Media Library

Complaints Filed in Hepatitis Probe

By BRENDAN RILEY Associated Press Writer 04/28/2008

CARSON CITY, Nev.—The state Board of Medical Examiners filed 10-count complaints Monday against two doctors linked to a hepatitis C outbreak in southern Nevada, and the state attorney general filed motions in court to keep the doctors from practicing until the complaints are resolved.

The medical examiners panel filed the separate disciplinary complaints against Dr. Dipak Desai, who has been running the Endoscopy Center of Southern Nevada and several other clinics, and against Dr. Eladio Carrera, who worked at and is a co-owner of the center.

The complaints were filed by Tony Clark, executive director of the medical board. The attorney general's office filed against Desai and Carrera in Clark County District Court, seeking restraining orders to prevent them from practice.

The complaints describe several cases in which patients at the endoscopy center were treated by Desai and Carrera and later were diagnosed with hepatitis C. Both doctors are accused of conduct that put the patients' health and safety at risk.

The doctors also are accused of conduct that brings the medical profession into disrepute, exploiting physician-patient relationships for financial gain, and failing to use "reasonable care, skill or knowledge ordinarily used under similar circumstances."

Action against other doctors is expected, Clark said, adding, "We're starting with these two. The board's investigative committee believes they did several of the procedures which we understand resulted in hepatitis C."

Besides the medical board's activity, state legislators were told last week that the Las Vegas Metropolitan Police Department, the FBI, Attorney General Catherine Cortez Masto's office and the Clark County district attorney are involved in a criminal probe into the crisis.

The outbreak prompted health officers to advise tens of thousands of former patients at several clinics to be checked for exposure to hepatitis and HIV.

Authorities blame the infections on the reuse of needles and vials of medication on multiple patients, and say they've traced eight acute cases of hepatitis C to Desai's endoscopy center and to another one he operated. The two clinics have surrendered business licenses and paid a total of $500,000 in fines.

Clinic's Doctors Retain Licenses

By PAUL HARASIM and ANNETTE WELLS REVIEW-JOURNAL

Two months after the origins of a hepatitis outbreak were discovered, the question lawmakers get asked the most by constituents is this: Why are the doctors who worked at the Endoscopy Center of Southern Nevada still practicing medicine?

Assembly Speaker Barbara Buckley posed the question in early March to medical regulatory officials at a legislative hearing.

Last week, other legislators ratcheted up the criticism, which culminated Friday in a letter to the governor asking that physician licenses be suspended.

Tony Clark, the executive director of the Nevada State Board of Medical Examiners, and Keith Lee, the agency's legislative counsel, told lawmakers at the hearing Monday that the board couldn't summarily suspend the physicians' licenses.

Assemblywoman Sheila Leslie, D-Reno, was stunned, suggesting the very board charged with the investigation of the physicians isn't aware of its own power.

"How can the board do its job when it doesn't know what it can do?" she asked after the hearing.

Leslie said she and other lawmakers, who hear the frustration of their constituents, have lost confidence in the medical board's ability to respond.

She and state Sen. Steven Horsford, D-Las Vegas, want all the doctors working at clinics affiliated with the Shadow Lane facility and its owner, Dr. Dipak Desai, to be suspended. They've also asked that a special counsel be appointed to do an independent investigation.

"People are scared," Leslie said. "They're telling us they want to know where these doctors are so they can protect themselves."

It may be easy for politicians to take state officials to task on an issue that resonates so deeply with the public, but Clark said gathering specific evidence against specific doctors is another matter.

"We've got three investigators on this case full time," he said.

Clark said the medical board will eventually get to the bottom of what happened, the state will be better off in the long run, and the public will end up appreciating the work it did.

Clark said Friday evening in response to the letter to Gov. Jim Gibbons that legal action would be taken this week against doctors, although he wouldn't specify what type of action and against whom.

Nevada Revised Statute 233B.127 says a physician's license can be suspended by the board if the agency finds "that public health, safety or welfare imperatively require emergency action."

A search of state records by the Review-Journal found that the board has taken such action on at least seven occasions in the last 18 years.

On Nov. 28, 2007, the board even sent out a news release about an emergency meeting held to summarily suspend a physician's medical license.

Following Monday's hearing, Clark said the board does indeed have the power to summarily suspend a physician's license.

"I may not have made it clear that you can hand out a summary suspension, but only if you have enough evidence," Clark said a day after the hearing. "We're not sure that enough evidence has been available."

About the doctors, he said, "I'm sure they're worried that their licenses could be taken away for something they didn't do. You have to remember that license represents their livelihoods. We don't know which doctors are involved yet."

