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WISCONSIN DEPARTMENT OF REGULATION LICENSING

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					                           WISCONSIN DEP ARTMENT OF
                            REGULATION & LICENSING




Wisconsin Department of Regulation & Licensing
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        Open Records law, sections 19.31-19.39 Wisconsin Statutes.

Please read this agreement prior to viewing the Decision:

      The Reports of Decisions is designed to contain copies of all orders issued by credentialing
       authorities within the Department of Regulation and Licensing from November, 1998 to the
       present. In addition, many but not all orders for the time period between 1977 and November,
       1998 are posted. Not all orders issued by a credentialing authority constitute a formal
       disciplinary action.
      Reports of Decisions contains information as it exists at a specific point in time in the
       Department of Regulation and Licensing data base. Because this data base changes
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      There may be discrepancies between the online copies and the original document. Original
       documents should be consulted as the definitive representation of the order's content. Copies
       of original orders may be obtained by mailing requests to the Department of Regulation and
       Licensing, PO Box 8935, Madison, WI 53708-8935. The Department charges copying fees.
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       appears on the order.
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         06/2?/!/37     OR:57        REGLILQTION    FIND LICENSING     $ GUTGLASS     ERICKSO                     NC       aai   ~002/006
    -.
’          .




                                                           Stnteof W isconsin            -                             I
                                               Beforethe DentistryExaminingBoard
               .--------__---_--__L------..----------..-.-----------------------...---------------------------.
                                        In the Matterof DisciplinaryProceedings            Against
                                                      ManijehKhorshidi,D.D.S
                                                            LS 9605023DEN
               -.._.__-__...__.-__-----------------..---.-----.-------------------..--.----.-.---------------
                                                  FINAL DECISIONAND ORDER


                                                   for      of                are:
                       The partiesto this proceeding purposes s. 227.53,Stats.,
               ManijehKhorshidi, D.D.S.
               400 ProspectDrive
               Brookfield W I 53005

               DentistryExaminingBoard
                          of         and
               Department Regulation Licensing
               P.O.Box 8935
               Madison W I 53708

               Division of Enforcement
                           of
               Department RegulationandI.icensing
               P.O.Box 8935
               Madison W l 53708

                    The partiesto this proceeding          to           stipulation, Dentist
                                                havingagreed the attached          the                                 y
                                                                                                                       ‘!
               ExaminingBoard makesthe following
                                                                                                                                  .*
                                                          FINDINGSOF FACT

                                                                                       to
               I. ManijehKhorshidi, D.D.S.,was bornon June17, 1949,and is licensed pmcricedenu
               the stateof W isconsinpursuant license
                                              to                                 on -i, ‘
                                                         number3729,first granted November
                                                                              -.e_       ,’   24,198
                       _- ..~               ~         .;.:--.,:
                                          .‘ : 1-y-.;;‘                                         ..~.-’
               2.X% June3, 1994.Dr~~Khb;shidi    provideddentals~r&es to patientJ-c., a threeyearold
                                  a
               Tho child presented dilXcult patientmanagement                           a
                                                                situation,demonstratinghigh level of
               anxietyandfear of dentalprocedures.

                              s              part
               3. The patient’ father observed of the interaction from outsidethe trcatmcntarea. As
                                      s                                             the       s
               rcsuh of Dr. Khorshidi’ conducttowardthe patientfollowing trentment, patient’ fathr
                           that                          the
               complained Dr. KhorshIdihad frightened child by verbalandphyalcal        contact.
    06/25/97    OS:57     REGULRTION   FlND LICENSfNG   + GUTGLRSS   ERICKSO                NO. 481    P003f006
’




                                                     in
        4. Dr. Khorshididoesnot agreethat sheengaged uny unprofessional                  her
                                                                         conductin regards
                                                                                as
        conductwith PatientJ.C.,but shedoesagreethat her conductwas not perceived an
                   or
        educational calminginteraction.
                                     CONCLUSIONS LAW  OF
                                                                          to
        1. The DentistryExaminingBoardhasjurisdictionin this matterpursuant S.447.07,Stats.

                         s                         of                      a
        2. Dr. Khorshidi’ conductfollowing treatment PatientJ.C. constitutes violationof
        s. 447.07(3),stn1s.

                                                ORDER
                    that                                                          she
        It is ordered Dr. Khorshidishall complywith the following protocol whenever is treating
                                     a
        a pediatricpatientwho presents behaviormanagement  challenge:

                                             the       of        s                 in
               1. Dr. Khnrshidishall request prcscnce the patient’ parentor guardian the
        treatmentarcafor the durationof the procedure.

