Documentation of dental malpractice, for reference only

 

OCTOBER 2021:  I came to Dr Hart with two pressing concerns: a) No. 30  (crowned in 1976 in NH) was infected & needed a root canal, crown lengthening,  build up & new crown.  No. 4  was already infected after an unsuccessful previous December 2020 treatment (not originally infected) of a prophylactic root canal, post "build up & crown @ the Morongo Basin District Health Center Yucca Valley).  Excluding my  wisdom teeth (extracted in 1981) I had already lost nos. 2, 3, 14, 15, & 19 to failed root canals, & no. 18 was rapidly growing upwards because it had been out of occlusion for 18 years. 

Also, nos. 7 & 10 had missing fillings in the sides, & because of a prior occlusal over-adjustment (NH 1995) those teeth were thin & barely able to hold fillings. (8 & 9 were chipped at the bottom, unsightly, but not in danger of infection I was worried about infection, Dr Hart didn't address that because it was a MediCal issue that wouldn't be profitable for him. 

(Records & X-Rays of my teeth, prior to 10/2022 are extant at both Dr Baek's office in Joshua Tree*, and MBHCD in Yucca Valley*)

Dr Hart promised me the world & told me that Medicare pays for senior implants.  He elaborated that each tooth extraction results in a fractured jaw,  Medicare hates jagged edges & pays for bone graphs & reconstructive jaw surgery. It pays him so much for the surgery that he can absorb the cost of the implants, posts & restoration. 

Frankly Mr Wright, I had lost enough teeth & was suicidal at the thought of losing more (nos 4 & 30 & being a part of that segment of the population wearing dentures. (Partial dentures I tried the previous year were unacceptable). Hart advised me not to bother with any more root canals, crown lengthening & such, as root canals have a much higher failure rate than dentistry owns up too (I agree) & if any implant fails, Medicare pays to remove it, then replace it. Medicare's rules are very strict & rigid. Only one quadrant done every 90 days, the dentist must have a $200,000 360° Catscan machine etc, but he promised me a full set of teeth in about 6 months. 

Please note: Hart confirmed nos 30 & 4 were actively infected (according to the radiology report) but refused me antibiotics, saying he didn't believe in them! I had to get antibiotics from my PCP right up until surgery -- at which Hart only prescribed a Z-Pac suitable for tonsillitis, but unsuitable for teeth. 

Dr Hart's reputation is horrible, & everyone advised me to stay away. Calls to (800) MEDICARE only resulted in denials of implant coverage, with no alternative recommended. I had to turn over both my Medicare & Medical cards to send to a third party overseeing this, though they wouldn't tell me who that third party was, so I couldn't get an alternative "Medicare Implant" dentist. 

November 2021 made one last consultation with Hart, hoping he'd show me before & after success photos to put me at ease. He blew up & told me, "You've already consulted me enough, either you trust me or you don't! Make an appointment soon & commit yourself while you can!" 

On December 20, 2021: Harry Hart pulled # 4, & instead of sending me home with antibiotics & letting it heal, he just started packing bone material & an implant into what seems like infected tissue (though he claims to remove it surgically) & he also did the same to #3-- with the intent of empty # 2 space being a "cantilever". Again, the ZPac I got had to be augmented by other antibiotics prescribed by my NP.  He also performed a "sinus lift" that he concerned wasn't necessary, & I suspect that caused the post operative pain. 

January 17, 2022 Dr Hart pulled # 30 (while infected)  & immediately packed in cadaver bone & added an implant. The pain from that particular surgery gradually subsided, but the pain from the previous months surgery persisted.

Winter 2022 I refused interim partial dentures (according to Medicare rules to temporarily fill in the gap) & Hart told me I must have them because he'd be out $1200. I told him to lie & say he made them to get the money. He actually did, & the office manager put down delivered when they were never made.

