A Landmark Defense of a Dentist’s License

April 22nd, 2016

Here’s a story that appeared in Massachusetts Lawyers weekly about a case that changed the way the Board of Registration in Dentistry does business.  The main holding was that the Board cannot enforce OSHA regulations.  But we also argued that the Board’s regulations were so vague that dentists could not anticipate what conduct might result in a sanction.  After the Chadwick case, the Board issued new, more specific regulations.  The reported decision is here

SJC: dental license suspension invalid

ROSEN

The Supreme Judicial Court has found that the state Board of Registration in Dentistry did not have the authority to interpret, apply or enforce federal Occupational Safety and Health Administration standards regarding workplace safety.

The plaintiff dentist argued that the suspension of his license was improper because it was based on the board’s determination that he failed to comply with federal standards.

The SJC agreed.

Justice Robert J. Cordy, writing for the unanimous court, said the board’s finding conflicted with the “full purposes and objectives” of OSHA in two ways.

“First, it represents State interpretation, application, and enforcement of OSHA standards, constituting an improper assertion of concurrent jurisdiction,” Cordy stated. “Second, it represents direct and substantial State regulation of occupational safety and health issues for which Federal OSHA standards are in effect.”

The 37-page decision is Chadwick v. Board of Registration in Dentistry, Lawyers Weekly No. 10-175-11. The full text of the ruling can be found by clicking here.

Occupied field

Andover attorney Joel Rosen, who represented the plaintiff dentist, said the ruling will alter how state administrative agencies address occupational health concerns in Massachusetts.

“This is the first case I have seen where a state agency has tried to exert power in an area of exclusive federal jurisdiction,” Rosen said.

Rosen cited U.S. Supreme Court precedent finding that Congress clearly carved out exclusive jurisdiction in the field of occupational health and safety under OSHA.

“In oral arguments, a judge asked me why the state couldn’t just take the OSHA rulebook, erase the word ‘OSHA’ and write ‘Massachusetts,’” Rosen said. “And I said, ‘It’s not who wrote the rules; it’s who occupies the field.’”

He said that giving multiple agencies the authority to enforce OSHA rules would be unfair because different entities could interpret the rules differently, leaving licensed professionals uncertain about which standards to follow. Congress intended to avoid that very problem, which ended up harming his client’s career, Rosen said.

He acknowledged that the Board of Registration had authority to sanction the plaintiffs for certain public health regulations dealing with issues not covered by OSHA, but he disagreed with the board’s interpretation of the evidence presented on those issues.

“Either way, the board had no authority for 80 percent of what it accused him of, so query whether the punishment would have been the same,” Rosen said.

Assistant Attorney General Amy Spector represented the board. She declined to comment on the case.

Braintree attorney Frank J. Riccio, a former dentist, said the SJC drew a line between occupational safety and public safety.

“If patients were affected, then the public safety aspect would come into play and the state would not be preempted from acting,” he said.

Visit to the dentist

On July 10, 1981, the board issued plaintiff Stephen Chadwick a license to practice dentistry.

In November 2003 and April 2004, the board received two complaints from patients under Chadwick’s care. It subsequently dispatched compliance officers to inspect Chadwick’s offices on July 19, 2004, Sept. 27, 2004, and May 11, 2005. The inspections revealed a number of deficiencies beyond the ones alleged in the patient complaints, which were later dismissed by the board.

On May 13, 2005, the board directed Chadwick to show cause why his license should not be revoked or suspended pursuant to G.L.c. 112, §61. Chadwick filed his answer and request for a hearing on June 1, 2005.

In its decision, the board found that Chadwick failed to comply with OSHA standards, Centers for Disease Control and Prevention guidelines and Department of Public Health regulations “with respect to spore testing, annual office training, the proper handling and disposal of medical waste, proper maintenance and disposal of sharps [i.e., sharp items, such as needles, scalers, burs, laboratory knives, and wires], the maintenance of complete and accurate records with respect to hepatitis B inoculations, and basic exposure control protocols.”

The board concluded that his conduct “constitute[d] deceit, malpractice and gross misconduct in the practice of the profession in violation of G.L.c. 112, §61,” and “seriously undermine[d] the integrity of the profession of dentistry and the public’s confidence in the practice of dentistry.”

It suspended Chadwick’s license in Massachusetts for six months and imposed a five-year probationary period to follow the suspension.

OSHA never conducted an investigation or commenced any action against Chadwick.

Congressional intent

“Congress established a regime in which the federal government maintains or a state assumes through a statutorily prescribed process, responsibility for occupational safety and health issues,” Cordy said.

Having not set up a state workplace safety system via the OSHA process, Massachusetts officials retain authority over only those occupational safety and health issues for which no federal OSHA standard is in effect, he added.

“The board’s use of OSHA standards in its disciplinary proceeding falls outside [the state’s] limited powers,” Cordy wrote. “Where Congress intended for a single set of regulations to exist, the board, in effect, created two: the standards OSHA promulgates and the board’s interpretation of those standards.”

Thus, the SJC said the board’s decision regarding the plaintiff’s alleged violations of OSHA regulations “must be preempted as interfering with the methods by which the federal statute was designed to reach its goal.”

But the court’s analysis went one step further “because the act’s preemptive effect extends not only to a state’s interpretation, application, and enforcement of the OSHA standards themselves, but also to any state law that directly, specifically, and substantially regulates an occupational safety and health issue for which a federal OSHA standard is in effect.”

In other words, OSHA’s authority preempts any state rule that covers something OSHA already regulates.

The SJC acknowledged, however, that “the board may mandate compliance with OSHA standards in dental practices and sanction dentists for professional misconduct after OSHA has determined a violation has occurred.”

For more information about the judge mentioned in this story, visit the Judge Center at www.massjudgecenter.com.

CASE:Chadwick v. Board of Registration in Dentistry, Lawyers Weekly No. 10-175-11

COURT: Supreme Judicial Court

ISSUE: Is a state licensing board preempted from interpreting, applying and enforcing OSHA standards when disciplining a professional under its authority?

DECISION: Yes, because Congress clearly indicated its intent to confine state authority to occupational safety and health issues for which no federal OSHA standard exists

posted by: joelrosen in Announcements, For Medical Professionals | No Comments

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