Court Opinion

ID: 9773411
Source: CourtListenerOpinion
Date Created: 2023-08-29 17:44:56.556815+00
Date Added: 2024-06-11T07:31:53.525885
License: Public Domain

McCRAW, Justice,
dissenting.
I respectfully dissent. The majority has misapplied the proper standard of review to be used by the court hearing an appeal from the revocation of a professional license. After a review of the statement of facts and application of the appellate review standard, I must conclude that the rulings of the Texas State Board of Dental Examiners and the 95th District Court should be affirmed.
*399The Examining Board reached three conclusions in support of their order revoking Sizemore’s license: (1) Sizemore prescribed controlled substances that were not necessary or required in the practice of dentistry and the prescription use would promote and further addiction in violation of Texas Revised Civil Statute article 4551h;1 (2) Sizemore exhibited dishonorable conduct by grossly over-prescribing narcotic drugs in violation of article 4549; and (3) Sizemore failed to make the prescription of narcotic drugs a part of his patient’s dental records.
Hearings and the appeal from hearings on disciplinary actions against dentists is governed by article 6252-13a, the Administrative Procedure and Texas Register Act. TEX.CIV.STAT.ANN. art. 4549, § 4(b) (Vernon Supp.1987). The scope of judicial review is defined in article 6252-13a, sec. 19(e):
The scope of judicial review of agency decisions is as provided by the law under which review is sought.... Where the law authorizes review under the substantial evidence rule, or where the law does not define the scope of judicial review, the court may not substitute its judgment for that of the agency as to the weight of the evidence on questions committed to agency discretion but may affirm the decision of the agency in whole or in part and shall reverse or remand the case for further proceedings if substantial rights of the appellant have been prejudiced....
The substantial evidence test is applicable in the present case. The test is set out in Dotson v. Texas Board of Medical Examiners, 612 S.W.2d 921, 922 (Tex.1981):
The correct substantial evidence rule test is whether the evidence as a whole is such that reasonable minds could have reached the conclusion that the agency must have reached in order to justify its action.
(Emphasis added). This test has been used consistently in Texas courts. See Imperial American Resources Fund v. Railroad Commission of Texas, 557 S.W.2d 280, 286 (Tex.1977); Balla v. Texas State Board of Medical Examiners, 693 S.W.2d 715, 716 (Tex.App.—Dallas 1985, writ ref’d n.r.e.); Kelley v. Texas Real Estate Commission, 671 S.W.2d 936, 939 (Tex.App.—Houston [14th Dist.] 1984, writ ref’d n.r.e.); Wood v. Texas State Board of Medical Examiners, 615 S.W.2d 942, 943 (Tex.Civ.App—Fort Worth 1981, no writ); Thompson v. Texas Board of Medical Examiners, 570 S.W.2d 123, 130 (Tex.Civ.App.—Tyler 1978, writ ref’d n.r.e.); Korndorffer v. Texas State Board of Medical Examiners, 448 S.W.2d 819, 823 (Tex.Civ.App.—Houston [14th Dist.]), aff'd in part, reversed in part, 460 S.W.2d 879 (Tex.1970). The examining board’s order is deemed prima facie valid. Imperial, 557 S.W.2d 283; Kelley, 671 S.W.2d at 939; Korndorffer, 448 S.W.2d at 823. The burden of proof is upon the complaining parties to show an absence of substantial evidence and that the orders are unreasonable and unjust. Imperial, 557 S.W.2d 283; see Kelley, 671 S.W.2d at 939; Komdorffer, 448 S.W.2d at 823. When substantial evidence supports the board’s decision, article 6253-13a, section 19(e) prohibits the reviewing court from substituting its judgment for that of the agency, even though the court may have “struck a different balance.” Kelley, 671 S.W.2d at 939; see Wood, 615 S.W.2d at 943.
This court must review the entire record to determine if the Board’s order is reasonably supported by substantial evidence. Dr. Arthur Jeske, an associate professor of pharmacology and restorative dentistry at the University of Texas dental branch in Houston testified for the Board. Jeske has a Ph.D. in pharmacology, a D.M.D. degree, and has published several papers. He recently co-authored a textbook entitled Pharmacological Therapeutics in Dentistry. His expertise was not challenged. Dr. Jeske testified that Percodan, a chemical relative of morphine, is a strong narcotic analgesic that relieves pain centrally. Per-codan has an addictive quality and creates physical and psychological dependence by producing a state of euphoria in the user. Dr. Jeske stated that “if given in sufficient quantity for sufficient time, [Percodan use] can result in dependence of the patient psychologically to maintain a state of well-*400being.” Dr. Jeske evaluated the use of Percodan by a patient with temporal mandibular joint pain (TMJ). Dr. Jeske stated that the use of Percodan is not normal in the treatment of TMJ. It is usually treated with a combination of physical measures and occasional use of pharmacological measures, such as the use of muscle relaxants or anti-inflammatory analgesics. Percodan is not an anti-inflammatory analgesic.
The TMJ patient’s prescriptions for Per-codan commenced on September 10, 1981, through August 23, 1982. In Dr. Jeske testified “with a reasonable degree of medical certainty” that Sizemore prescribed controlled substances that were not necessary or required. He was especially impressed by the fact that Sizemore started the TMJ patient on Percodan in September and allowed two months to elapse during which time further prescriptions were issued and “no definitive dental therapy was performed to alleviate the problem.” Sizemore himself admitted there was a problem with the treatment of the TMJ patient. The patient was given additional prescriptions for Percodan from February 28 through June 2, but received no treatment because he allegedly did not have time for the procedures. Sizemore admitted that he could have demanded that the patient come in to the office and suspend issuance of the prescriptions and “probably should have.” He further admitted that “it’s obvious that my judgment was not so good [in failing to demand that the patient have treatment].” Sizemore realized that he “may have been used by this person.” This patient received 382 pills.
Another of Sizemore’s patients had upper-anterior pain in his teeth. Sizemore gave the patient a prescription for Perco-dan and antibiotics. This regiment was continued for two months before the teeth were extracted. The patient received 121 tablets in this two month period. Dr. Jeske testified that the initial prescriptions may have been justified, but that two months was a “fairly long time” to maintain a patient on pain control and antibiotic. Dr. Jeske stated that the Percodan was probably unnecessary or not required after the first two weeks of therapy. Five days after the painful teeth were removed, the patient was again placed on Percodan and antibiotic for an additional two month period for a problem “of endodontic origin.” Dr. Jeske stated that in his opinion the prescriptions became unnecessary or were not required after twenty-four days.
A third patient received prescriptions for Percodan on April 27, May 9, May 13, May 18, June 2 and June 16. No antibiotic was used in conjunction with the prescription. On June 2, amalgam restorations were performed. Dr. Jeske stated that in his opinion, the Percodan prescribed on May 9, 13, and 18 were not necessary or required. In five and one-half months this patient received 220 pills.
Sizemore admits that he failed to properly keep complete records on his patients. There is no evidence presented to controvert the fact that Sizemore did not record all the prescriptions he issued to his patients.
Upon a proper review of all the evidence, I would hold that Sizemore has not met his burden to prove the absence of substantial evidence. The prima facie presumption that the Board’s order is valid has not been rebutted. Reasonable minds could have reached the conclusions that the Board reached. I would affirm the judgment of the trial court and the orders of the Board.

. All references are to Texas Revised Civil Statutes, unless otherwise noted.