Media Library

FBI, IRS launch Medicare fraud investigations

As thousands of valley residents await lab test results that could signal their early deaths, the FBI and IRS have launched Medicare fraud investigations into the health care center that has put more than 40,000 people at risk of hepatitis and HIV infections.

Physicians' licenses targeted

CARSON CITY -- An official with the state Board of Medical Examiners told lawmakers Thursday that he will recommend the board ask doctors working for the Endoscopy Center of Southern Nevada to surrender their licenses.

Office permitted to reopen in NLV

North Las Vegas officials on Thursday lifted their cease and desist order against a Lake Mead Boulevard medical office affiliated with a clinic at the center of a massive health alert, saying the office does not pose a risk to patients.

The Gastroenterology Center of Nevada at 1815 E. Lake Mead Blvd., Suite 207, was shut down by the city on Tuesday after it was deemed a public nuisance for its "demonstrated willful failure to observe long accepted and mandated medical sanitary protocols." It could reopen as early as today.

The office is affiliated with the Endoscopy Center of Southern Nevada, which was shut down by Las Vegas officials in the wake of an investigation that found staff reused syringes on infected patients and contaminated vials of medicine that were shared among patients. Six patients have tested positive for hepatitis C.

Health officials have sent 40,000 letters to that clinic's patients, urging them to get tested for hepatitis C and B and HIV.

Three other affiliated medical branches also closed this week after their business licenses were suspended by Las Vegas, Henderson or Clark County officials.

A sixth location, the Gastroenterology Center of Nevada at 3150 N. Tenaya Way, has not been ordered closed but was not open when a reporter visited on Thursday. According to the office's answering machine, its regular business hours are 8 a.m. to 5 p.m., Monday through Friday.

Officials in North Las Vegas on Tuesday said no evidence had been found to indicate patients at the Lake Mead office were exposed to deadly diseases, and that they closed the office simply as a precaution.

On Thursday, the city issued a written statement saying inspectors had verified that the office "was not equipped to conduct surgical or other invasive procedures that would require the administration of intravenous medications."

"The entire intent was to determine whether there was a threat to public safety," said Brenda S. Fischer, a city spokeswoman. "From our understanding, the threat to the public has been about surgical procedures and anesthesia. Since this facility doesn't perform those, there's no risk."

Fischer said patients need the office to reopen so they can access their medical records and receive physician referrals.

In a letter lifting the cease and desist order, the city specified that the office is allowed "strictly to perform consultations, prescribe medication and counsel and interpret patient laboratory results. No procedures or diagnostic testing may be performed at this location."

-Lynette Curtis, Review-Journal

Public Health Crisis: LV patient feels at fault

Sitting at his dining room table, a patient of the Endoscopy Center of Southern Nevada tried to comprehend how on Sept. 21, 2007, some of his blood might have made its way into the bloodstream of five other patients, infecting them with hepatitis C.

Lawyers: Pain, suffering cap won't bring justice

Just as local trial attorneys begin preparing massive class-action cases against the Endoscopy Center of Southern Nevada, they're running into a potentially big roadblock: a $350,000 state cap on emotional damages in medical-malpractice lawsuits.

Husband, wife suspect clinic source of infection

For more than a year, Deborah Hilty kept asking herself what she did wrong.

She had hepatitis C and no clue why.

Every day the 58-year-old day care owner talked about it with her husband, Robert. Every day they were left with more questions than answers -- until last week.

More clinic offices closed

The Henderson and North Las Vegas offices of a clinic at the center of a massive health alert were shut down by officials in the cities Tuesday.

Citing the public health emergency, officials in both cities ordered the Gastroenterology Center of Nevada to cease operations, effectively shuttering all but one of the group's facilities in the valley.

Related Clinics Closed

With public fear and outrage growing, Clark County health officials on Monday shut down three clinics owned by the same medical group that exposed patients to incurable diseases at its Las Vegas clinic.

County agents hand-delivered orders suspending the licenses of the Desert Shadow Endoscopy Center, the Gastroenterology Center of Nevada and the Spanish Hills Surgical Center hours after city administrators upheld the suspension of the Endoscopy Center of Southern Nevada.

In written statements, county leaders indicated that no evidence points to patients being exposed to deadly diseases at the three clinics they closed Monday. Suspending the business licenses was a precaution, they said.

"The practices at their sister facility requires us to take action to protect the public," Commissioner Rory Reid said, referring to the Las Vegas clinic. "When dealing with such serious matters, it is best to treat each situation with an abundance of caution to minimize the risk to the public."

