xerox acquired in 2010, didn't dedicate enough trained staff to vet dentists' Medicaid requests, allowing dentists to receive payments for procedures not covered by the program.

Xerox declined to comment on the Texas investigation but said it doesn't face similar scrutiny in other states. The company said it helps administer Medicaid programs in 36 states and the District of Columbia, processing $54 billion in annual Medicaid spending.

"Xerox has more than 40 years of experience working with government health agencies to enhance the efficiency of health programs," company spokeswoman Jennifer Wasmer said.

A 2008 audit by the Texas health agency's inspector general found that ACS had one dentist on staff to review thousands of Medicaid requests, and that the dentist examined only about 10% of them. ACS responded that its contract with Texas didn't require all requests to be reviewed by a licensed dental professional.

The current scrutiny of Xerox in Texas, covering a period from 2008 to 2011, is part of a broader state investigation into Medicaid abuse that has so far largely targeted dentists and orthodontists, who have been accused by state officials of improperly billing the state for procedures including putting braces on youngsters for purely cosmetic reasons and performing unnecessary root canals on small children.

The Texas Medicaid program paid out $1.4 billion to dentists and orthodontists last year—a roughly fourfold increase since 2006. In 2010, the Texas Medicaid program spent more on braces than all other state Medicaid programs combined, according to a report from the U.S. House Committee on Oversight and Government Reform.

Texas dentists and orthodontists note that they are required to obtain the state's approval before billing Medicaid.

The Texas Health and Human Services Commission, in turn, has tried to pin some of the blame on Xerox for allegedly signing off on questionable procedures.

The agency's inspector general is auditing Xerox and will fine the company if it concludes Xerox didn't live up to the terms of its contract with the state, said Stephanie Goodman, a spokeswoman for the agency.

The Texas Attorney General's Office in June also issued a civil investigative demand, akin to a subpoena, against Xerox in connection with the agency's investigation into Medicaid fraud.

At the behest of Texas officials, Xerox hired a new dental director to review Medicaid requests last year, Ms. Goodman said, noting that the current audit of Xerox should be completed later this year.

Xerox's role has been diminished, she added, because in March the state shifted much of the responsibility for approving Medicaid requests to managed-care organizations.

Write to Nathan Koppel at nathan.koppel@wsj.com

Kool Smiles Complaint # 153359

• Date Occurred:08/14/2012
• Reported Damages:$1,300.00

Over a 3 week period of time i had gone into cool smiles for fillings. I was told they couldn't do it all at once and said it was going to take 6 visits. I told them every week for 6 weeks is unacceptable seeing as i have 3 small kids and am new in town and don't have a babysitter! we got it down to 3 weeks by doing top right and bottom left. next visit was top left bottom right, and last trip was the top and bottom front. I knew that we had some bad cavities but the dentist assured me they would do every thing they could to avoid a root canal! well the first dentist who worked on me wasn't the dentist i originally met and talked with. Threw the 3 weeks i was never told how or what they were going to do to my teeth. Never was told a name of my dentist or nurse ( which were different every time). The work was done shoddy so every time i went back i told them of my still growing pain and discomfort. They just kept filing down the fillings. after the 3rd weeks visits i told them i was still in bad pain. they then said without x-rays that m 2 back molars must have gotten fractured and all my insurance would cover was to extract them! No way! They would ultimately end up pulling 3 to 4 teeth if i let them do that. Then after the last visit when i got home i noticed when brushing my teeth something crunchy. It the "filling" they did. they just covered 2 teeth together so i couldn't brush or floss in between and that had fallen out after the 1st day of it being filled. It left a gap big enough to see a cavity that was not cleaned or filled properly at all. I have tried to call the locations manage but the nurse/receptionist that answered the phone kept changing the subject and wouldn't listen to me or help. I then called the call center (which hung up on me 3 times before actually taking my call) and made a formal complaint to the highest up section i could who then forwarded a copy of my complaint to headquarters and the store manager. Going on 8 days past now and still no call backs from any one!!!! I am in excruciating pain and cant eat even with antibiotics for the abscess this drama has causes and pain pills which barely help and make me sick to my stomach! I asked for my x-rays to go to another dentist and was refused them even though i paid for them. The nurse said "what do you need them for" and never would release them! I hate that we chose this place and i hate all the crap and suffering I'm having to go through and they cant even be human enough to call back or see if they can fix it or do any thing to help! We will NEVER go back there ever again!

