This summary also appears under Healthcare Law
Issues: Discipline of the respondent for violating a general duty of care to a patient; Appellate review of an agency decision; Const. 1963, art. 6, § 28; Proceedings under the Michigan Public Health Code (MCL 333.1101 et seq.); Administrative Procedures Act (MCL 24.201 et seq.); Michigan Elec. Coop. Ass'n v. Public Serv. Comm'n; Expert testimony; Whether a decision is supported by competent, material and substantial evidence on the whole record; Department of Cmty. Health v. Risch; Whether inadequate record keeping is a breach of the standard of care; MCL 333.16221(a); Mich. Admin. Code, R. 338.11120(2); Boyd v. Wyandotte; Zdrojewski v. Murphy; Bureau of Health Care Services (BHS)
Court: Michigan Court of Appeals (Unpublished)
Case Name: Bureau of Health Care Servs. v. Armstrong
e-Journal Number: 59479
Judge(s): Per Curiam – Jansen, Meter, and Beckering
The court held that the petitioner-BHS's punishment of the respondent-dentist was supported by competent, material and substantial evidence on the whole record. Following a hearing, the ALJ found that respondent violated his general duty by indicating that one of his patient's teeth had a "hopeless prognosis." As a result, petitioner placed respondent on probation for a minimum of one day, required him to complete specified continuing education, and fined him $5,000 for violating his general duty to a patient through either negligence or failure to exercise due care. On appeal, the court rejected his argument that petitioner's "final order was not supported by competent, material and substantial evidence on the whole record because no expert testimony was presented to show that respondent was negligent or failed to exercise due care with respect to determining in [the patient's] chart that tooth # 14 had a 'hopeless prognosis - ext required.'" It found there was "expert testimony sufficient to establish the standard of care and breach of that standard as to the note at issue." It also rejected his argument that the "final order was not supported by competent, material and substantial evidence on the whole record because even if expert testimony was offered as to the standard of care regarding respondent's 'hopeless prognosis - ext required' entry, a failure to keep adequate records was not a breach of the standard of care." It noted that the ALJ was concerned with what respondent actually noted in the patient's chart. "The ALJ found that what respondent noted in [the] chart was incongruous with the advice given to [the patient], and that the characterization of the tooth as 'hopeless' at the time he noted as much was a violation of the standard of care. As noted, this finding was supported by" expert testimony. Further, "maintaining a patient record would be of little use if it does not accurately reflect the physician's diagnosis, prognosis, and medical condition, both for subsequent treatment and for determining whether a patient has been given accurate information." Finally, the court rejected his argument that the "final order was not supported by competent, material and substantial evidence on the whole record because the phrase 'hopeless prognosis - ext required' was ambiguous and the interpretation of the phrase by the ALJ was speculative." It held that "even if what respondent meant was that [the patient] should wait to see if the symptoms persist, it was still premature for respondent to note . . . that extraction would be required. Accordingly, the ALJ's interpretation that it was premature at best for respondent to have noted that the tooth had a hopeless prognosis and that extraction was to follow was supported by substantial evidence." Affirmed.
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