 I began to complain about the upper right quadrant pain (nos 3 & 4) & Dr Hart insisted NO pain, nothing wrong, as the x-rays showed. In his eyes I was crying "wolf", but ultimately the Catscan proved #4 was a failed implant. I wasn't crying wolf. 

Spring 2022: Concurrently, something had to be done about nos. 7 & 10, for which I saw Dr Baek as my DentiCal dentist. Baek told me that he could fill 7 & 10, but crowns on 7, 8, 9 & 10 would be better. (The unsightly chips at the bottom of structurally & functionally sound nos. 8 & 9 bothered dentists more than I). He submitted a TAR to DentiCal which was denied, but immediately approved upon appeal. However, then upon closer inspection, Dr Baek informed me that in order to crown those four teeth, I'd wind up buck toothed. Unacceptable. 

(To digress & be even handed, I'm 1995 a NH dentist filed down way too much molar & premolar enamel trying to even the bite -- with me misdirecting him a bit. The result was a marked lowering of the bite, putting the weight of the bite towards the front where my lower teeth are crooked. Big miscalculation on my part not to factor in the thickness of the crown to the tooth material in making the front-heavy bite worse. I wish I veneered them at my expensnse. 

March 29, 2022 because Hart said he could do the crowns that won't leave me buck toothed, DentiCal issued a new authorization #  22087160301 (now expired, never billed) to Dr Hart to provide me with 4 porcelain veneered metal crowns 7, 8, 9 & 10 for $330 a piece. He said it would be his last DentiCal project because they don't pay, Medicare does. 

April 25, 2022 Hart recklessly filed down all those teeth to stubbs. See photo, & see how inexcusable filing down 7 & 10 was. Yes, he inherited potential occlusal issues, but no excuse knowing those stubbs can't hold crowns. They couldn't! They kept falling off, & were the texture & thickness of temporary crowns -- not metal porcelain. Flimsy. Several attempts even at bonding two together, & ultimately all 4. They felt unnatural & downright painful (vertical & horizontal pressure) & I'm glad they fell off. Dr Hart doesn't use wax impressions, he uses an inferior digital system that's geared towards making crowns out of cheap denture material that only looks good cosmetically. 

NOTE! Those teeth in the enclosed photo have been bare & exposed from April 25, 2022 to present! A miracle none are infected now. 

I went on a futile safari hunt to many DentiCal dentists, seeing about crown lengthening (elaborate disfiguring surgery, not covered by DentiCal, that only could yield about 2mm in an average adult mouth, my child size mouth maybe 1.5mm). Other mainstream "solutions" to do a root canal, post &  build up to hold crowns without fusing them together. Ironically, before 04/25/22 I had enough tooth structure to start out with. Also, root canals fail as Hart pointed out. I know I've had 6 root canals & 2 apicoectomies that failed imidiately , & I won't have another root canal. 

06/06/22 failed implant # 4 was extracted & repacked with cadaver bone, but we had to wait three months later to put in the implant. 

(Implants #14 & 19 went smoothly & I'm uncertain about the dates, but no snags). 

Summer 2022: I was distraught about the front teeth. Dr Hart assured me there'd be a solution. I mused & inquired about pulling one lower front tooth, & straightening the rest with braces, this opening up the front bite. He said he would consider that as he makes so much money off me he can "give away free stuff". Later I came up with the idea of  "opening up the bite" by crowning nos. 5, 12 & 13. I reminded him that my former Federal Funded Morongo Basin District Health Care Dental Clinic charges only $140 per crown for low income people (I'm on minimal SSI & they had already crowned #4). He said that's a steal & he'd pay for them to get me 'off his ass'. 

MBHD dentist Dr Miller refused me & told me I must see a prosthedontosts. He asserted there are "free" prosthedontsl benefits at teaching universities such as Western, UCLA, USC & Loma Linda, & if I'm turned down I'm "not talking to the right person". This triggered yet another wild goose chase, beating up my car driving hundreds & hundreds of miles in search for non existent prosthodontosts, starting with DentiCal providers -- all of whom demand tens of thousands of out of pocket dollars not covered by DentiCal. 

