ARIZONA DENTAL BOARD COMPLAINT FORM
COMPLAINANT/REPORTER DATE: _________________
Your Name: Hempfling___________Suesie_________________K________________________
Last First M.I.
Address: _ ____________
Street Address Apartment/Unit #
City State ZIP Code ______________________________
Home Telephone: (480) __982-3739___Work Telephone: () __N/A__ Best Time to Call: __AM__
SUBJECT OF COMPLAINT/REPORT DENTIST INFORMATION
Dentist’s Names: _ ELWYNN C CAFFALL and JOHN A. BIGLER _______
Last First M.I
Practice Address: ___ 110 South Idaho Road Suite 260__________________________________
Street Address Apartment/Unit #
_____ Apache Junction, AZ 85219_____________________________________
City State ZIP Code
Work Telephone: (480 ) _ 982-0782___________
PATIENT INFORMATION (Complete this section if Patient is not the same as Complainant/Reporter)
Name of Patient: ______________________________________________________________________________________________________
Last First M.I.
Street Address Apartment/Unit #
City State ZIP Code
Home Telephone:( ) _____________ Work Telephone ( ) ____________
YOUR RELATIONSHIP TO PATIENT
Self Parent Son/Daughter Spouse Brother/Sister Friend
*** Legal Guardian/provide court documents Other
NATURE OF COMPLAINT/REPORT (Please check all that apply).
Crown and Bridge Root Canal Periodontal treatment Inappropriate prescribing of
medication Substance Abuse Mis-diagnosis of a condition Inappropriate Physical contact
with a patient Insurance Fraud Failure to Release records Patient Abandonment
Fillings Unnecessary Treatment Orthodontics Oral Surgery Implants
Dentures Problem other than listed above___See attachment Complaint____
Have you attempted to contact the practitioner concerning your complaint?
Yes Date: No
Would you be willing to testify if this matter goes to a formal hearing?
If the incident involved criminal conduct, you should contact your local law enforcement authority. Have you contacted your local law enforcement authority?
If yes, state the name of the person or office that you contacted._______________________ When did you
make this contact? _______________ Please give case number if available.___________________________
***NOTE: If other than patient or parent of a minor patient, please provide documentation indicating appointment
YOU MUST LIST ANY PRIOR AND/OR SUBSEQUENT TREATING DENTISTS RELATIVE TO YOUR COMPLAINT.
Full Name: Address: Telephone Number:
James Bourne (current) 1804 South Signal Butte Road Suite 111 Mesa, AZ 85209 (prior) 110 South Idaho Road Suite 260 Apache Junction, AZ 85219
Prior treating Subsequent treating
Full Name: Address: Telephone Number:
Trevor Caffall 110 South Idaho Road Suite 260 Apache Junction, AZ 85219
Prior treating Subsequent treating
Please give full details of your complaint/report: include facts, details, dates, locations, etc. Please attach copies of medical records, correspondence, contracts, amount paid for disputed treatment and any other documents that will help support your complaint. (Attach additional sheets if necessary).
I have attached copies of dental records as the copy provided to me by the dentists, correspondence, contracts, and any other documents that will help support my complaint.
After entering into a duty relationship with complainant1, ELWYNN C CAFFALL and JOHN A. BIGLER (reference Canyon Vista Dental Care LLC, Arizona Corporation Commission File Number: L-1198705-6, and its owners, hereafter known as ELWYNN C CAFFALL and JOHN A. BIGLER, et.al.) did breach that duty2, directly resulting in harm and damage to the complainant 3, by acting in a manner that placed Dr. James Bourne in severe distress. But for gross negligence by ELWYNN C CAFFALL and JOHN A. BIGLER et. al. , the harm and injury might have been prevented.4
ELWYNN C CAFFALL and JOHN A. BIGLER et. al. did manipulate and distress the mental condition of Dr. James Bourne in the time leading up to, and the day of, the complainant’s scheduled, multiple teeth extraction session. Business was down and costs needed to be cut. The son of the practice’s owner had graduated and became a licensed Dentist5 during the time leading up to the complainant’s schedule procedure and after. Shortly after, Dr. James Bourne, a full time dentist and his assistant were no longer employed6, Trevor Caffall, son of the practice owner7, took Bourne’s place part time, right after Bourne’s wife had given birth.