http://www.scambook.com/report/view/153359/kool-smiles-Complaint-153359-for-$1,300.00

(as taken from website, with typos corrected)

Dental care in America: A study in austerity, neglect and profiteering

 

Dental care in America: A study in austerity, neglect and profiteering

By Gary Joad
1 September 2012

A Frontline production on the Public Broadcasting System (PBS) aired in June documented the painful and ill experiences of millions of working class families and their children, the disabled and poor, and retired persons as they seek dental care in the United States.

In the opening scene of “Dollars and Dentists,” hundreds of people with jaw and tooth pain form long lines in the early morning freezing rain of southern Virginia, seeking relief from a volunteer dental clinic. Most patients declare on camera that they are often too sick and sore to eat, and that they are compelled to live with pain every hour of their lives.

As the clinic’s Dr. Terry Dickenson states at the program’s beginning, “Gas, food, and rent compete with dental care for the dollars these persons have.”

Washington, D.C. resident Vanessa Nations, 31, reported that she had been significantly ill with dental and gum infections for many years, until her problems became so severe that she needed all her teeth extracted. She commented, “I feel like little bits of poison are killing me.”

She could not eat sufficiently, and therefore could not maintain a normal weight. Virtually all her teeth were chipped, broken off, and discolored. Poignantly, she brought a smiling teenage photo of herself to show the dentists how she wanted to look again, as they planned the removal of her ruined teeth and the manufacture of her dentures.

Dr. Li Lu Skelton, DDS–San Antonio, Texas

Dr. Li Lu Skelton – Li Dental Implant & Smile Center – appears to be an habitual offender. It seems landing in front the the Texas State Dental Board of Examiner’s is nothing more than the normal course of doing business. 

Dr. Li Skelton’s record at the Texas State Board of Dental Examiners reflects she serves up some substandard dental care pretty regularly. In one case alone, she had to pay an $8,000 fine and $11,000 fine. In at least one other case, she delivered too much anesthesia to a patient, causing that patient seizures and hospitalization, according to the KSAT report.

When KSAT-TV featured one of her mangled patients – Darryl Davis- in a May 2012 report, Dr. Skelton sent this lovely letter to the station when asked for comment.

Li Dental Care, PC
In San Antonio, Texas
18th of May 2012

(The patient) has made several accusations relating to his treatment. He had accepted and signed three agreements which include confidentiality as to the content of these agreements.

[ Note, the very first paragraph in her comment, was to point out she felt as though she had convinced – I call it duped- her patient into signing three agreements to keep quiet about her gross negligence, malpractice and battery.

If threats standard procedure for Dr. Li Lu Skelton, wonder how many patients are out there, that have been mangled, feel intimidated by her and feel they have no place to turn for help.]

Dr. Li and the Dental Practice have made every reasonable effort to satisfy (the patient's) concerns and his continued attempts at demanding money and challenging the professional reputation of this Dental Practice are unfortunate.

[Clearly, Dr. Li Lu Skelton, has NOT made every effort to “satisfy” this patient’s concerns, instead she took him to court to try and shut him up.]

By making this a public issue, (the patient) may be considering our release of this patient information to the public. We will not do so. Patient confidentiality is not something we take lightly and will not ever violate patient confidentiality. Therefore, we cannot respond directly to (the patient).

[Huh? First, considering Dr. Li Lu Skelton’s many complaints from patients, this is a public issue, she could well be a danger to public health.]

Li Dental Care, PC is a professional Dental Practice operating in San Antonio for over 15 years, providing professional dental service to thousands of patients. Additionally, Dr. Li has placed over 6,000 implants and had produced thousands of wonderful smiles for Texans.

As in most matters of human endeavor sometimes things do not work out as planned. Even in manufacturing there is a failure rate. In the matter of implants a small percentage are going to fail. It does happen and sometimes there is no identifiable reason as to why implants fail. The good news is that this is ordinarily fixable.

