The state appeals court has denied the request of Woodbury dentist Marko Kamel to reinstate his dentistry license.

The appeals court said in its late December ruling that it found no reason to question the findings of the administrative law judge (ALJ) who oversaw the hearing that led to Kamel's suspension in March.

"The ALJ made extensive and thoughtful findings … we must defer to the ALJ's conclusions …" wrote appeals court judge Francis J. Connolly, writing for the three-judge appeals panel of himself, Sarah I. Wheelock and Michael L. Kirk.

The Dec. 23 ruling comes amid bankruptcy proceedings for Kamel in which his shuttered practice, Woodbury Dental Arts, is being sued by multiple creditors over some $2 million in debts. Former patients who handed over tens of thousands of dollars for implant surgeries they say never happened or were botched are among those hoping to get some of their money back.

Kamel, who closed his practice and was reported to be working in California, where he has been licensed to practice dentistry since 2016, could not be reached for comment.

Unbeknownst to patients who were spending tens of thousands of dollars for implant surgeries, Kamel spent much of 2023 and early 2024 under a cloud of regulatory discipline. The state dentistry board twice temporarily suspended Kamel's license in May and November 2023 before ordering his license suspended indefinitely on March 5, 2024.

The case has prompted questions about oversight, notifications to patients and whether any of the approximately 55 patients will see their money returned after paying about $1 million in deposits only to be left with uncompleted work.

Although dozens of patients came forward with reports of substandard care, the case for Kamel's suspension relied on the experiences of two unnamed patients who testified that their procedures were botched, painful and had questionable practices.

A patient identified in court papers as Patient #1 said many of the implants that Kamel installed in her mouth in August 2021 failed. The implants were removed or replaced by Kamel over a series of visits until, two years after her initial surgery, the woman sought a second opinion from an oral surgeon at the University of Minnesota who removed four more implants after finding multiple problems. A second patient, identified as Patient #2, said her 12 implants caused tremendous pain and she ended up at the Maple Grove Hospital Emergency room three days later. When Kamel learned that she might go to the University of Minnesota for more treatment, he left her a voicemail saying she should not go there and that he wanted to see her.

In his appeal, Kamel said the administrative law judge's ruling that he demonstrated gross incompetence or ignorance was not supported by the evidence. He also argued that his experts' testimony was ignored.

The appeals court said there was ample evidence to support the law judge's ruling of incompetence: Patient #1 had an implant that failed three times. Out of 12 implants in all for Patient #1, seven failed. That's a failure rate of 58%, much higher than the industry standard of 1% to 2%, the court found.

Kamel said the ALJ should have calculated his failure rate by counting all of the implants he successfully installed over his career and not just the rate for a single patient.

The appeals court disagreed, saying the administrative law judge "simply compared the failure rate of individual implants for patient 1 with the average failure rate of individual implants in the profession." The ALJ also relied in part on the assessment of expert witnesses, and the court said it would defer to their opinion.

Kamel also argued that the administrative law judge disregarded the testimony from "multiple witnesses" that his treatment of Patient #2 was not substandard. The patient ended up at the University of Minnesota where an oral surgeon found bone fragments in the patient's mouth, along with a dangerous infection that required a five-day hospital stay. Kamel testified that he "was positive" that he didn't leave bone fragments in the patient's mouth and that he did not believe the patient had an infection. The administrative law judge didn't find Kamel's testimony to be credible, the appeals court said, adding that it would defer to the ALJ's decision.

Kamel's voicemail to patients discouraging them from seeking medical care was also a problem that showed either ignorance or incompetence in the practice of dentistry, the ALJ found, and the appeals court said it would defer to the ALJ's decision.

"Dr. Kamel is unable to meet his burden of showing that the board's decision to suspend his license to practice dentistry is not supported by substantial evidence," the appeals court ruled.