KNOXVILLE (WATE) - A state judge recommends that Morristown dentist Dr. Paul Muscari be stripped of his license, face a stiff fine and pay costs associated with his prosecution.
Administrative Judge J. Randall Lafevor writes that Dr. Muscari's violations are "many and substantial." He recommends that Dr. Muscari's license to practice dentistry in Tennessee "be revoked for no less than 20 years" and that he be fined $36,000.
The recommendations are detailed in a 39-page initial order.
Dr. Muscari's attorney, Willis Jackson, has until December 27 to appeal the civil penalties. If he doesn't, under the rules the initial order against his client becomes final.
"A great deal of this case has to do with money," Jackson said.
In late September during a two day hearing, Jackson argued that the charges against Dr. Muscari were the result of a disgruntled former employee and unhappy patients.
He also argued that patient complaints reported by 6 News since February 2007 encouraged litigation that contributed to civil charges against Dr. Muscari.
The state Department of Health's deputy general counsel David Himmelreich countered, "This is a case of betrayal of trust.
Himmelreich argued that Dr. Muscari failed his patients by not following the rules that govern his profession.
Taped testimony from state witness Dr. James Allen, a board certified prosthodontist, and Dr. Christina Honey, a general dentist, doomed Dr. Muscari's argument of innocence.
The two expert witnesses reviewed the care of patients like Kathleen Evans who complained that her implants didn't work.
They reviewed the charts of Francis Payne who said her upper crown bridge failed in a matter of weeks.
When it came to Polly Booth's story of badly-botched dental work, the experts read Dr. Muscari's charts and other pertinent information.
Based on their extensive reviews, Dr. Allen and Dr. Honey said that Dr. Muscari deviated from standards of care violated standards of professional conduct, and fell below the standards of care for diagnosis and treatment planning of his patients.
In his order, Judge Lafevor wrote that Dr. Muscari was "not a credible witness" during his hearing, that "he was evasive on cross examination," and "gave misleading or false information to patients about a number of matters."
Also, Judge Lafevor said Dr. Muscari's assertions that my own testimony would reveal "improper influence" with the dentist's patients was overzealous and wrong.
The judge says contrary to Dr. Muscari's contentions:
He was at times practicing while impaired by alcohol.
He engaged in a pattern of continued or repeated malpractice, ignorance, negligence or incompetence.
He engaged in unprofessional conduct by abandoning his patients.
He failed to complete work within a reasonable amount of time.
Infection control and sterilization procedures were not followed.
He maintained inadequate patient records that he made false entries into patient records.
He failed to provide records to patients and to the state.
He failed to ensure full disclosure regarding Care Credit, a company that loans money for dental and medical expenses. Patients were misled and Dr. Muscari didn't remove charges when promised.
This isn't the first time Dr. Muscari has been in trouble with the state dental board.
In May 2004, his license was suspended as a result of complaints. But six months later, the dental board lifted the suspension and placed him on probation.
In this new order, Judge Lafevor writes that "probation and rehabilitation have failed." He concludes the protection of public health, safety and welfare requires that Dr. Muscari's license be revoked this time.
Dr. Muscari's attorney said he's "never seen a punishment this harsh," and he has "not yet received instructions" from his client on whether to appeal.
If Dr. Muscari does appeal, the dental board may hear the matter at its next scheduled meeting at the end of January.