Duvall Discipline Panel Decision (redacted) - College of Dental ...

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-28 The Panel has concluded that Dr. Duvall's breach of the Code of Ethics is professional misconduct and is an offence pursuant to Section 39(1)(c) of the HPA. Citation #18(b) In or about 2006, as regards your patient, BC, y ou b. provided inadequate restorations to teeth 5.5, 5.4, 6.5, 6.4, 7.5, 7.4, 8.4 and/or 8.5 In this instance the Panel reviewed the report and affidavit from Dr. DH, an affidavit from GC (patient's mother), the patient's chart, radiographs, a response letter from Dr. Duvall and heard testimony from Dr. Penner. GC deposed that Dr. Duvall saw her daughter B in 2006. B was 7 1/2 years old at the time. Dr. Duvall advised that B would need fillings to eight teeth. This restorative work was performed by Dr. Duvall in April and July 2006. Some time later, GC took B to another dentist, Dr. M, who advised her that six of the eight fillings placed by Dr. Duvall required replacement. Dr. M took radiographs of the teeth before he replaced the fillings. Dr. DH provided those radiographs to the CDSBC. He reviewed them and deposed that they show the fillings were insufficient. Dr. Penner testified the radiographs confirmed there was a lack of filling material between the tooth and the filling in teeth 5.5, 8.4, 8.5, 6.4, 7.4 and 7.5. He further pointed out that the provision of such restorations is basic routine dentistry and there was no apparent reason for the work to have been poorly performed. In his response, Dr. Duvall said that the composite material used in Fort St. John was not of the same quality as that used in another dental office in Chetwynd. The Panel can not accept this explanation - if the filling material used was in fact inadequate, he should not have used it. The Panel concludes that Dr. Duvall's provision of the restorations was inadequate in respect of the 6 teeth and is incompetent dentistry within the meaning of Section 39(1)(d) of the HPA.
-29 Citation #19 In or about 2006, as regards your patient, CO, you provided substandard care in the placement of a crown on tooth 3.6. The Panel reviewed Dr. DH’s report and affidavit, the patient's chart, a radiograph, Dr. Duvall's response and heard testimony from Dr. Penner. The patient, CO, was a certified dental assistant who worked for Dr. Duvall at Fort St John Dental Clinic. Dr. Duvall placed a crown on tooth 3.6 on December 22, 2006 that did not fit properly. On a recall examination on April 4, 2007, Dr. DH examined the tooth and took a periapical radiograph of it. He deposed that "on examination of Ms. O, the mesial of 3.6 had gingival inflammation, irritation and the papilla crowded out. The radiograph revealed a 2 to 3 m m overhanging mesial margin. On April 4, 2007, I redid the crown." Dr. Penner reviewed CO’s chart and radiograph. He confirmed there was a 2 to 3 mm overhang on the mesial of the crown. This overhang would have been apparent to Dr. Duvall on the tryin and the crown should not have been permanently placed in the mouth. It should have been re-fabricated. When the patient went to Dr. DH for the placement, the mesial had gingival inflammation, irritation and the papilla was crowded out due to this overhang. In his response Dr. Duvall acknowledged that the crown needed to be redone but suggested he did not have the opportunity to do so. Dr. Penner pointed out that if Dr. Duvall had planned to redo the crown, there was no need to wait four months to do so, because a crown takes about one week to prepare. The Panel has carefully examined Dr. Duvall's response. It does not address the issue of the overhang or the problems this caused for the patient. The Panel has concluded the provision of a crown is a part of basic dentistry. There is no reason to insert a crown that does not fit properly and this would have been apparent to Dr. Duvall. It
Page 1 and 2: IN THE MATTER OF THE COLLEGE OF DEN
Page 3 and 4: - 3 In its decision, whenever the P
Page 5 and 6: - 5 Citation #2. In or about 2007,
Page 7 and 8: - 7 The Panel is unable to accept D
Page 9 and 10: - 9 c. you improperly placed an imp
Page 11 and 12: - 11 In January and February 2006,
Page 13 and 14: - 13- The evidence established that
Page 15 and 16: - 15- · Dr. Penner testified that
Page 17 and 18: - 17 The Panel reviewed a letter of
Page 19 and 20: - 19 did not contain any entry that
Page 21 and 22: -21 The Panel reviewed a letter of
Page 23 and 24: -23- The Panel understands the Coll
Page 25 and 26: -25 work. The Oct 24, 2006 radiogra
Page 27: -27 RK could see that some of the c
Page 31 and 32: -31 is left in the mouth there is a
Page 33 and 34: -33 In response to this aspect of t
Page 35 and 36: -35 Dr. Penner agreed with Dr. D H
Page 37 and 38: -37 The patient, 17 years old, was
Page 39 and 40: -39 patient would be. Dr. Duvall di
Page 41 and 42: -41 Both GC and her mother were unc
Page 43 and 44: -43 Section 8(j) of the AUSPA requi
Page 45 and 46: -45 Section 8(n) of the AUSPA requi
Page 47 and 48: Appendix "A" College of Dental Surg
Page 49 and 50: 3 11. In or about 2009, as regards
Page 51 and 52: 5 (d) (f) (j) (k) to fully comply w
Page 53 and 54: -46- from Dr. L to the effect that
Page 55: -46- from Dr. L to the effect that

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