ELWYNN C CAFFALL and JOHN A. BIGLER et. al. did supervise, control and compensate Dr. James Bourne, in the manner and forceful means he employed in administering local anesthesia through a reckless disregard for the welfare of the complainant, which immediately resulted in bi-lateral physical damage8 to the trigeminal nerve, from both sides of the center of the upper lip, extending to the physical limit of Dr. Bourne’s needle injections, and radiating upward to each main nerve9. A cat scan shows no possible spontaneous cause. Dr. Bourne himself was asked to treat the pain resulting from that injury10. The complainant’s Neurologist refuses to provide a prognosis as the pain continues, albeit diluted through heavy doses of Gabapentin, with horrible side-effects due to that drug11.
The pressure Bourne was held under by ELWYNN C CAFFALL and JOHN A. BIGLER et. al., resulted in;
§ Dr. James Bourne’s infliction of physical harm to the complainant12 by quickly, without regard for patient safety, plunging needle after furious needle, deep into the upper jaw, pushing deeply, then injecting without regard for quantity, whether bone was struck, if a spur developed at the needle tip, or possible intraneural injection, depth or safety with excessive pressure and no control over delivery13. Each needle attack was a fast and deep thrust into the tissue, then heavy squirt of anesthesia, making the complainant recoil in pain.
§ Dr. James Bourne’s dismissal of the presenting symptoms of pain and slow healing, as temporary, minor, or otherwise not worthy of treatment. An improper diagnosis and failure of patient care.14
§ Dr. Trevor Caffall’s treatment for a disease and condition the patient did not have. Issuing prescriptions, at his father’s suggestion (a managing member), for an anti-biotic that could have had dire consequences to the patient with colon damage as a prime side-effect, after the patient’s record specifically informed the practice of the complainant’s colorectal cancer patient history.17
§ Dr. Trevor Caffall’s misdiagnosis of the condition was the result of the admitted consultation of Dr. Wynn Caffall and Dr. John Bigler18.
§ Dr. Trevor Caffall’s reopening the patient record to insert back-dated statements, admittedly a day after the practice received certified notification to provide the record to the complainant.
§ The complainant suffered severe physical damage19 from improper and unethical use of needle injections, which has dramatic potential to be a life-long debilitating injury, leaving the complainant without upper teeth, and in constant throbbing pain, controlled only by high doses of Gabapentin.
Such injury to the patient could not have occurred unless there was negligence by the doctor’s having control over the patient and gross negligence through the actions of WPF HOLDINGS et. al. to place Dr. James Bourne in an emotional fear for his job.
ELWYNN C CAFFALL and JOHN A. BIGLER et. al. willfully, and intentionally caused supervised personnel, operating under its supervision to perform a scheduled procedure in an act resulting in physical injury to the complainant, by placing the Dentist under severe mental duress for his job, starting when Trevor Caffall graduated20 Dental college, escalated when Trevor Caffall received his license and ended when neither Bourne, nor his assistant were employed by the practice21; which was a conduct that constituted a danger to the health, welfare and safety of the patient.
Through the reprehensible method in which ELWYNN C CAFFALL and JOHN A. BIGLER et. al. lead up to the severance of Dr. James Bourne from employment, ELWYNN C CAFFALL and JOHN A. BIGLER et. al. placed Bourne in a mental condition that rendered him physically unable to safely engage in the activities of a competent, trained dentist. ELWYNN C CAFFALL and JOHN A. BIGLER et. al. placed Bourne in a severe mental state of distress immediately prior to the scheduled extraction session of June 8, 2009.
ELWYNN C CAFFALL and JOHN A. BIGLER et. al. did not show even the slightest amount of care in their reckless and willful disregard for the safety of Dr. Bourne’s patients.