Clark said board investigators were well aware of documentation that was used by the city of Las Vegas to revoke the business licenses of the Endoscopy Center's Shadow Lane clinic on Feb. 29.

In a letter written to Desai and three of his administrators that gave the grounds for the emergency business license suspension, Jim DiFiore, manager of the city's business services division, said a "tiger team" comprised of investigators from the Southern Nevada Health District, the state Bureau of Licensure and Certification and the Center for Disease Control, found that practices at the clinics "fell well below accepted medical practice."

"Specifically, you instructed your registered nurses and certified registered nurse anesthetists to reuse syringes when administering anesthesia," DiFiore wrote the doctors. "In addition, you instructed them to reuse vials of medication."

DiFiore went on to say that investigators were told by nurses that they were "ordered by administrators, principally Dr. Desai, to engage in the practice in order to save money."

Clark said that although investigators from city, state and federal agencies have been willing to share information, it takes time to re-interview the individuals other agencies contacted.

"We just can't go on what other investigations have found in order to hand out a summary suspension," Clark said. "If we did that, we would be basing the suspension on hearsay. We need to talk to the people ourselves. We need to have all our evidence together."

In the city's business license revocation letter, the only physicians mentioned are those to whom the letter was addressed: Desai and Drs. Eladio Carrera, Vishvinder Sharma and Clifford Carrol.

Clark said he wouldn't be at all surprised if physicians "say they never saw what happened, that they say they weren't around. It's very possible."

To this point, the only action that the public has seen the board take is exact a promise from Desai not to practice medicine in Nevada.

No emergency medical board meeting has ever been called to address the crisis.

"It wasn't necessary," Clark said, stressing that even though its in new territory, the board knows how to handle the situation.

Once the investigation is complete, Clark said, the public will be impressed that the board could be both thorough and protective of physicians' due process.

Summary suspensions, which are first recommended by an investigative committee and then approved by a majority of the board, should only be handed out if there is overwhelming evidence to later sustain a permanent revocation, he said.

And if disciplinary action is warranted, the response will be proper, he said.

"I think we've been doing an excellent job in our investigation. Our sole purpose is to protect the public. We work on behalf of them every day."

Some lawmakers don't share Clark's evaluation of the board, which consists of six physicians and three members representing the public. All are gubernatorial appointees.

"The board has not shown a sense of urgency in dealing with what could be the biggest health care crisis in the nation's history," Leslie said. "It appears that they are more interested in protecting doctors."

Horsford was equally blunt: "It appears that the board does not want to protect the public."

If Dr. Lawrence Sands, chief of the Southern Nevada Health District, gets his way, authorities won't have to wait on the medical board to take action.

At Monday's hearing, Sands proposed the authority of local health districts be expanded to include the ability of the chief health officer to issue a "cease and desist order" to facilities or medical care providers when no other agency has specific authority, or when an agency defers action. "These look like excellent recommendations," Leslie told Sands.

Lawmakers are using the input at the hearings to decide what steps might be taken by the next Legislature to better protect public health.

Dr. Sidney Wolfe of Public Citizen, an advocacy group begun by Ralph Nader, has long argued that the Nevada medical board engages in "lax discipline of doctors." Wolfe said last week that the Nevada medical board "is paralyzing itself into not taking action."

"There has been more than enough evidence for an emergency suspension," Wolfe said. "If you had to have all your evidence together at the outset, then you would just revoke a license, not suspend it. You have an investigation to determine whether it should be a permanent revocation."

Buckley, D-Las Vegas, can't believe that suspensions can't be handed down.

"If we can't get summary suspensions after what's happened here, when can we?" she said.

Clark said "allegation letters" were sent out about two weeks ago to all the doctors associated with Desai's clinics. They were asked to provide responses within a couple weeks. He said the allegation letters contained questions about physician roles at the clinics "that the doctor's lawyers apparently don't want them to answer."

"They're not really answering the questions," he said of the physician response letters.

Soon, Clark said, another letter will be sent from the board's investigating committee. This time, physicians must answer within five days.

If they don't, Clark said, the board could take disciplinary action, including suspending a physician's license. He said he is sure that if the doctors answer truthfully, some of them could end up with revoked licenses.

Why did the board wait until two weeks ago to try and formally make contact with the physicians?

"I can't answer that," Clark said. "I don't know why. I did try and talk to the doctors' lawyers about them volunteering not to practice," as Desai did. "But that didn't work out."

According to Clark, board president Dr. Javaid Anwar, a longtime friend and business associate of Desai, came to the conclusion that there wasn't enough evidence to summarily suspend Desai's license.

