The Health Laws Violation: Dr. Nicoletti’s Case Essay

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Darlene Nicoletti’s consent order for voluntary surrender of her license and right to practice dentistry in Commonwealth Virginia was signed on December 10, 2014. Her license was suspended earlier that year, on July 18, 2014, with a formal hearing needed to review allegations of violating several laws and regulations governing the practice of dentistry. By signing the consent order, she admitted the truth of the several Findings of Fact as detailed below and agreed to the sanctions imposed on her in response to her violations. The order was signed in lieu of a formal administrative hearing, and by signing it, Dr. Nicoletti waived her rights to one.

Dr. Nicoletti has committed a total of six types of violations of the Code of Virginia 1950. She violated 54.1-2706(15) and 54.1-3404 by failing to maintain inventory of the controlled substances she has ordered for her practice. Dr. Nicoletti has issued the controlled substances to her patients on three documented occasions, despite treatment records of these patients not indicating consultation in relation to any of these substances. Thus, she violated 54.1-2706(4) and (15) and 54.1-3408(A) by issuing fraudulent prescriptions and utilizing the substances for her unauthorized personal use. The restricted substances include Vicoprofen, hydrocodone, and ibuprofen. She is unsafe to practice dentistry in violation of 54.1-2706(3) due to experiencing substance abuse and engaging in unpredictable behaviors caused by her addiction. Dr. Nicoletti admitted to experiencing substance dependency, and her condition requires monitoring.

Furthermore, Dr. Nicoletti violated 54.1-2706(12)(13) and (15), 54.1-3408(A), and 54.1-2709.1 of the Code by providing Botox and Juvederm treatments to patients despite not possessing required certifications. She did not hold oral and maxillofacial surgery qualifications and was not authorized to perform any cosmetic procedures. In falsely advertising her practice as one that legally provides such treatments, Dr. Nicoletti violated 54.1-2706(7) of the Code and 18 VAC 60-20-180(F)(2) of Regulations Governing Dental Practice. Finally, she violated 54.1-2706(4) and (9), 54.1-111(A)(7) of the Code and 18 VAC 60-20-170(4) of Regulations Governing Dental Practice by refusing to provide medical records to the Board’s investigator.

Dr. Nicoletti has admitted having been deceiving her patients by advertising services she had no qualifications to provide for her personal gain. She has formally assigned her patients medication without their knowledge or consent on multiple occasions between years 2006 and 2013. Therefore, it can be concluded that she has violated several ethical principles of The ADA Principles of Ethics and Code of Conduct, namely veracity, patient autonomy, and non-maleficence. Her displaying false advertisements on her website has been a violation of veracity, or truthfulness, and conformity to facts. Her forging patient’s records to include Vicoprofen, hydrocodone and ibuprofen have been a violation of patients’ autonomy. Finally, her providing Botox and Juvederm treatments without necessary training or certification has been a violation of non-maleficence, as it has placed her patients in direct danger.

To prevent future violations of the regulations, Dr. Nicoletti is undergoing mental and physical recovery to deal with the harmful effects of her substance addiction. In particular, she has surrendered her registration with the Drug Enforcement Agency as of February 2014. Furthermore, as Dr. Nicoletti terminates her practice for the time being, she will not have access to patients or restricted substances unless her license is reinstalled.

If Dr. Nicoletti ever wishes to reinstall her license, an administrative proceeding should be held to evaluate such application in accordance with the Administrative Proceedings Act. She would be expected to demonstrate and prove that she is safe and competent to return to practice. By her own accord, and as evident from the case, she has a history of substance abuse. At the moment, she has stated having no intent to continue to practice dentistry, as she is currently focusing on her physical and mental recovery.

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