County commissioners will review the clinics' suspended licenses at their March 18 meeting.

The endoscopy and gastroenterology clinics are at 4275 Burnham Ave., near Flamingo Road, and the surgical center is at 5915 S. Rainbow Blvd., near Russell Road.

The city of Las Vegas shut down the endoscopy clinic at 700 Shadow Lane on Friday after investigators found that staff reused syringes, contaminating vials of medication and infecting six people with hepatitis C.

The Southern Nevada Health District last week sent out 40,000 letters to that clinic's patients, urging them to get tested for hepatitis C and B and HIV, the virus that causes AIDS.

The Burnham center improperly allowed vials to be used multiple times but did not reuse syringes, so there was no proof of contamination, state health officials said last week.

Still, county leaders insisted that the reported medical practices were alarming enough to shut down the clinics in their jurisdiction.

"These are serious accusations and call for an equally serious response," Commissioner Lawrence Weekly said. "We are dealing with deadly diseases and so, to put it simply, it is better to be safe than sorry."

Commissioner Bruce Woodbury agreed.

"The alleged practices of this group are troubling and totally unacceptable," Woodbury said. "It is our responsibility to make sure businesses are operating in a safe and lawful manner."

In a Monday afternoon meeting with city officials, attorneys and doctors representing the Shadow Lane clinic failed to persuade the city to reinstate its business license.

"It is the decision of the undersigned ... that the appeal is denied," said Mayor Oscar Goodman, who announced the results of the hearing but did not attend.

"Now it's suspended. For the time being, we have their license and the license will remain with us."

The clinic has the option of taking the license suspension to court.

"We haven't made any decisions at this point," said Abe Vigil, a lawyer representing the clinic. "We have to assess how to proceed."

He declined to discuss the hearing itself, saying only, "We definitely tried to put our best foot forward. We were grateful for the opportunity."

A city statement issued Monday noted that although the center has agreed to no longer engage in the practice of reusing syringes on vials, "city business license officials are not confident the practice will stop."

The hearing was closed to the public and the press. Goodman said interest in the meeting was so high that it would've been "impractical" to let everyone in.

"We wanted to give them immediate due process," he said. "We couldn't notice it in compliance with the open meeting law."

The hearing was conducted by city manager Doug Selby, finance director Mark Vincent and Jim DiFiore, who oversees the business services division.

Doctors Dipak Desai and Clifford Carrol attended, along with three attorneys representing them. The other doctors listed on the license are Eladio Carrera and Vishvinder Sharma.

Both Desai and Carrol have hospital privileges at Sunrise Hospital and Medical Center as well Valley Hospital Medical Center.

Officials from both medical facilities said the two physicians are still on staff and continue to see patients.

"We cannot speak to the practice inside other facilities,'' said Ashlee Seymour, a spokeswoman for Sunrise. "We can however speak to the practices at Sunrise. We do not reuse syringes."

No one from the Shadow Lane clinic would comment immediately after the meeting at City Hall, which started at 1:30 p.m. and wrapped up about 45 minutes later.

The fact that the meeting was closed disappointed Mary Jane Perry and her daughter, Dawn, who went downtown to attend.

Mary Jane Perry said she went to the clinic for a colonoscopy. The procedure went well -- in fact, she liked the staff there so much she baked three loaves of banana bread for them.

She underwent testing for hepatitis and HIV Monday morning.

Though she thought the clinic's actions were "disgusting" -- "I can't believe they got away with it this long," she said -- Perry also said that at 76 years old, she's not anxious about her health.

"I'm not worried for myself," she said. "What I worry about are these young people. Their lives haven't started.

"I just figure God will take care of it in the end. No sense getting sick over it."

She added, however, that she hopes the clinic stays out of business.

"I don't think they're nice people," she said.

The city of Las Vegas has received more than 60 calls, letters and e-mails about closing the clinic, all of them supportive of the city's action, a spokesman said.

-Annette Wells, Review-Journal

Public Health Crisis:Criminal Inquiry starts

Las Vegas police and county prosecutors opened a preliminary criminal investigation Monday into the Las Vegas clinic accused of shoddy medical practices that exposed patients to potentially deadly infections.

The investigation joins inquiries by the FBI and the Nevada attorney general's office into practices at the Endoscopy Center of Southern Nevada, which health officials have said put people at risk of contracting HIV, hepatitis strains B and C and other blood-borne diseases.

