Between 21 and 24 September 2020, the Health Practitioners Disciplinary Tribunal (the Tribunal) considered a charge laid by a Professional Conduct Committee (PCC) against Dalila Gabb, registered dentist of Whakatane (the Dentist).
The charge was laid under section 100(1)(a) and (b) of the Health Practitioners Competence Assurance Act 2003 (HPCA Act). The charge related to the Dentist’s provision of edentulous dental treatment to her patient.
The charge alleged that the Dentist failed to act in accordance with acceptable standards in four areas of her dental practice. The particulars alleged that the Dentist;
- failed to have a treatment plan or adequate treatment plan for the patient
- failed to obtain the patient’s fully informed consent prior to commencing treatment
- acted outside her professional expertise in taking on the patient’s case
- failed to keep adequate clinical notes and documentation in relation to the patient.
It is alleged that these failures both separately and cumulatively amounted to malpractice and/or negligence or conduct that had brought, or is likely to bring, discredit to the dental profession.
The Dentist qualified with a Bachelor of Dental Surgery from the University of Mato Grosso do Sul in Brazil in 1991 and immigrated to New Zealand in 1999. In 2001, she was registered by the Dental Council as a general dentist.
The Dentist met the patient who was seeking an alternative to dentures. The Dentist suggested implants as a solution.
The patient attended the Dentist’s practice for the patient’s first consultation in 2006. The Dentist explained to the patient that three parties would be involved in the process: Dr M, Mr E and herself.
The Dentist was responsible for the overall treatment plan and explaining the costs, risks and benefits of various options available, obtaining the patient’s consent and ensuring that all her clinical documentation was adequate.
There is no evidence that any written treatment plan, estimate of costs or any signed informed consent document was ever provided to the patient prior to undergoing the first surgery with Dr M. The Dentist maintained that some of her clinical notes and records had been lost from this period and later.
The patient’s treatment was plagued by problems at almost every step of the treatment with Dr M, Mr E and the Dentist over eight years, between May 2006 and September 2014. The problems persisted through much of 2014 and for much of the time, the patient had on-going pain with his temporary dentures.
In 2014, the patient advised the Dentist in writing that he wished to discontinue treatment. The patient did not have a resolution for his dentures but the pain and cost of on-going treatment had become too great.
The hearing proceeded on an agreed summary of facts. The Dentist denied the charge and maintained that her conduct did not amount to professional misconduct.
The Tribunal found that the charge was established in respect of all particulars. The charge was established as negligence in relation to the scope of the Dentist’s practice and was a breach of professional standards, likely to bring discredit to her profession.
The Tribunal was satisfied that the established conduct set out in the charge fell short of the conduct expected of a reasonably competent dentist.
The Tribunal was also satisfied that each of the particulars were separately and cumulatively departures from acceptable standards and were significant enough to warrant a disciplinary sanction.
- Censured the Dentist;
- Imposed conditions for the Dentist that she engage in professional supervision;
- Ordered the Dentist to pay 45% of the costs amounting to $89,944.00.
The Tribunal directed publication of the decision and a summary.