BY CHRISTINE BEDELL Californian government editor firstname.lastname@example.org
LOS ANGELES -- The two patients at the heart of the state Attorney General's gross negligence case against Bakersfield dentist Robert Tupac have testified to harrowing experiences in the dental chair and with their new teeth.
But some of their testimony -- and that of other witnesses who've taken the stand in an administrative hearing about the allegations this week -- was contradicted by a woman who once worked for Tupac as a dental assistant.
Former Tupac patient Sheila Rios of Squaw Valley testified Wednesday and Thursday to enduring eight hours of difficult teeth extraction under inadequate pain medication, having to wear temporary teeth for several months that were ill-fitting and ugly and being coerced into accepting similarly unacceptable permanent teeth unless she wanted to go home with no teeth at all.
During direct questioning by Deputy Attorney General Morgan Malek Wednesday, Rios said she went to Tupac's office July 3, 2007, with the understanding she'd have 11 upper and lower teeth pulled and implant surgery for the eventual placement of permanent teeth --- and have the procedure done under general anesthesia.
Rios had testified that childhood issues had left her with severe dental problems.
"He said not to worry, I'd be asleep and wake up with a new smile," Rios quoted Tupac as saying the day before the procedure.
But the morning of the surgery, she testified, Tupac told her an anesthesiologist wasn't coming. Tupac instead numbed her mouth and said that would be the most painful part of the day's work, Rios said.
It didn't turn out that way, Rios testified, describing how Tupac had a difficult time pulling teeth.
"I was screaming, I was crying. It really hurt," the petite woman said.
Rios kept taking pain pills and getting numbing shots, she said, but they weren't taking away all the pain. During a 20-minute break about five hours into the surgery, she looked in the mirror and saw her face covered in blood, Rios said.
Tupac removed some of her lower teeth, which also proved to be a tough job. She said she cried but not as loudly as she was more "out of it" from the drugs.
The entire surgery lasted eight hours, Rios said. She had a temporary prosthesis put in then she and her husband made a 2 Â½-hour drive home.
The next morning brought another shock, Rios said. She had no molars.
Rios then described multiple, unsuccessful and frustrating visits to Tupac's office to get a solution to her ill-fitting, bulky and wrong-sized temporary prosthesis. One time when Tupac removed her upper fixture, she could smell a foul odor that she now suspects was a sign of infection, but Tupac said it was normal.
Oftentimes her temporary false teeth broke and Tupac's repairs left them discolored and rough and causing canker-sores.
Rios said she went in to get her permanent teeth placed in February 2008. She said Tupac wouldn't let her see them before he put them in and when he did, the top ones proved to be large and bulky and the lower ones too small.
"They were awful, I didn't like them," Rios said.
Over the course of a couple hours, a lab tech tried to make fixes but couldn't to Rios' satisfaction, she said. Rios said she didn't want to sign consent forms accepting the teeth but felt pressured to do so because her temporaries had "crumbled" and one of Tupac's dental assistants said her only other option was to go home with no teeth.
So, Rios said, she signed the documents and had the teeth put in. And again, she soon discovered, there were no molars.
"If I had known from the beginning I wouldn't have back teeth, I never would have done it," Rios said of the dental work by Tupac.
"We were just disgusted," Rios said. "It had been a long, grueling ordeal."
She didn't see Tupac again until April, 2008, when she complained to him that the permanent restoration -- her new teeth and the supporting structure -- was ill fitting and loose, food was getting caught in it, implant threads were visible through her gum tissue and crowns were too big. Tupac, she said, blamed her, saying she had poor oral hygiene.
Around this time, Rios said she'd been seeing other dental experts about what to do.
"He looked in my mouth and said, 'No, no, no...'" Rios quoted one dentist as saying. "'Do you have a good lawyer? You're going to need a lawyer. This will cost at least $100,000 to fix.' He was just horrified."
Rios has had six or seven reconstructive surgeries since, she said.
Rios also described struggles getting Tupac to give her a contract for the work, which he didn't, and learning she was charged for an implant she never received.
On Thursday, Rios' husband, Rory, testified. Tupac's lawyer, Jason Friedman of the firm Stark, Friedman & Chapman in Long Beach, asked him why he didn't have his wife accept the new, permanent teeth but not sign the form accepting them if they were so unhappy.
Rory Rios said the couple was tired after an arduous day and he felt Tupac would eventually make things right as there had been talk she could wear her permanent teeth for a few weeks and make sure they were OK.
"I still was under the illusion this was on the up and up," Rory Rios said of Tupac's care.
Friedman also had Rory Rios acknowledge his wife had to make follow-up visits to the dentists who did restorative and routine work on her teeth after her experience with Tupac. Rios said Friedman was making more of those follow-up visits than what they were.
Also on Thursday, former Tupac patient Rick Lawhon of Bakersfield described the many times he had to go back to Tupac's office to have both his temporary and permanent teeth repaired, which for a while he took in stride.
Lawhon described becoming really angry when one day he came in to have a permanent tooth fixed. Tupac numbed him to the point he couldn't talk and lectured him about how he couldn't keep making repairs for free, Lawhon said.
"I wanted to say, 'How dare you,'" Lawhon testified, saying he believed the $30,000 he paid Tupac for all the work covered necessary repairs.
Lawhon said he later told Tupac he expected the dentist to be responsible for his work.
Eventually, Lawhon said, he paid Bakersfield dentist Robert Reed $35,000 for a whole new set of hybrid dentures and today remains "ecstatic" with them.
Sometimes-contentious testimony followed when Malek called Stefanie Meier, who has worked as a dental assistant for both Tupac and Reed, to the stand.
She denied telling Reed that she was in distress about staff having to do procedures they weren't supposed to do under their license. Reed had testified Tuesday that she did tell him that.
Meier testified that when she asked Reed 1 Â½ to two years ago for a letter of recommendation, he said he would write her the letter if she gave him names of patients unsatisfied with Tupac's work. Reed filed a complaint about Tupac's work with the Dental Board of California after filling in for him during a medical leave.
Meier said she wouldn't give names because it violated privacy laws.
"He asked me to do something illegal," Meier testified.
Reed testified Tuesday he never made such a demand as there were plenty of people unhappy with Tupac's work and that he only complained to the board to protect the health and welfare of his community.
Meier denied to Malek that she repeatedly resisted attempts by a Dental Board investigator to interview her in order to get a good letter of recommendation from Tupac. Meier said she already had one.
Meier also said that the day Sheila Rios received her permanent teeth, Rios was "happy" with their appearance. She said that when Rios returned to the office several months later, Meier was "appalled" by her appearance.
Meier said she could only count on one hand the number of failed implants placed by Tupac and that the office was "very successful" at providing the service.
Administrative law judge Julie Cabos-Owen has presided over the civil trial-like hearing and will make a recommendation on the case to the dental board.
Because the judge is ill, Friday's proceedings were canceled. The hearing will be continued to summer or fall because of scheduling conflicts.