Little v. North Carolina State Board of Dental Examiners

Citations: 306 S.E.2d 534; 64 N.C. App. 67; 1983 N.C. App. LEXIS 3226Docket: 8210SC1035

Court: Court of Appeals of North Carolina; September 20, 1983; North Carolina; State Appellate Court

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Dr. Thomas A. Little's appeal against the North Carolina State Board of Dental Examiners' decision to revoke his dental license was affirmed by the Court of Appeals of North Carolina. The Board found that Dr. Little violated the North Carolina Dental Practice Act through improper delegation of duties to dental assistants, unauthorized prescription of Valium to family members, and dental malpractice involving specific patients. Dr. Little raised eight questions regarding the trial court's support of the Board's findings, including challenges to the agency's decisions as arbitrary and capricious. The court's review was governed by the Administrative Procedure Act, applying the "whole record" test to determine if substantial evidence supported the agency's findings. The court emphasized that the administrative body holds the responsibility to assess evidence and witness credibility, and the reviewing court cannot substitute its judgment for that of the agency if substantial evidence exists to uphold the ruling.

The petitioner is appealing the trial tribunal and administrative agency's decision, claiming it was arbitrary and capricious as defined by G.S. 150A-51(6). Specifically, this standard applies when decisions lack fair consideration, fail to demonstrate reasoning, or result in unfairness despite adherence to statutory requirements. Dr. Little contends that contradictory evidence was overlooked by the Board of Dental Examiners, leading to an arbitrary decision. However, the appellate court finds that substantial evidence supports the final Agency decision and the superior court's ruling. 

Examining specific charges against Dr. Little, particularly regarding the delegation of duties to Connie Watts Verricchia—who was unlicensed and undertrained—it is noted that she was allowed to perform various dental procedures, including removing bone splinters, applying anesthetic, diagnosing conditions, and taking X-rays. The Board's findings indicate she performed a significant portion of the X-rays during her employment and was responsible for managing patients with complications. The transcript corroborates these findings, detailing her methods in treating patients, thus affirming the Board's conclusions and dismissing Dr. Little's claims of arbitrary decision-making.

Ms. Verricchia conducted procedures related to bone splinters on patient Ellen Rommel multiple times and accounted for approximately 20% of the daily patient load at the office. Her testimony was corroborated by Ellen Rommel, David Terry Maness, and Jane Venters. Dr. Little countered her claims, stating that he never authorized Ms. Verricchia to take X-rays prior to completing her technical course in October 1980 or to perform certain dental procedures. His assertions were supported by witnesses James Bradley, Susan Summerlin, and Jane Venters, who also noted Ms. Verricchia's attempts to involve them in legal actions against him. Dr. Little emphasized that the Board overlooked testimony from Appellant, suggesting Ms. Verricchia was part of a disgruntled group aiming to undermine his practice, thereby questioning her credibility and that of her colleagues. 

The appeal centers on witness credibility, with ample impeachment evidence presented. The appellate court found substantial evidence supporting the Board and trial court's conclusions, noting that it is the fact-finder's role to assess evidence quality and believability. Regarding allegations of unauthorized Valium prescriptions, the Board established that Dr. Little purchased significant quantities of Valium and dispensed it to family members for various stress-related issues. While Dr. Little did not dispute the findings about his purchasing habits, he challenged findings suggesting he dispensed Valium as part of his dental practice and noted the absence of treatment records for the family members involved. The transcript confirmed that he did not dispense Valium in connection with his dental practice and lacked dental treatment records for the individuals he dispensed medication to.

The assignment of error regarding dental malpractice in the treatment of Ellen Rommel is overruled due to insufficient evidence. Rommel first visited Dr. Little on July 29, 1980, complaining of upper left mouth pain and requesting treatment for her teeth. Following a clinical examination and X-rays, Dr. Little diagnosed her with periodontal disease, recommending the extraction of all her teeth without presenting alternative treatment options. Although Rommel consented to the extractions, the Board found no supporting documentation for such a diagnosis, noting that most of her teeth, except for four severely decayed ones, could have been restored. The Board concluded that Dr. Little's failure to inform Rommel of available treatment options constituted negligence and malpractice, violating the standard of care expected of dentists in North Carolina at that time. Expert witness Dr. Harry Rickenbacker supported Dr. Little’s actions but acknowledged that several teeth could have been saved. Conversely, Dr. Michael J. Noonan, another dentist, testified that only four teeth required extraction and criticized Dr. Little’s approach as contrary to accepted practice. Evidence, including X-rays, indicated that Rommel's periodontal disease was moderate, further supporting the Board's findings against Dr. Little.

Dr. Noonan's testimony was deemed sufficient expert opinion evidence, which, combined with other evidence, justified the Board's conclusion that Dr. Little was negligent in his treatment of Ms. Rommel. The Board of Dental Examiners, comprised of licensed dental professionals, was qualified to assess whether Dr. Little adhered to the standard of care expected of dentists in the Wilmington area. The Board is authorized to leverage its expertise in disciplinary hearings and is not mandated by law to disclose its reasoning or credibility assessment methods when evaluating expert testimony. All errors alleged by the appellant were found to lack merit. The Board's final decision is supported by substantial evidence and is not considered arbitrary or capricious, leading to the affirmation of the Board's decision. Judges ARNOLD and WEBB concurred.