ELWYNN C CAFFALL and JOHN A. BIGLER’s et. al. breach of their duty to the patient resulted in harm and possibly lifelong damage. ELWYNN C CAFFALL and JOHN A. BIGLER et. al. dental records, as provided to the complainant, in compliance with law, show a willful disregard for the injury and the needs of the patient.
But for the calculated pressure placed upon Dr. Bourne by ELWYNN C CAFFALL and JOHN A. BIGLER et. al., Dr. Bourne’s two year employment seniority, and joyful moment of the birth of his new child would have prevailed and Bourne would not have employed needles with carelessness, in fearful speed to impress his employer, without control over depth and angle of penetration, and there would be no such injury today.
It is not, in anyway, the behavior of a competent professional with specialized training, experience and reasonable prudence to inject anesthesia in a reckless and grossly negligent manner, physically damaging the Trigeminal nerve on both sides of the face, behind the upper lip. A similar circumstance would have to include the pressure applied upon Dr. Bourne by ELWYNN C CAFFALL and JOHN A. BIGLER et. al.. The standard of care, and the professional duty of Dr. Bourne was directly affected by ELWYNN C CAFFALL and JOHN A. BIGLER et. al., resulting in serious and potentially lifelong injury, and ELWYNN C CAFFALL and JOHN A. BIGLER et. al. was well aware of the consequences of their actions.
ELWYNN C CAFFALL and JOHN A. BIGLER et. al. further, failed to provide the entire dental record, upon certified mail request. A photograph of the patient was taken following the insertion of her temporary appliance, same day of the extractions, a procedure schedule for one hour that took less than 30 minutes to complete, including the installation of the flipper retainer. It was not merely provided to the patient. A note, requested by ELWYNN C CAFFALL and JOHN A. BIGLER’s et. al. office manager, Brenda, detailed the patient’s complaints about Dr. Bourne. It was presented to Dr. Trevor Caffall, as requested22. A copy of that handwritten note was not provided to the patient. It is most logical that the note is in Dr. Bourne’s personnel file, or destroyed.
ELWYNN C CAFFALL and JOHN A. BIGLER et. al. supervised Dr. Trevor Caffall while he opened the dental record23, after receipt of the 15 day notice, on the day after it was received by the practice, and proceeded to enter additional, post dated updates. First entry is Trevor Caffall’s first involvement on 6/29/09. Trevor Caffall then proceeded to enter into the record, information that would have been impossible for him to know24. The entry for 6/8/09 claims the partial was not inserted due to swelling and that the ‘fit was never checked’. Nothing could be further from the truth25. It was installed so tightly that the complainant screamed and cried in removing it, and Dr. Trevor Caffall could never have known one way or the other. He was not employed at that practice on that date, he was not even licensed on that date, yet he entered it into the record, post dated. Such entries were not only ‘doctoring’ the record, they are falsifying the record by a person unable to have known the fact, for a calculated nefarious purpose26.
ELWYNN C CAFFALL and JOHN A. BIGLER et. al. are responsible for the standard of care afforded to patients. The emotional condition Dr. James Bourne was in, by the willful actions of ELWYNN C CAFFALL and JOHN A. BIGLER et. al., cannot represent the level of skill, expertise, and care possessed and practiced by dentists found in the same or similar community as the relevant one.
ELWYNN C CAFFALL and JOHN A. BIGLER et. al. were not only the employer, or purchaser of contract services of Dr. James Bourne, and vicariously liable for the injury he caused, but are directly responsible for such injury. Dr. Bourne was advised of pain resulting from his attack on the patient, on 6/8/09. Should ELWYNN C CAFFALL and JOHN A. BIGLER et. al. not have filed, a Reports of Adverse Occurrences, they are in violation of rule R4-11-130427.
Dr. Trevor Caffall, after consulting with Dr. Wynn Caffall, after not treating the injury, after diagnosing it as a nasal cavity problem, suggested the complainant see a Prosthodontist and recommended one such office which in the record is listed as costing a different amount for the same evaluation. “$91 dollars if it went medical and $71 if it is dental related.28” Such variance in fee is evaluation motive, dependent. Complainant was evaluated by a lawyer-suggested Prosthodontist, who suggested a Neurologist take the case. At no time was complainant under the care of that Prosthodontist. The fee was drastically higher than the arbitrary assignment of responsibility invoked by a fee variance for specific results. The variable ‘medical’ versus the variable ‘dental’ can only be indicative of protecting the offending license holder, as anything at all in the mouth is ‘dental’.