Those above mentioned  institutions offer free cleanings & fillings by students only. Only USC & Lima Linda have a prosthodontic department. Initial out of pocket evaluation is $400 at LLUMC & $20,000-40,000 in out of pocket costs. $500 evaluation & $30,000-50,000 at USC. 

October 10, 2022 Hart reopened number 4 by performing a "flap", cutting the Hell out of the buccal side of the gum. He then closed it up with the skimpiest gauge of suture ever. Two weeks later I came in to get the stitches out, only to find them busted wide open with a full blown infection. He prescribed another Z-Pac, & in lieu of bothering my PCP, for a better prescription, I dropped by a the ER next door to my EMC Palm Springs orthopedist on 12/03/22.  Please read the visit notes enclosed, & take note of the words "patient is unhappy with his Yucca Valley surgeon and doesn't want to go back to him" 

At that time I noticed that the "flap" totally disfigured the formerly smooth buccal gum wall. It was terraced & hurt, & I'm still feeling an inflamed sensation there. 

With the help of my PCP, we tried to find an oral surgeon to help. None in the lower desert taking Medi-medi. I couldn't even get a LLUH oral surgeon appointment. On November 17, 2022 I went to the LLUH free dental clinic to get help with the upper quadrant pain, & the nakedly over prepped front teeth with its occlusal issues. They told me that post-operative implant pain is often par for the course &.they informally grabbed an oral surgeon who shrugged his shoulders & said the implants outwardly appear "clinically acceptable" he did note the "indenture" caused by the flap & acknowledged it could cause pain. The dental teacher recommended dentures, & I replied that I'd kill myself first. I also got an appointment & referral to LLUH Prosthodontics that I had to cancel because it was totally unaffordable. 

Late January to March my PCP,  tried to get my dental records that (predictably) Harr Family Dental stonewalled. (And it turns out their imagery is unreadable at other institutions such as LLUH). She ordered MRIs of my mouth that disproved my claim of relentless infection. (It sure feels like it!)

04/03/23 I finally got an LLUH Oral surgery appointment. They deemed the implants "clinically acceptable" & theorized that my pain is due to the post being a food trap. They recommended to clean it & finish the restoration phase. Later, a TJM expert, Dr Shafik, echoed that proposal. I reject it because # 14 post was also unrestored & dirty, but  no pain there on 14. 

Spring 2023: Harr tells me that we must finish the restorative phase because Medicare will not let us sit on our hands indefinitely & he wants to get paid. I reminded him he told me he "absorbs" the restoration cost, & he emphasized that he gets paid for that too. (Probably not enough money for his liking, the surgery is where he makes his big bucks). I asked "what about the lower braces to fix the front bite? " He replied " he doesn't do orthodontics any more & that I don't have time. 

His idea was to "open up the bite" by  doing bridge work that fuses two sets of 4 crowns: 5 to 8; 9-12. Attempting to start on the right side, he arbitrarily piled on composite material to the left front teeth to raise the bite A FIXED LEVEL (presumably). When I came in to have the bridge affixed, they didn't fit, & he started carelessly filing down the #5 portion of the bridge & # 5 tooth, & it was too much. Why? Because the composite material level has significantly wore down to a lower level, & Hart didn't catch that. (Mr Wright, have you ever know of a crown & tooth being filled & shaped the moment they're cemented on?) Those crowns were unusable that day, & yet another digital measurement was done that day for new crowns -- but the lower level defeated the purpose of doing that. Far less opening up on the bite because #5 would be too low  to take the pressure off the front bite.(& that later turned out being the case, but Hart wouldn't listen). I rejected those crowns just because of the length, & I was bucktoothed & looked like Bugs Bunny Totally unacceptable. (I still have those tucked away. They're a thin, brittle  joke!) 