"He (Anwar) came up with the idea of asking him (Desai) to volunteer not to practice and asked me to carry out the negotiations," Clark said.

The board was not notified beforehand of Anwar's idea, Clark said, adding that such an action is legal.

Anwar, who did consulting work for Desai last year, has not returned calls since March 6, the day before the nonbinding promise he and Clark brokered with Desai was announced.

In published reports, Anwar has said that he followed the advice of Christine Guerci, chief deputy attorney general, in securing the promise.

In an April 3 written response to e-mailed questions from the Review-Journal, Guerci said her involvement "was limited to obtaining a written confirmation of the voluntary agreement from Abe Vigil, Dr. Desai's attorney."

The agreement allows Desai to keep his license, leaving the door open for him to practice elsewhere. "But he is a danger to no one in Nevada, because he is not practicing," Clark said.

He acknowledged that Desai can start practicing again in Nevada whenever he wants.

If Desai's license had been suspended, that wouldn't be the case. Suspension information would have been entered in the National Practitioner Data Bank and available to health care organizations and licensing agencies in every state.

"The data bank is there to protect people from bad physicians simply going from state to state," Wolfe said.

Leslie said she is appalled by the board's agreement with Desai, who served on the medical board from 1993 to 2001.

"I think the public was clearly not satisfied with the promise the board extracted from Dr. Desai to stop practicing while the investigation is under way," Leslie said.

"It sounds more like a grand concession or gesture on his part, rather than the board carrying out its duty to protect the public. It seems that the board had to be pushed by the public's outrage to even go that far, further eroding confidence in their ability or motivation to hold the doctors accountable."

Leslie says the state's nursing board has acted more responsibly during the crisis.

So far, six nurse anesthetists who worked at the Shadow Lane facility have surrendered their licenses.

Debra Scott, executive director of the state Board of Nursing, said the regulatory body has interviewed about 20 other registered nurses and licensed vocational nurses who worked at Desai's clinics.

Clark has voiced concerns about what a summary suspension can do to a physician's career.

When such a report is made to the National Practitioner Data Bank, he said, it stays as a "black mark" against a physician for a lifetime, often ensuring that health care organizations won't hire the individual.

But David Bowman, a spokesman for the Health Resources and Services Administration, which oversees the data bank, said it is not uncommon for a report to be voided if an investigation of a physician finds there is no malpractice involved.

If there is just slight culpability in a situation, he said, the report to the data bank is often amended.

When Clark was told of Bowman's remarks, he was surprised. "I didn't know that," he said. Clark also said there is a concern physicians who are suspended from practicing medicine could sue if the board's action is not sustained at a later revocation hearing.

He acknowledged the board has immunity under the law from such complaints.

But, Clark said, "people can still name you in a suit, and it really bothers you," adding that the state does carry some funds to pay off "nuisance" suits.

Overall, Clark believes his agency will be able to do a better job in the future, because whenever a health care investigation is initiated by the state, the appropriate oversight board immediately will be contacted.

"That will give us a leg up," he said, adding that the medical board didn't learn of the outbreak investigation until the Feb. 27 news conference. "It gave too many people the opportunity to get lawyered up," he said.

Eighth Hepatitis C Case Linked to Medical Clinic

Apr. 27, 2008 Las Vegas Review-Journal

Health officials reported last week an eighth case of acute hepatitis C was linked to a Las Vegas endoscopy center, and that thousands more might have been exposed to that and other blood-borne diseases.

Brian Labus, the Southern Nevada Health District's senior epidemiologist, said the latest acute hepatitis C case was linked to the Endoscopy Center of Southern Nevada's clinic at 700 Shadow Lane. The patient underwent a procedure at the facility in June 2005 and developed symptoms within nine weeks, Labus said.

The case was never reported to the health district, as required under state law.

The Shadow Lane facility is at the center of the health crisis, which caused officials to send warnings to 40,000 people to be tested for hepatitis strains and HIV.

Labus informed the health district board that thousands more patients who might have been exposed to blood-borne diseases during medical procedures at the clinic have yet to be warned they're at risk. Some 10,000 patients have not been notified, because clinic staff didn't give their names to investigators.

"The clinic told us that they had given us a complete list. Obviously, that wasn't true,'' Labus said Thursday. "Why? I can't answer that.''

Suspend Doctors

By PAUL HARASIM and ANNETTE WELLS REVIEW-JOURNAL

The Nevada Board of Medical Examiners should summarily suspend the licenses of Las Vegas physicians associated with the valley's hepatitis C outbreak and appoint a special counsel to independently investigate the doctors, two lawmakers told Gov. Jim Gibbons in a letter Friday.