ELWYNN C CAFFALL and JOHN A. BIGLER’s et. al. continuous imposition of a stressful emotional environment for Dr. James Bourne, under the supervision of ELWYNN C CAFFALL and JOHN A. BIGLER et. al., engaged in conduct and practice that without regard for the safety of the patient, constituted a danger to the health, welfare or safety of the patient; the act of Dr. Trevor Caffall in adding post dated information to the official record, including a fraudulent statement, in connection with the practice of dentistry, falsifying the record, without personal gain for it (he was not employed at that time29) could only have been done to protect the ELWYNN C CAFFALL and JOHN A. BIGLER et. al. and results in unprofessional conduct by ELWYNN C CAFFALL and JOHN A. BIGLER et. al. which constitutes malpractice.
Disciplinary action must be taken against ELWYNN C CAFFALL and JOHN A. BIGLER et. al. for unethical conduct, and for engaging in conduct and practice that constituted a danger to the health, welfare or safety of the patient. The complainant is entitled to restitution of all fees; the imposition of an administrative penalty against ELWYNN C CAFFALL and JOHN A. BIGLER et. al. for each incident to the fullest extent of law; revocation of ELWYNN C CAFFALL and JOHN A. BIGLER et. al. ‘s professional license to practice; the posting of a notice of revocation of license at all places of business of ELWYNN C CAFFALL and JOHN A. BIGLER et. al.; a thorough and complete investigation of ELWYNN C CAFFALL and JOHN A. BIGLER’s et. al. criminal responsibility in the potentially life-long injury perpetrated upon the complainant.
The injury sustained, and the manner, in which it was perpetrated, at the direction of ELWYNN C CAFFALL and JOHN A. BIGLER et. al., is a very serious medical health condition. In a study of Complications due to Orthodontic Treatment30; the seventh most common area of alleged negligence was anesthesia complications and this category tied with extractions for the most fatalities.
Putting a health care professional in the mental condition Dr. James Bourne was placed in, with full knowledge that such pressure would result in unprofessional conduct resulting in injuries done to the person of another, and doing so by for a calculated reason to make room for the practice owner’s son, without regard for the consequences to patient welfare. ELWYNN C CAFFALL and JOHN A. BIGLER et. al., owners of the LLC acting as the health care provider, failed to exercise the degree of care, skill and learning expected of a reasonable, prudent health care provider of the same class.
Such collective unprofessional conduct was the proximate cause of the injury.
When, ELWYNN C CAFFALL, in both his personal and official capacity, or a person acting on behalf of him, at his direction, or JOHN A. BIGLER, in both his personal and official capacity, or a person acting on behalf of him, caused Canyon Vista Dental Care LLC’s employees (ELWYNN C CAFFALL and JOHN A. BIGLER et. al.) to comply with the law (See 35 below) by responding to the properly structured demand for an accurate copy of the official dental record within the required 15 days, they did knowingly, by complying within the time limit of the law, attest that the documents transmitted to the complainant were in fact genuine copies of the actual dental record(See 35 below). Transmitting documents purported to be a ‘copy of the dental record’ is the law. The 15 days is only its time limit.
If the latter is ever claimed to not be the truth, through the submission of a ‘dental record’ or parts thereof, that do not, in every detail, perfectly match the documents transmitted to the complainant in compliance with law:
§ then ELWYNN C CAFFALL and JOHN A. BIGLER et. al. would be responsible for failing to comply with the law in not responding within the required 15 days, Failure to Release records31, (in addition to not having provided the items previously mentioned) and
§ would be responsible for not providing a true and accurate copy of the entire official dental record32 as a ‘copy’ that is not a true and accurate one, is not a copy.