[So, the “good news” is that this is ordinarily fixable? Really?  With all “good news” statements like that, there is always the “bad news” to follow. For this patient, the bad news is:

“I will need to lose all of my back molars a total of 6 teeth, and that's not the best news. I have front teeth that were crowned over teeth with soft tissue and will need them removed as well. So, at a young age I will need to wear an upper denture for at least 6 months so the infections in my sinuses both left and right side can heal. And imagine there is no help for dental patients that have been treated this way. I am left without words!” – Darryl Davis

Li Dental Care, P.C. stands on its very high quality reputation for professional services and patient care. Dr. Li’s goals include helping her patients achieve the new smile they so much desire and deserve.

[High quality reputation, hmmm, just how is that measured and where can I find that reputation? Not on file at the dental board, that’s for sure, not looking good in Bexar country district court records either, see below.]

Darryl was getting “No Satisfaction” from Dr. Li Lu Skelton, so he took it to the public. Like me, he started a blog!

 

The original name of the blog about Davis’s gruesome experience was Dr. Li Skelton Dental Nightmare, it’s since changed to Dr. Li Skelton – My Dental Experience.

Dr. Li Lu Skelton filed a lawsuit against her former patient, Darryl Davis, on June 1, 2012 - 13 days after KTSA ran the story of his dental nightmare, with Skelton. I’ve not seen the suit, but I suspect it’s a SLAPP suit of sorts. Texas enacted anti-SLAPP suit legislation in 2011.

For Dr. Li Lu Skelton to be taking some “Holier Than Thou” attitude toward her patient is absurd! Look at Davis’ radiograhphs!

If you have had a bad experience with Dr. Li Lu Skelton, click here, this one needs to be stopped, ASAP. Don’t depend on the TSBDE to do the stopping, they recently renewed her license to practice dentistry for another year. Only plus there, is for the malpractice attorney.

LAWSUITS

Dr. Li Lu Skelton, DDS is no virgin to Bexar County District court either. She has had 6 cases in 4 years filed against her. Imagine her Malpractice Insurance costs!! Hope she has some, what if she’s been canceled?

Dr. Li Lu Skelton DDS Bexar County Lawsuits

Search Texas Cases

According to the lawsuits, it looks like Dr. Li Lu Skelton used to work for Carillon Hills Dental Associates, with John A. Moore, DDS. Dr. Moore doesn’t seem to rate very high either, he has one star and a comment says they didn’t even think he was a real dentist…  lol !

 

Darryl Davis’ attorney is:

Adam T. Froeschl
9045 Grissom Road. Suite B.
San Antonio, TX  78251
210-680-1918

Fugitive on the run–Elizabeth(Dr. Liz) Hinojosa and Monica Salazar Orozco

Mother, daughter accused of posing as dentists in Oklahoma City sought by authorities

Elizabeth Hinojosa and Monica Salazar Orozco, of Oklahoma City, worked in offices where alleged crimes took place after hours, investigators said

By Tim Willert | Published: August 31, 2012

A mother and daughter accused of posing as dentists pulled teeth, performed root canals, injected anesthesia and forged prescriptions, court papers show.

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Elizabeth Hinojosa, 47, and Monica Salazar Orozco, 28, both of Oklahoma City, were charged Friday in Oklahoma County District Court with practicing dentistry without a license, a felony. Hinojosa also was charged with one count each of forgery, medical battery and embezzlement.

Warrants were issued for their arrest Thursday, authorities said.

Hinojosa was a dental assistant and her daughter was a receptionist where the alleged crimes took place between September 2010 and May 2011, according to a probable cause affidavit filed with the charges.

Both worked for Dr. Salam Ramadan, who owns and operates Dental Spa locations at 1211 SW 44 and 3315 NW 63 in Oklahoma City.

Ramadan said Friday she didn't find out about the alleged crimes until she was contacted by the Oklahoma Board of Dentistry. The board started investigating after receiving a complaint.

“I was blindsided by it,” she said. “I had no idea it was going on.”