In the two-page letter, Assemblywoman Sheila Leslie, D-Reno, and State Sen. Steven Horsford, D-Las Vegas, said what's needed is a "thorough, complete and independent investigation into the conduct" of 14 physicians who worked at the Endoscopy Center of Southern Nevada.

Health officials have linked the Shadow Lane facility to seven cases of hepatitis C and have notified some 40,000 patients to be tested for blood-borne diseases.

The results of the special counsel's investigation, the lawmakers said, should be given to the Board of Medical Examiners, which has been conducting its own investigation into the physicians. In addition, "to the extent permitted by law," findings should also be reported and provided to Gibbons and the Legislative Committee on Health Care.

That committee, which includes Horsford, is chaired by Leslie.

"This is an indication that we have lost confidence both in the board's motivation and ability to conduct the investigation," Leslie said in an interview. "We have heard a lot of excuses for not taking action. I have lost my patience."

The special counsel would not have any power to take action independent of the medical board, but the lawmakers want the investigation to ensure that nothing goes unnoticed.

Ben Kieckhefer, Gibbons' press secretary, said Friday that Gibbons read the letter and has inquired into whether he has legal authority to appoint a special counsel.

"The governor has been active in encouraging the medical board to take strong action, and to do so quickly," Kieckhefer said. "He's been on record about that and his feelings haven't changed."

Tony Clark, executive director of the medical board, said that although neither he nor his staff believes there is any evidence to support summary suspensions of doctors, the board is working with Attorney General Catherine Cortez Masto to take legal action against some physicians who performed procedures at the Shadow Lane facility.

He declined to elaborate on what that action might be, but did say it will not take the form of summary suspensions.

"I can tell you that we're not just sitting around not doing anything," he said.

The culpability of physicians, who have not acknowledged wrongdoing, in the current crisis is unclear.

When the city of Las Vegas revoked the business licenses of Dr. Dipak Desai's endoscopy clinics, the head of the licensing division said health care investigators learned that some doctors had ordered nurses to reuse syringes and single dose vials of anesthesia.

Horsford said the goal behind Friday's requests is to be more responsive to the public than the medical board has been.

He noted that it has been more than eight weeks since state public health officials announced a cluster of six hepatitis C cases. Authorities more recently linked another acute case of hepatitis C to the Shadow Lane facility and one to a sister clinic on Burnham Avenue.

"Having the governor appoint special counsel elevates the importance of this issue," Horsford said. "We need to hold those people who are responsible, accountable. Also, we need to determine if there are doctors under investigation who did not put any patients in harm's way to allow them to move forward and away from this cloud of suspicion over their medical practices."

Adding to lawmakers' sense of urgency were issues raised at a Monday meeting of the Legislative Committee on Health Care and the Southern Nevada Health District's announcement Thursday that 10,000 additional patients need to get tested for hepatitis and HIV.

"Every day that the board fails to act, more evidence comes forward, and we learn that more patients could have been put in harm's way," Horsford said. "People want to know action is being taken. Should there be due process? Absolutely. But more should be done to ensure public confidence."

Don Havins, chief executive officer of the Clark County Medical Society, called the lawmakers' request "an unprecedented action.''

"It certainly puts the Board of Medical Examiners on notice that the legislative commission is not satisfied with its actions to date,'' he said. "I think the governor should look at all options in addressing this public health concern.''

Horsford said lawmakers have learned from public health officials that six of the physicians working within Desai's consulting practice are still practicing in Nevada. It is still unclear where, however. Desai has told the medical board that he would temporarily stop practicing medicine.

In addition to Desai, 13 other doctors were listed on the Gastroenterology Center of Nevada's Web site at the time state licensing officials performed their inspections: Eladio Carrera, Clifford Carrol, Vishvinder Sharma, Dipesh Banker, Snehai Desai, Frank Faris, Carmelo Herrero, David Manuel, Albert Mason, Ranadev Mukherjee, Sanjay Nayyar, Shahid Wahid and Nicolae Weisz.

Herrero and Mason have an office together -- South Hill Gastroenterology at 2625 Wigwam Parkway -- where they are evaluating patients but not doing procedures.

Other former associates of Desai are planning to open offices in the Las Vegas Valley.

According to documents on file with the Nevada secretary of state, Banker, Snehal Desai, Mukherjee and Wahid have formed a medical company known as Digestive Associates LLP in North Las Vegas. Yet to open, it will be at 2031 McDaniel St., near North Vista Hospital.