§ any document that is not identical to that supplied by ELWYNN C CAFFALL and JOHN A. BIGLER et. al. to the complainant (which has already been submitted as evidence through the Bourne and Trevor Caffall complaints as well as this complaint) would be admission of submitting false and fraudulent documents in response to a legal requirement, which should immediately and summarily find judgment in complainant’s favor and criminal prosecution to the fullest extent of the law, for each infraction. Only a genuine, conscious decision could have caused the ‘dental record’ sent to the complainant to have happened, as office manager Brenda wrote upon the face of one of the pages33, and Dr. Trevor Caffall confirmed34 genuine intent to comply with the law35.
§ ELWYNN C CAFFALL and JOHN A. BIGLER et. al. must be barred from entering into evidence any document purported to be the ‘dental record’ that does not comport to the documents they previously and legally attested to having declared to have been in compliance with law36, unless they openly admit the transmission of fraudulent documents, in violation of the law, which should immediately and summarily find judgment in complainant’s favor and criminal prosecution to the fullest extent of the law.
§ Submission within the time limit is attestation of compliance with the entire law, not just the time limit to comply with the law. ELWYNN C CAFFALL and JOHN A. BIGLER et. al. must be required to rest upon the document they legally attested to as being genuine (already in evidence in both previously mentioned complaints), through the compliance of the law, within its time limit.
At no time was the complainant negligent. At no time did the complainant cause any of the harm that befell her. The complainant tried desperately to mitigate the damages done to her, but the dentists assigned to her ignored the pain, then misdiagnosed its cause and failed to treat it. The complainant signed an informed consent to knowingly expect the potential of numbness, but under no circumstance did the patient enter into an agreement to be attacked with needles, from an emotionally distraught Dentist needing to prove his worth to keep his job. Trigeminal Neuralgia is sometimes known to have been caused by spontaneous means, but a CAT scan shows no such evidence in the instant case. The complainant did not withhold any medical or dental history from the dentist or ELWYNN C CAFFALL and JOHN A. BIGLER et. al. The complainant did not fail to provide all answers to every question asked by the dentists, even though the copy of the dental record indicates a ‘yes’ when the answer was ‘no’ and the cat scan proves there were no existing nasal cavity problems. There was no presence of mouth disease, or other issue. There was no adverse prognosis for the complainant before the malicious injury, as she had been cancer free for 20 years. The complainant has not been under the care of any dentist following the injury, other than Dr. Trevor Caffall. She is under the care of a Neurologist. The chain of events and evidence is completely intact.
IN ACCORDANCE WITH THE REQUIREMENTS OF ARIZONA REVISED STATUTES (A.R.S. §32-1263.02(b), I HEREBY VERIFY THAT THE FOREGOING STATEMENTS IN THIS STATEMENT ARE TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE AND RECOLLECTION AND DO AFFIRM THAT THE COMPLAINT IS FILED IN GOOD FAITH.
SIGN & DATE: ________________________________________________________
1 Page 4 Records.
2 Page 32 Records.
3 Page 23 Records.
4 Page 34 Records.
5 Page 29 Records, Trevor Caffall licensed on 6/16/09 Number D 7794
6 Page 33 Records.
7 Page 27 Records, Elwynn C. Caffall Number D 2561
8 Page 23, Records, follow up pain and numbness date, 6/9/09 incorrect should be 6/8/09,
9 Page 36, see 8/14/09 entry admitting pain a result of extraction procedure by Dr. Bourne.
10 Page 33 Records.
11 Page 22,23,24 Records.
12 Page 23, Records, follow up pain and numbness date, 6/9/09 incorrect should be 6/8/09,
13 Such complications can arise when the needle either approaches the inferior orbital fissure at the height of the posterior maxilla or when an injection of too much anesthetic solution is delivered under excessive pressure. http://www.jada.info/cgi/content/full/134/7/888
14 Page 33 Records.
15 Page 35, Records, 8/3/09 in responding to the pain informed by complainant, Dr. Trevor Caffall discussed, explained nerve, thought complaint was referred pain, upper area taking too long to heal,
16 Page 36 Records. Entry made out of date order, 8/18/09 entered after 8/19/09 which was after the record was to be sent to the patient as admitted in 8/18/09 entry. Post dated entries to the record violate the sanctity of the record. Posted dated: 6/8/09 claims no insertion and is false. Anesthesia, extractions and fitting and installation of the flipper took place in under 30 minutes. Post dated 7/24/09 entry admits practice was advised of pain from 6/8/09 procedure. Post dated 8/12/09 entry: first indication of prescription of Clyndimycin with adverse side effects to colon. Post dated 8/13/09 entry: indicating failure to diagnose pain and cause of pain.