I met with Mason, Hart's grandson & in-house lab crown maker. I pointed out the upper teeth can be smaller, can curve away but still curve back, & I described the vertical & horizontal pain &  pressure all his bridges caused me. He guaranteed me to keep trying until he gets it right, as his digital system is evolving. I informed him that it might all be moot, as SB County Land Use Code Enforcement cited my landlady for letting me live in my trailer in her private property. Living only  on $1150 SS & $106 EBT, I had no viably quiet places to go. 

(June 1, 2023, the date of my eviction deadline, I was carried out of my trailer unconscious, with a systolic blood pressure of under 40 from a suicide overdose. Unfortunately I survived, & after the 5150 I had to sleep in my car, & developed severe leg & foot edema, that's caused me injury. I also set a deadline of Labor day to find a quiet place & got lucky 08/10/23.)

From the Canyon Ridge, the  5150 facility, I called complaining about #5 feeling infected. It was over prepped & bare, & every cool breath hurt. Hart called in a Z-Pac, my PCP called in Augmentin, & even the facility NP agreed a Z-Pac is inappropriate for tooth infections 

When I got out of the 5150, Hart's office manager booked another in-office Catscan after my numerous complaints of 5 feeling infected. 

July 2023 I came in for my appointment, & the "case" (right front 4 crown bridge bridge) was wrapped, & sitting & in sight on the stainless steel tray. Dr Hart walked in & shouted at me, "Number 5 is infected! Go! Go somewhere else & get a root canal! GO!" (Now I believe he was being sarcastic with full knowledge #5 wasn't infected, but later absentmindedly forgot the sarcasm. Hart discarded the 4 crown bridge case after I left). 

July 21, 2023 I consulted with Dr Baek at Joshua Tree, who adamantly insisted no. 5 was not infected. It was over prepped, too much lost enamel, but just needed to be covered & my pain would subside. (That turned out to be the case.) Baek erroneously observed # 30 was a failed implant (the healing cap was just unscrewing). I called Dr Hart on the his cell phone to tell him Baek's news & he told me not to bother him on his day off, & that Medicare regulations go by the radiology report, & the radiology report says # 5 is infected. (The radiology report did not! Say that, & he absentmindedly was believing his own former sarcasm.)

Here's another example of how I was "crying wolf" in Hart's eyes, but really it was his fault for over prepping #5 & failing to provide any temporary or permanent  crown that could stay on & cover it. His slovenly negligence! The discarded bridge case had to be duplicated from the digital impression. After then Mason (who's honorable with integrity) left me at the mercy of Dr Hart & a slovenly lab guy, Dave. Everything is done in house with denture material to save money -- as Hart asserted many times, the real money's in the surgery. . 

August 16, 2023 the right side bridge was put on, & Mason came through for me. It was good except that it had a small denture like support ridge in the lingual side (a compromise) & that #5 was too low & I knew the opposite side & everything else would be high. He wouldn't listen, he read me the riot act. No more consulting with other dentists & oral surgeons, no more rejecting his work, I'll have to take what he gives me -- just like all the other "grateful" seniors. 

September 27, 2023 # 18 was rasped down for a crown prep that would be bridged to # 19 implant.  At this point  he noticed the composite material was worn low, & just randomly slapped more on the left side, this creating a much higher reference level for the digital impression, & final restoration of the molars which I knew would be too high relative to 5, 6 7 & 9 (particularly 5) & nothing I could do to stop it. 