                                                                      speakwith the child ta cat the
                2. a. Dr. Khorshidiwill requestthat the parent/guardian
                            Dr.                         with
        child. if successfbl, Khorshidiwill proceed the procedure.

                                              s                                       Dr.
                b. If the parentor guardian’attemptto calm the child is unaucces~ful. Khorshi i wilt
                                                                                                T             .:      _.
        discuss                           the               of
                with the parent/guardian administration nitrousoxide or Valium, Visteril, or 1
        another tranquilizingor sedating  medication..If the parenrlguardian       the
                                                                            agrees, sedative Iis
                       and
        administered procedure        continues.Dr. Khorshidiwill requestthut the parentor guardi
        sign a consent                              of
                        form for the administration the sedative beforeadministering the
        Khorshidimay administer     nitrousoxide if shehasbeentrainedin its use,in compliance wi
        DI? 11, W is. Admin. Code.

                                          declines consent the admtnistration a
                c. If the parentor guardian       to              to          of
                      is                                                             witho
        the sedative unsuccessful calmingthe child sufficientlyfor treatmentto proceed
                                      in
                             Dr.                      the
        otherintervention, Khorshidimay request parentor guardianto hold the child’ bans
                         the
        legs to prevent child from injuring himselForherself. If the parentor
                  en              may           s
        consents, assistant hold the child’ handsor legsinsteadof the
        so.                    ...~                -_
                            *Ai-
                          ,;yy:y’
                                                    ..&L.‘
                                             r : I,j .:..-&. i I
                                                  ,..i.,.-. z::.~,.,ir
                                                             :,;y
                               possible treatthe child, despite
                d. If it is ndt‘      to                      the
                                   or
        aid of a parentor guardian assistant  holdingthe child’ s
                                          and
        term inatethe attemptat treatment, eitherrefer the
        the patientfor anothertime end another attemptat treatment.Dr. Khorshidi may also
        parent/guardian an option to admitthe child to
                          of                                                                                     .
        anesthetic.                                                                _.^ ;.___ _, .,       - .--..x..
                                                                                 -      ....:- . .
                                                                                                            -
                                                                                                        *ii ‘ so-
                                                                                                              .-
P                   608   266     2264
    06&S/97     ?0:le           REGULATION   AND LICENSING   + GUTGLQSS   ERICKSO         No.




              3. Whichevermethodis used, Dr. Khorshidi will beginthe procedureby addrcssin
                                            &Tell-Show-Do”
        simplesttask first incorporatingthe ‘            technique.

                                                                       to
        IT IS FURTHER ORDEREDthat Dr. Khorshidi will pay SlSOO.00 the Department          of
                                                              pursuantt0 8.440.22. Stats.
        Regulationand Licensinges the costs of this proceeding,

        IT IS FURTHER ORDEREDthat the licensepreviouslyissuedto Manijeh Khorshidi,D.C
                                 for
        mny be summarily suspended any violation of this Order.


        Dated this 9th day of Ju!y. 1997.
kl6/25/97       a8:58       REGULRTION     RND LICENSING      + GUTGLQSS ER[CKGO                         NO   81   P005/006
        *




                                                Stateof W isconsin
                                      Beforethe Dentistry ExaminingBoard
                ___---.---_.__._-__------------.----------.----------..-----------.--.-“.-----------------
                                In the Matterof DisciplinaryProceedings         Against

                                             ManijehKhorshidi,D.D.S.
                                                      Respondent
                                            CaseNo. LS 9605023          DEN
                ----1--_.-..-._--____I--------------.-.-------------..---------------------
                                                      Stipulation
                -1-----.~.~..~~“*~-~-~~~~1--111-~~-1-~~~~~~~~..~~~~~~~~~~.~~~~~~~~~~~~~~~~-~~-~~~

            It is herebystipulatedbetween                                 and
                                         ManijehKhorshidi,D.D.S.,personally on her own
                                                   s        and      B.
            behalf and ColleenFleming,Dr. Khorshidi’counsel, James Polewski,Attorney
                                          Department Regulation Licensing, follows:
            for the Division of Enforccmcnt,         of          and          as

               fhis
            1. ‘ stipulationis emend in resolutionof the pendingmntterconcerning Dr.
                      s                        and
            Khorshidi’license. The Stipulation the proposed  Final DecisionandO rdershall t
                    directly to tho DontistryExaminingBoardfor its consideration adoption
            presented                                                          and

                                              ,Dr.               to
            2. ht resolutionof theseproceedings, Khonhidi consents the entry of the attach1
            Final Decisionand O rder.

