• Homer dentist faces multiple accusations of substandard care after patients file complaints
By Hannah Heimbuch
Following the investigation of several formal complaints, Alaska’s Division of Corporations, Business and Professional Licensing made a recommendation to “suspend, revoke, or impose other disciplinary sanctions against the dental license” of Homer’s David Eugene Nelson, DDS.
According to a public accusation document filed by Chief Investigator Quinten Warren, Nelson is accused of allegedly performing medical procedures – namely dental implants – that did not conform to Alaska’s minimum standards of professional dentistry.
The accusation document, filed with the Office of Administrative Hearings on referral by the Alaska Board of Dental Examiners, lists three separate counts identified by the initials, K.F., C.O. and P. A.
One of those complaints belongs to Homer’s Penelope Anderson, who first sought dental care from Nelson in 2008.
Over the course of several procedures, Anderson received a sinus lift, a bone graft and four dental implants.
A dental implant is a device fused into the bone that acts as an anchor for a crown, bridge, denture or other dental prosthetic.
“The real trouble started in early 2012 when I went to Dr. Nelson complaining of an infection,” Anderson said. “He put me on antibiotics, so I was not too concerned.”
Her infection returned with more severe symptoms, and after several months, she was referred to an ear, nose and throat specialist for a CT scan to examine the infection.
Anderson was very nervous at the time, concerned that this worsening infection would inhibit her ability to care for her disabled daughter.
“My efforts to clear up the sinus infection were not working,” she said. “I made an appointment with Dr. Nelson. In his examination, he acknowledged a problem, but said in no way would the implants have to be removed.”
Anderson said Nelson called later, after reviewing her information, to say some implants would have to come out, but he wouldn’t know how many until he had started the procedure.
“I had already sought a second opinion,” Anderson said. “He (second opinion) made immediate arrangements for me to be seen by (a doctor at South Peninsula Hospital), who determined I needed to have surgery to clean out the gunk in my sinus, and recommended removal of the implants.”
According to the state report, the treatment plan Nelson established for Anderson wasn’t appropriate, because there was not enough bone to support the implants. He then allegedly failed to recognize that the procedure wasn’t working, and continued on a treatment plan that ended, ultimately, with a severe sinus infection and additional surgery to remove the implants.
“He did not adequately represent the nature of the treatment or his ability to provide the treatment properly,” the accusation document reads.
Following surgery to remove the implants, Anderson tested positive for eight different kinds of gut flora, which her doctor told her indicated a dental problem.
“All told, the experience cost me over $23,000,” Anderson said. “It’s been a little over a year, and I recently saw an implant specialist clinic in Bellevue, Wash. For $18,000, they could repeat the process of sinus lift, bone graft, three implants or – plan B – for $24,000, they could remove all the healthy teeth from my upper jaw and attach four implants on which to hang a set of upper dentures.”
Despite these options, Anderson said there is concern that her sinus membrane is still perforated, which would put her at risk for infection again.
Homer resident Pete Fineo is not named in the accusation, but has also filed complaint paperwork regarding care he received at Nelson’s practice. Fineo first visited Nelson’s office four years ago to have a three-tooth bridge replaced.
Fineo said he ended up with a dental implant and a crown on either side. When one of the crowns fell out almost immediately, Fineo said several attempts were made to keep it in place – which required grinding down the tooth a little each time. Then, Fineo said there wasn’t enough tooth left to support a new crown.
Nelson then allegedly recommended the tooth be pulled and an implant put in – which he eventually did. Following this course of treatment, and before it was time to put crowns on the implants, Fineo said he left Nelson’s care due to an administrative disagreement.
Because of the disagreement, he sought the care of another Homer dentist to put in the crowns that would top the implants.
“He takes X-rays and, low and behold, he says these implants were put in incorrectly,” Fineo said. “They should have never been put in the first place.”
According to Fineo, a second opinion from a dental surgeon in Wasilla produced the same information – that he should never have had implants put in an area with insufficient bone to support them.
Fineo’s options at that point were to remove the implants and go through a bone augmentation procedure that would support new implants, or get the crowns put on and see if they held. He opted for the later.
Fineo said this left him with two implants by Nelson with not enough bone to support them, two crowns on top of them by another dentist, and one remaining crown from Nelson.
“After I had the implants, I filed a complaint with the Alaska Board of Dental Examiners,” Fineo said.
According to a mid-December letter to Fineo from a board investigator, the accusation document may still be amended to include his and other complaints as investigation on those counts conclude.
“In a perfect world, there are two things I’d like to see happen,” Fineo said. “I’d like to get my money back so I can get repair work, and I’d like to see Nelson lose his license.”
Anderson is looking for similar actions.
“I would like to see Dr. Nelson repay all the money to the patients he victimized,” Anderson said. “If he repaid me, I could then pursue a remedy for my dental problem.”
In addition to punitive damages regarding Nelson’s dental licensing, Anderson said she would like the Board of Dental Examiners to be more proactive when licensing for certain procedures, in order to prevent these situations from happening in the first place.
“The surgery Dr. Nelson performed on me, and the placement of implants into my sinus cavity, was quite complex and dangerous,” Anderson said. “The implants were doomed to fail, because they never had a chance just hanging into an open cavity.”
Out of sensitivity to the ongoing investigation, members of the Alaska Board of Dental Examiners and state investigators were unable to comment on the details of the case, beyond those already available in the public documentation.
“In all dental board complaints alleging substandard patient care, two licensed members of the board review all of the records and information compiled during this preliminary stage and the division relies on their expertise to determine if violations occurred,” wrote Special Assistant to the Department of Commerce, Community and Economic Development Leslye Langla in an email.
“If a violation is substantiated, the division and a reviewing board member determine the appropriate disciplinary action,” she explained. “This is based on the seriousness of the violations, a history of board disciplinary action and other mitigating and aggravating factors.”
The accusation document, filed after the above-mentioned evaluations, concludes with the following recommendation:
“The Division respectfully requests that the Board revoke or suspend Nelson’s license to practice dentistry, or impose other lawful sanctions to his license that the Board deems appropriate.”
It also cites Alaska Statute 08.36.317, which states, “The board may impose a civil fine not to exceed $25,000 for each violation of this chapter.”
Attempts to reach Dr. Nelson for comment were unsuccessful. However, Nelson filed a Notice of Defense on Dec. 17 through his defense firm, Clapp, Peterson, Tiemessen, Thorsness and Johnson, LLC. The firm has offices in both Anchorage and Fairbanks, and professional licensing law is one of their advertised specialties.
The firm requested a hearing regarding the accusations filed.
Fineo said there is still opportunity for others to log their own concerns.
“Any of Nelson’s patients who feel they may have received questionable dental treatment can contact the State of Alaska Professional Licensing Investigative unit at (907) 269-8437 to discuss their concerns,” he said.
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