"This will be a broad-based investigation. We will be looking at every aspect which may involve criminal wrongdoing," District Attorney David Roger said.

Detectives will meet with health officials and review their findings before deciding whether to pursue a full-fledged criminal investigation, Deputy Chief Kathy Suey said.

"Right now we're looking at everything," she said.

Meanwhile, Nicole Moon of the attorney general's office said the agency's insurance fraud and Medicaid fraud units have been reviewing the case. And Lisa Jones, chief of the Nevada State Board of Licensure and Certification, said Monday that FBI agents contacted her department about its investigative report detailing problems at the clinic.

Also on Monday, Nevada lawmakers called for wide-ranging state investigations and for funding to help patients pay for the blood testing being recommended by the Southern Nevada Health District.

Sen. Randolph Townsend, chairman of the Legislative Commission, sent letters to Gov. Jim Gibbons and several state boards and agencies seeking a broad inquiry into the problems discovered at the Endoscopy Center of Southern Nevada, at 700 Shadow Lane.

In the letters, the Reno Republican asked for an immediate investigation into "the facts surrounding this outrage," which "may well be the largest breach of public trust in the history of the state."

Townsend said the agencies and boards should use all of their statutory and regulatory authority, including subpoena power, to get to the bottom of how the problems occurred.

An investigation made public Wednesday clinic found that staff reused syringes, contaminating vials of medication, which risked spreading disease.

Clinic staff told health investigators they were ordered by administrators, principally majority owner Dr. Dipak Desai, to reuse supplies and medications to save money, according to a letter by Las Vegas Business Services Manager Jim DiFiore, who suspended the clinic's business license Friday.

Health officials have confirmed that six patients who contracted hepatitis C at the clinic. The investigation was ongoing, and officials have urged blood testing for 40,000 patients who visited the clinic between March 2004 and Jan. 11 of this year.

Assembly Speaker Barbara Buckley, D-Las Vegas, said state lawmakers want to ensure testing for people regardless of whether they have insurance or can afford it. The clinic should pay those costs, but a plan is needed immediately to ensure testing is available, she said.

The Legislature might be able to help with those costs, with the Southern Nevada Health District and others, Buckley said.

Assemblywoman Sheila Leslie, chairwoman of the Legislative Committee on Health Care, said Monday she was "beyond appalled" by what happened at the clinic. Her committee will meet 9 a.m. Thursday at the Sawyer Building to discuss how to prevent such a scenario from reoccurring.

"We want to know what licensing boards are going to do," the Democrat from Reno said. "If the medical staff did this knowingly, they should lose their licenses and be pursued criminally."

Leslie said the maximum fine that can be issued the state Board of Licensure and Certification -- $1,000 per violation -- is "woefully inadequate."

"I want to see if our laws are substandard on a national level," she said. "We need more teeth in our regulations."

Larry Matheis, executive director of the Nevada State Medical Association, said it's probably easier to shut down a restaurant for health code violations than temporarily suspend the medical or nursing licenses of the health care workers responsible for the hepatitis C outbreak.

The "law is on their side," Matheis said.

Under Nevada's law, regulatory agencies must provide evidence that a medical care provider is a threat to the public.

Fred Olmsted, counsel for the Nevada State Board of Nursing, said his office had received a complaint about nurses at the Shadow Lane facility, but as of Monday, there was no evidence that they posed an "immediate threat'' to the public.

"If the board finds that there is immediate danger to the public, we can summarily suspend someone's license,'' he said. "However, since such a suspension would be in violation of (the nurses') constitutional rights, we have to have a hearing promptly so that they may tell their side of the story.''

An emergency meeting would have to be held within 30 days of the complaint, but no such hearings had been scheduled as of Monday.

"People are presumed not guilty until proven guilty,'' Olmsted said.

Dr. Javaid Anwar, president of the Nevada Board of Medical Examiners, said his agency needs evidence that a doctor is a threat to the public before suspending a medical license.

He said the board had not received information from its investigators identifying any violations by the doctors who ran the Endoscopy Center of Southern Nevada.

"Are those physicians posing potential harm to our patients at the center? We don't have the information from our investigators to make that determination,'' Anwar said.

Anwar said the medical board, nursing board and licensure bureau each have to finish investigations.

"We need to let them come up with what exactly is the problem. In the meantime, that place is closed.''

Unsafe cost cuts

When public health officials announced last week that dangerous medical practices at a local medical center had exposed Southern Nevadans to potentially lethal viruses, the center announced it had hired a consultant to help "ensure that it will never happen again."