(a) The initial reviewer shall review all the relevant information and records collected by the agency and determine whether the respondent has violated the standard of care applicable to the circumstances and issue a preliminary written report of that determination.     
      (b) The second reviewer shall review the initial reviewer's preliminary report and all the relevant information and records collected by the agency and determine whether the respondent has violated the standard of care applicable to the circumstances. If the second reviewer agrees with the conclusions of the initial reviewer, the second reviewer shall inform the initial reviewer and the initial reviewer shall issue a final written report on the matter. If the second reviewer does not agree with the conclusions of the initial reviewer, the second reviewer shall issue a secondary written report of his determination.     
      (c) If the initial and second reviewer do not agree on the determination, a third reviewer will be necessary. The third reviewer shall review the preliminary and secondary report and all the relevant information and records collected by the agency and determine whether the respondent has violated the standard of care applicable to the circumstances and issue a final written report of that determination. The final written report shall be issued by the third reviewer or the reviewer with whom the third reviewer concurs.     
      (d) The written reports shall include the following:      
        (1) the general qualifications of each reviewer; and       
        (2) the opinions of each reviewer regarding:                  (A) the relevant facts concerning the dental care rendered;                   (B) the applicable standard of care;                   (C) the application of the standard of care to the relevant facts;                   (D) a determination of whether the standard of care has been violated; and                   (E) the clinical basis for the determinations, including any reliance on peer-reviewed journals, studies, or reports.         
      (e) The reviewers may consult and communicate with each other in formulating their opinions and reports.     
     Source Note:        The provisions of this §107.109 adopted to be effective September 6, 2016, 41 TexReg 6694