Resources: Articles

Making information on dental complaints accessible in California Date: 09/11/14

By Mary Otto

Reporter Rachel Cook’s “Dental Dangers,” series, published this summer in The Bakersfield Californian, explores a long history of complaints and lawsuits against Robert Tupac, D.D.S., who, as a board-certified prosthodontist, specializes in the restoration and replacement of teeth.

Over three decades, more than a dozen of Tupac’s patients claimed his shoddy work left them with troubles ranging from bone loss to drooling, Cook recounted in her project. Yet her reporting – done as a 2013 California Health Journalism Fellow – uncovered a state dental board system that allowed the alleged problems with the dentist to pile up outside public view. “A potential patient searching for competent dental care would never know about many of Tupac’s alleged professional shortcomings — or those of any other California dentist — without undertaking extensive and often difficult research,” Cook wrote.

In this Q and A, Cook reflects on how this project unfolded, how she addressed the challenges she encountered along the way and the reactions she has received since the stories ran. She also shares some wisdom on the usefulness of bringing a portable scanner to the courthouse.

Q: What got you started on the story?

A: I started working on the story in January 2012 after news broke that the Dental Board of California had filed an accusation against Robert Tupac, who had opened a practice here in Bakersfield. At the time, I had just been accepted to The California Endowment Health Journalism Fellowships, a program run by USC’s Annenberg School for Communication & Journalism. I had proposed a reporting project on children’s dental health but after two days of searching court records and archives in Los Angeles and finding a handful of malpractice civil suits against Tupac dating back as far as the ’80s, my editor and I felt like there was a new important story to tell.

I switched my focus for the fellowship to exploring the mounting civil complaints against Tupac and how the Dental Board works. While there’s been coverage of how other healing arts boards in the California Department of Consumer Affairs regulate and discipline their licensees (i.e. doctors or nurses) not much had been done on dentists.

Q: You faced some formidable barriers in learning more about Tupac’s professional career. You wrote that the Dental Board of California makes it very hard for journalists, and for consumers, to see the complaint files of dentists - “an agency practice that severely limits the state’s patient protection system’s value to consumers.” In addition, you found that former patients were reluctant to talk; some were bound to silence by court settlements. Though his attorney submitted a letter defending him, Tupac wouldn’t talk either. What was most helpful to you in addressing these barriers and ending up with a story you could tell?

A: Court records, attorneys who specialize in dental malpractice cases and dentists mainly not related to this case were the most helpful in telling a story where few close to the matter wanted to talk. I made many trips to our local courthouse, as well as trips to courts in Los Angeles and Ventura counties. I found a portable scanner was key to keeping track of cases and taking records back to work with me without having to pay big copying fees.

The attorneys were also very helpful and willing to talk about the world of dental malpractice — including the risks of going to trial. Two attorneys who had represented patients against Tupac spoke with me. I also made several calls to a San Francisco-based attorney who is also a periodontist. I looked through the minutes and annual reports of the Dental Board and spent a lot of time talking with their flak. There were many emails back and forth with follow-up questions. Sometimes, it was tricky to get clear answers to questions about how the board works and the many steps in investigating consumer complaints. A few former patients were willing to talk to me, including ones who were very happy with Tupac’s treatment.

Beyond this case, the series really looked at what patients can do to protect themselves and what resources are out there for us. The California Dental Association was helpful in explaining how its peer review process works, and other dentists gave tips for what patients should be wary of before committing to expensive, major dental work.

The Bakersfield Californian also invested in sending me, and other reporters, to attend Tupac’s hearing at the Office of Administrative Hearings in Los Angeles. For me, it was helpful to watch how these complaints are heard and to see the evidence the Dental Board had collected.

Q: Do you know how typical the Dental Board of California is in its handling of complaints against dentists? Have you heard about boards in any other states that make it easier for the public to find out if dentists have been placed on probation or whether complaints or suits have been lodged against them?

A: Unfortunately, I don’t know a lot about how other states boards handle complaints. I do know that how boards operate varies state by state. There’s certainly a need for a much larger story comparing how different boards work and what consumers can and can’t find out around the country. One challenge seems to be the lack advocacy for patients.

Q: At the time your project ran in July, you wrote that the Dental Board of California’s case against Tupac was inching toward closure, with a hearing that was scheduled to resume. What has happened since then?

A: An administrative hearing in the case has concluded, but that’s not the end of the complaint. An administrative law judge will offer a proposed decision after receiving closing briefs from the state Attorney General’s Office and Tupac’s attorney, but the Dental Board’s members will ultimately decide what to do.

Q: You interviewed Tina Gomes, a San Fernando Valley woman who said she was motivated by her own bad experiences with a dentist to work for better protections for dental patients and more transparency from the dental board. Since your stories ran, are you hearing from others who are asking for reforms or defending the way the board operates now?

A: I’ve heard from a few people, but not anyone with big intentions to change how the board works. Mostly, I’ve received positive feedback from people here in Bakersfield who read the series.

Q: You worked on this project as a California Health Journalism Fellow. How was the fellowship most useful to you in your reporting?

A: I appreciated direction from my adviser on the project, Patrick Boyle. I also enjoyed meeting with the other fellows in spring 2013 and was inspired by the projects they were working on.

Q: Are you planning any follow-up stories on this topic?

A: In January, I moved to a new position at the newspaper as an assistant editor for our magazines, so I’ve had to pass this project back to the newsroom since the series published in July. The Californian’s current health reporter, Courtenay Edelhart, is keeping track of where this complaint is going. My hope is that we continue to follow this case to its conclusion. I think it’s extremely valuable for us to see how long it takes to complete one of these complaints from start to finish, and to see what the outcome will be.