Court records fill in gaps when dentist's patients keep mum

A painful eight-hour dental surgery performed without general anesthesia, crumbling dental work, drooling and bone loss.

The allegations of dental negligence against Dr. Robert Tupac — both in civil lawsuits and an accusation filed against him by the state agency that disciplines dentists — described a host of problems.

As The Bakersfield Californian’s health reporter, I began looking into the allegations in January 2013 after news broke that the Dental Board of California had filed an accusation against Tupac, who had opened a practice in Bakersfield and practiced in the Los Angeles area. I continued working on the story until July 2014, attending hearings in Los Angeles, digging through court records, interviewing attorneys and dental experts, and identifying and attempting to contact plaintiffs in civil lawsuits.

In early 2013, I was accepted to The California Endowment Health Journalism Fellowships — but based on a different project proposal. I quickly switched my fellowship focus to the mounting civil complaints against Tupac and researching how the dental board works. 

While other healing arts boards in the California Department of Consumer Affairs have been scrutinized for their regulation and disciplining of their licensees (such as the Los Angeles Times/ProPublica series on the California Board of Registered Nursing), the media had shed little light on the dental board.

One of the primary challenges in reporting this project was the unwillingness of most people at the heart of the California Dental Board’s complaint to speak about the accusation. Two patients testified at an administrative hearing in downtown Los Angeles. One of those declined to comment after initially agreeing to an interview; the other did not return calls. Tupac agreed to an interview but never responded to an emailed list of questions, though attorneys did email a statement on his behalf.

Despite the roadblocks, I was able to utilize court records in several counties and conducted numerous interviews with dental malpractice attorneys, dental specialists, consumer advocates, state officials and academics.

I found many cases available on microfiche in Los Angeles County court archives, and others still on file in courthouses in Ventura, Los Angeles and Bakersfield. For researching court records, I convinced newsroom editors to let me buy a portable scanner, which was invaluable. The scanner kept copying fees to a minimum and made it easy to review files once I’d downloaded them onto my computer.

There were other obstacles. Some case files in Los Angeles had been destroyed. It was difficult speaking to plaintiffs from the lawsuits; attorneys said patients in dental malpractice cases often sign nondisclosure agreements as part of a settlement. Additionally, understanding cases’ resolutions was difficult because records often indicated a case was settled or dismissed, but gave no information about the final outcome.

Using court records I constructed a timeline of the cases filed against Tupac. I spoke with dental malpractice attorneys, two who have represented patients in cases against Tupac and one who is also a periodontist. I also spoke with the California Dental Association and the California Dental Board about their practices, how patients can make complaints, and what happens to those complaints after they are voiced.

I also attended part of the administrative hearing on the dental board’s accusation against Tupac, where I listened to experts and patients testify and watched an attorney from the state Attorney General’s Office spar with Tupac’s lawyer. 

The challenges I faced show how hard it is for consumers to thoroughly vet a dentist. Unless consumers look up a dentist’s license online, they’d likely never know whether the dentist was disciplined by the dental board. It’s hard for people to know what questions to ask and what to be wary of when in a dentist’s chair. Dental patients also may be unaware of available resources such as peer review in cases where something goes wrong.

It was valuable for The Californian to spend the time, resources and effort to show how a little known state body like the Dental Board works.

Aside from the reporting challenges, timing was tough. The project originally was due in August 2013, but the hearing against Tupac was still in process. We waited to run the final project — six stories and three sidebars published over two days — until the last leg of the hearing started in July 2014.

I also switched jobs in January 2014 to become the assistant editor for The Californian’s Niche Publications department. I was very fortunate my new editor, Olivia Garcia, and old editors, Christine Bedell and Steve Levin, continued working with me, helping me split my time and encouraging me to finish. I also appreciated the support of The Californian’s Executive Editor, Robert Price, who jumped into the project as it wrapped up, and former Executive Editor John Arthur, who provided much-needed guidance as the project progressed. Their support was invaluable in managing and refining the project.

While my project is done, The Californian’s coverage of this story continues. An administrative law judge will issue a proposed decision regarding the Dental Board’s claims before the board makes its final decision. The dental board is also preparing for its quadrennial review before the California Legislature.

Rachel Cook produced the series "Dental Dangers" as a fellow in the 2014 California Health Journalism Fellowship, a program of the University of Southern California’s Annenberg School of Journalism. To read the series, click here.