                                                         each
            3. Dr. Khorshidi is nwareof andunderstands of her righlr, including:
                   l -                         on
                        the right to a hearing the allegations         her,
                                                                against at which the statewou
                                                                   by
                        havethe burdenof provingthe allegations a preponderance the  of
                        evidence,
                   -                                            the
                        the right to confrontandcross-examine witnesses      againsther,
                                                    on
                   l .’ the right to call witnesses his own behalf  andto compcitheir attendant,
                        by subpoena,
                   l .~ the right to testify herself,

                   l _                              to
                        the right to file objections any proposed           and
                                                                   decision to presentbriefs o
                                          to                            the
                        orat arguments the offtcials who areto render final decision,
   _               v *I the right to peiitionfor rehearing,
                                                     at
                   * c the right to be represented every stageof the proceeding,  includingthe
                                                     by                          at
                        makingof anystipulation, an attorneyof her choosing, her own
                        expense,
                   .    all other rightsaffordedto her under the UnitedStates Constitution,the
                                                  the                  and
                        W isconsinConstitution, W isconsinStatutes the W isconsin
                        Administrative    Code.                                                                               .y-,- _

                                                that                     she
        4. Dr. Khorshidiis awareandunderstands by signingthis stipulation voluntari
                                                          3      and
        and knowingly waivesthe rightssetforth in paragraph above, doesvoluntarily an
        knowingly waive thoserights.                                                                                 :        i
        LdD/Z3/~I       ldt(i53                       REGULATION   RND LICENSING   + GUTGLQSS   ERICKSO         NO   31   P006/006
:
    1    ;




                                                   arc           to
                5. If the terms of this stipulation not acceptable the Board,thepartiesshallnot I
                                        of                                           to
                boundby the contents this stipulation,and the mnttershullbe returned the Divisil
                                                        In
                of Enforccmcntfor furtherproceedings. the cvcnt that this stipulationis not accepts
                                                 not
                by the Board,the pnrticsagree to contendthat the Boardhasbeenprcjudiccd      or
                                                          of
                biasedin any mannerby the consideration this attempted  resolution.

                6. The particsto this stipulationagreethat the attorneyfor the Division of Enforcemel
                                                                            as
                andthe memberof the DentistryExaminingBoardassigned an advisorin this
                investigationmay appear                                               in
                                          beforethe Board for the purposeof speaking favor of this
                          and
                agreement answering                 that             of
                                          questions the members the Boardmay havein
                connection                         on
                           with their deliberations the stipulation.




                                                                                           6/3&l
                                                                                         Date




                                                                                                  t 3s    &F?
                                                                                         Date
                Attorney
                Division of Enforcement




                                    i            .,

                                .

                    _      -_           .Y.__~        ..,   .
                              STATE OF WISCONSIN
                   DEPARTMENT OF REGULATION AND LICENSING
                    BEFORE THE DENTISTRY EXAMINING BOARD
  In the Matter of the Disciplinary ProceedingsAgainst

       Manijeh Khorshidi, D.D.S.,                                AFFIDAVIT OF MAILING

           Respondent.

STATE OF WISCONSIN           )
   _.. -.-
COUNTY OF DANE

           1, Kate Rotenberg, having been duly sworn on oath, state the following to be true and
correct basedon my personal knowledge:

           1: I am employed by the Wisconsin Department of Regulation and Licensing.

           2. On July 10, 1997, I served the Final Decision and Order dated July 9, 1997,
                                                          s
LS9605023DEN, upon the RespondentManijeh Khorshidi’ attorney by enclosing a true and
accuratecopy of the above-describeddocument in an envelope properly stamped and addressed
                                 s
to the above-namedRespondent’ attorney and placing the envelope in the State of Wisconsin
mail system to be mailed by the United StatesPost Office by certified mail. The certified mail
receipt number on the envelope is P 221 157 325.

              Colleen Fleming, Attorney
              735 N. Water Street, Suite 1400
              Milwaukee WI 53202-4267




                                                         Department of Regaation and Licensing
                                                         Office of Legal Counsel




Notary Pub!& &ate 6f Wisconsin
My commission is permanent.
              NOTICE     OF APPEAL       INFORMATION
Notice Of Rights For Rehearing Or Judiciaf Review, The Times Allowed For
 Each, And The Identification Of The Party To Be Named As Respondent.


                Serve Petition for Rehearing or Judicial Review on:
          STATE OF-WISCONSIN DENTISTRY EXAMINING BOARD
                           1400 East Washington Avenue                       -A
                                  P.O. Box 8935                           i ?
                               won,      w53,0**                      :    ..:

				
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