October 18, 2023, nos 18 & 19 were put on, & before the digital impression for the upper left counterpart ((implant 14 coupled with cantilever 15)  tried to call attention to the recent addition of composite material that would throw everything askew & raise the whole left side higher than the right. He snapped, "don't go there, don't even try, I'm doing this out of the goodness of my heart, all I have to do is finish restoring #14 & my obligation to you is over. No more out of you or you're on your own! "

October 30, 2023: #14 implant restoration w/# 15 cantilever were put on. # 14 was a little too high (hitting against 19) # 15 was huge hitting against 18. He did begin to adjust it, but not nearly enough. In reactions to my pleas to rasp it down further he blew up, "you're not getting perfection here. The other teeth are hitting so THATS IT! " (15 caused me such discomfort I rasped it down myself with a nail file & did a good job.  #14 is still a little high, but because of its shape it can't be approached & fixed at home with a nail file. I also had to rasp the sides of the left molars.  because I was always  bitting my cheek & getting kanja sores. 

(Note: I had planned all along to finish with Hart, & then to  find a "DTR" trained dentist with a  Tekscan digital T-scan device, that would digital analyze & facilitate accurate occlusion adjustments.)

November 6, 2023 Hart prepped nos, 9, 10,11 & 12 for the digital scan to make the bridge, as well as scanning mos 3 & 4 for restoration (which would , & recklessly &  grossly over prepped number 12 (even more than 5, 7 & 9). I know because the temporary crowns fell off in 2 days, & the gap between 12 & 21 was huge, more than enough room to stick a crown on. 

November 30, 2023 I waiting for two hours, then finally got the radiologist news that #30 had t failed, that it was just a loose healing cap. Dr Hart hastily put on the implant crowns to #4, #3 w/ a cantilever for #2 without cleaning the posts that Dr Shafik said are food traps Predictably # 2 & #3 were way too high, & he openly berated his new lab guy, Dave, for making it so big. He put it on, started adjusting it, but then stopped when it was hitting way too high - that can be filed down by me or another dentist, but: the number # 4 portion of that implant bridge is totally out of occlusion it's so small -- & that's not fixable.  He ran articulating paper through that area, & the paper barely grazed against the outer cusps, but didn't hit squarely at all.  Then Hart aggressively numbed up the upper quadrant to file the remnants of the temporary crowns. At the blink of an e immediately slapped on the left front quadrant bridge, & I couldn't believe how bad they were. I tried to tell him they were way off, & he warned me, "don't do that to yourself, don't do that to yourself. (A clear threat to terminate services on the spot)

I was hustled out of the room, & given a form to sign agreeing that everything was the right size & shape. The assistant said Dr Hart relayed the message " just try them for a while" (hinting hell fix them if needed)  Big mistake! I signed it, but I did so under the assumption that they could be properly rectified & shaped elsewhere by a DTR dentist with a T-scan machine out of pocket, after which I'd be  done with Dr Hart for good after #30 is completed. The date for the post, digital scan of #30 is January 15, 2024, & it should be all "done" Feb 1st. 

What's wrong? It's indescribable in words: In contrast to the right side that hugs the tooth, is concave, dainty, & hugs the pallette just a bit; the upper left quadrant bridge has denture-like lingual support ledge that's entirely convex, hollow, & extends from  the bottom of the tooth to the pallete. It can't lend itself to occlusal adjustment, as the rasp will cut through the hollow loop. Furthermore it so open it's a food trap, & I suspect the teeth aren't fully covered by the denture material on the lingual side. It's an invitation for rot, & all I feel occlusially is #12 11 19 & 9. 

(I tried to draw pictures & they're in the "Staples" PDF along with Dr Shafik's 08/18/23 letter)

Also what's wrong is that the upper right quadrant work is so wide that I can insert my fingernail between the crown & upper buccal gum line. It IS a food trap there. The size is huge, abrading my tongue, but what's unfixable is #4 is so small that I can slide the tip of my tongue through the lingual cusp of # 4 & rest it on the tip of plunger cusp of # 29 with my mouth closed & teeth clenched. Predictably, the left side is way higher than the right & it can be shown (to some extent) from the outside  by a smiling selfie I'll take later upon request. I also wish I took a selfie showing  # 12 exposed & so needlessly over prepped. The eye teeth (nos. 6 & 11 are the only substantial cornerstones holding those bridges on.   