17 Page 35 Records. Entry 8/3/09 and Page 1.
18 Page 27 Records, Elwynn C. Caffall Number D 2561
19 Page 23,24, Records, follow up pain and numbness date, 6/9/09 incorrect should be 6/8/09,
20 Page 29 Records, Trevor Caffall licensed on 6/16/09 Number D 7794
21 Page 33, Records, 6/8/09 James Bourne extractions session, install flipper, 6/15/10 James Bourne, adjust flipper, bone fragments, 6/6/09 Trevor Caffall licensed (see Page 29, Records) 6/22/09 within 90 minutes of this appointment, licensee advised Dr. Bourne was no longer with them. 6/29/09 Dr. Trevor Caffall employed, reports partial is too painful
22 Page 21, Records, personal statement of complainant regarding Dr. Bourne’s treatment.
23 Page 36 records.
24 Page 29 Records, Trevor Caffall licensed on 6/16/09 Number D 7794
25 Hand written chart notes Record Page 5, 6/8/09 ‘deliver interim partial’ is all that is listed regarding the installation of the partial, Clinical Notes Record Page 32, entry 6/8/09; large entry about residence decision, but no entry about partial other than, ‘to have … final delivery’. The partial was installed in this session. 6/15/09 ‘some adjustments’. Partial was installed on 6/8/09 and removed later that night due to it being installed too tightly, reference 6/15/09 ‘can’t try in flipper due to some lingering swelling’, it was removed on 6/8/09 followed by swelling, NOT as Dr. Trevor Caffall wrote post dated for 6/8/09 that it was not installed due to swelling. 6/15/09 ‘patient had to take the flipper out because it hurt.’ Patient did not install the flipper herself.
26 Audio files included in evidence CD of Trevor Caffall’s phone messages the day the practice received notice of sending the record, and the day before Trevor Caffall corrupted the record.
27 Page 36 8/14/09 entry.
28 Page 36, records, 8/14/09 entry.
29 Page 29 Records, Trevor Caffall licensed on 6/16/09 Number D 7794
30 http://www.experts.com/showArticle.aspx?Articleid=144 MALPRACTICE SURVEY , A Survey Of 242 Dental Negligence Cases With Breakdown As To The Sex Of The Defendant Dentist By: Crystal Baxter DMD,MDS ; Table 5:
31 Trevor Caffall Phone Message 08/19/09 at 11:37AM, on CD in evidence: (See footnote 16, same day as false entry)
“Hello, Lee and Suesie, this is Doctor Trevor, and I’m just callin’ and got your letter um about getting your records I wanted to call and um give you some suggestions on maybe a prosthodondist that you can go look I don’t know if you’ve found anybody else, yet, um, theres a doctor, Doctor Mark Montana, 480-820-3901, um, recommended by my father, um, and ah, as far as finances i know you guys expect money on that partial, its not working for ya, i’d like to reimburse ya for that, um if you have any questions at all we’ll get your records together , ah wished we could do more for ya , exhausted my ability here, and hope you can find some resolution (unintelligible) , questions, 480-773-9500, thank bye”
32 See 31
33 Dental Records page two of the Single Patient Ledger, received with the aforementioned ‘records’
34 See 31 “we’ll get your records together”
35 “The law requires that within 15 days of a patient’s written request, the dentist, dental hygienist, denturist or business entity provide a COPY of the entire patient record. The original records belong to the licensee and a reasonable fee may be charged to the patient for the copies.” http://www.azdentalboard.us/faq.html
36 See 31 “got your letter um about getting your records”