1) #4 & 29 way out of occlusion

2) #5 & 28 too low, barely in occlusion. 

3) #2/3 & 31 too high

4) # 19/18 hitting 14/15 adequately

5) #9, 10 11 WAY too high

6) #12 absolutely prominent, with the lingual cusp so large it rests against #20 instead of 21. 

(Also a big gap between crown # 19 & natural tooth #20 creating a food trap, & now some pain). 

Mr Wright, I have devoted so much effort into finding an interventional force to circumvent this catastrophy! Maybe 40-50 calls to 800 MEDICARE with denials of implant benefits, & no referrals to a decent Medicare implant provider within driving distance. Thousands of miles going on DentiCal wild goose chases. 

Yesterday, 12/06/23 I saw a dentical provider at Apple Valley's Jess Ranch Dental only to get blown off. 1) They refused to touch another dentist's work.  2) he was shocked & incredulous that the existing denture implant material is a permanent crown, he mused that I'm mistaken & that permanent metal porcelains are right around the corner for me 3) in response to my assertion that root canal/build ups are a bad idea (w/my history of failed root canals) he claimed he never fused any crowns together, he efused to even consider redoing the crowns, saying that he doesn't know if metal porcelain bridges could hold (he's never done anything like that 4) he refused to confirm that #2/3 are so wide they're not sealed & a food trap 5) he left confirmed the denture-like lingual ledge is a food trap, but refused to investigate my concern that the teeth 9 -- 12 aren"t covered in the back by the denture crowns, but maybe a thin layer of composite material used to cement them.  

So the Jess Ranch dentist recused himself with one last insult to add to my injury. He recommended Loma Linda or USC as an alternative, alluding to non-existing "free benefits", & he was incredulous at my findings when I went to Lima Linda : nothing "free"  at LLUH except fillings & cleanings. Crowns are $800 a piece after deducting the 30% discount. Crown lengthenings are $450, but you can't even get an appointment with LLUH periodontics. He didn't believe me, we had a heated argument. 

I HATE that monster so much, & it won't be prudent to elaborate my feelings in detail. Because of Dr Hart's monopoly, he's the only person I fear & loath. A bully I can't ultimately stand up to, &  the only person I can't extricate myself from. Doctors I confront & fire all the time, but Hart has me by the throat.  I have a December 13, appointment with Dr Hart when I plan to confront him & ask for remakes. He will tell me he's not getting paid for the front bridges (he hasn't billed DentiCal ) & he's doing me a favor. I plan on throwing a printed picture of those over prepped teeth & asking "this is a favor?" It looks like things will blow up before # 30 is restored next month. 

I have to point out:

1) that once my bridges are burned with Dr Hart who will fix this mess, & who will do "free Medicare implants" when another natural tooth gets infected. (I'm with Hart about root canals!)

2) if any of my denture material breaks who will fix it? They are not strong & . I've seen other patients come into Hart's office with teeth they claim they broke by biting on a French Fry. The digital impression is stored away & they make new teeth

3) any financial award (& it won't be much) will be deducted from my SSI which is a poverty program designed to keep people like me down. 

I'm 67 & what do I do? If lucky I'll not wake up tomorrow. 

Sincerely 

TC Tomaselli 

On Tue, Dec 5, 2023, 1:06 PM David Wright <david@kjtlawgroup.com> wrote:

--

David M. Wright, Esq.

Senior Trial Counsel

KJT Law Group, LLP

230 N. Maryland Ave. Suite 306

Glendale, CA 91206

P: 818.507.8525

F: 818.507.8588

 

This communication, including attachments, is confidential, may be subject to legal privileges, and is intended for the sole use of the addressee. Any use, duplication, disclosure or dissemination of this communication, other than by the addressee, is prohibited. If you have received this communication in error, please notify the sender immediately and delete or destroy this communication and all copies.