County's Hands Tied in Endoscopy Clinic Case

By SCOTT WYLAND REVIEW-JOURNAL More Info

* Hepatitis C Investigation

As much as Clark County leaders might want to punish clinics in their territory for shoddy medical practices, they are handcuffed by a century-old law designed to curb local authority.

Dillon's Rule, enacted at the turn of the 20th century, gave state lawmakers overriding power over local governments as a way to suppress corrupt political machines.

The law prevents the county from meting out penalties that are not outlined in the state statutes. That would include imposing fines on the four clinics in its jurisdiction the way the city of Las Vegas slapped a $500,000 fine on the Endoscopy Center of Nevada after it was found to be reusing syringes and single-dose vials of medication.

Eight cases of hepatitis C have been linked to the center and an affiliated clinic. Officials are wrestling with how to better respond to similar situations should they arise, and lawmakers have criticized state medical regulatory officials for not acting more forcefully against the clinics.

The city, unlike the county, has a charter that gives it more autonomy within its borders, including the power to devise punishments without the state's say-so.

"It's less confusing for a city because they do have a charter," said Sabra Smith-Newby, the county's director of administrative services and its head lobbyist.

By contrast, counties are subdivisions of the state, putting them directly under the state's authority, Smith-Newby said.

So strict is Dillon's Rule that lawmakers had to grant the county permission to change a code so that it could tow abandoned vehicles from public property, she said. The code specified that the county could tow vehicles from private property.

If the county wants to fine the clinics, it would have to submit a bill to the state Legislature in September and wait until next year's session before it's considered, Smith-Newby said.

County commissioners must decide how much of a priority it is to punish clinics, given that each county can introduce only four bills to the Legislature, she said. Each county once could sponsor 15 bills per session.

Last session, the county floated a bill that would have created a code for penalizing companies that violated the terms of their business licenses, Smith-Newby said, but lawmakers rejected it. Had it passed, the county could have fined the clinics, she said.

The county has restricted the four clinics in its jurisdiction to offering consultations to patients. No invasive procedures are allowed. Three of the clinics have voluntarily shut down.

Allowing the city, but not the county, to fine an errant clinic is a double standard that underlines the need to loosen the state's leash, said Jeff Fontaine, executive director of the Nevada Association of Counties.

"It's a consistency issue," Fontaine said. "What difference does it make if it (a clinic) is in the city or the county?"

A problem in Nevada is that lawmakers meet every two years, forcing counties to put important proposals on hold for 18-plus months, he said.

A law that hinders the county in the face of a public health threat might draw attention to the need for greater home rule, Fontaine said. "This is a salient example of where home rule would have made a difference," he said.

However, even a health crisis of this magnitude isn't likely to budge such an entrenched set of limits, especially on Clark County, said David Damore, political science professor at the University of Nevada, Las Vegas.

Lawmakers from the rural areas would resist giving any more power to Clark County, for fear that the state's largest county could break loose and run roughshod over the smaller ones, Damore said.

"This is the county that has the most to gain by having more autonomy," he said.

However, Commissioner Rory Reid said lawmakers are usually open to requests for tougher codes and penalties if the county can show a pressing need. Conversely, they are more likely to deny a request from the county to broaden its authority if there's no specific problem to fix, he said.

Reid said he's fairly certain that the Legislature would be receptive to a bill that punishes an entity for imperiling the public. He said he will push for the county to sponsor such a bill.

As for Dillon's Rule?

"I don't think it's been that much of a problem," Reid said. "It's the classic tension between state and local governments."

Debate, Investigation Continues in Nevada's hepatitis C Outbreak

Associated Press - April 21, 2008 6:35 PM ET

CARSON CITY, Nev. (AP) - Authorities are moving ahead with a criminal investigation into health care crisis that resulted in eight cases of hepatitis C contracted by patients treated at two southern Nevada clinics.

The probe has been slowed by the seizure of more than 2,000 boxes of medical records of more than 100,000 patients at several clinics, but a Las Vegas Metropolitan Police captain said the seizure was needed because of concern that records might be destroyed.

Capt. Al Salinas told the Legislative Committee on Health Care that a "very active" criminal investigation is under way into the hepatitis outbreak linked to unsafe medical procedures. Agencies involved include his department, the FBI, state attorney general, Clark County district attorney and public health agencies.

The legislative panel, meeting in Las Vegas and Carson City, was told by Lawrence Sands, chief health officer for the Southern Nevada Health District, that the reported hepatitis A cases include seven at a Las Vegas endoscopy center headed by Dr. Dipak Desai.

The eighth case was at another endoscopy clinic also headed by Desai, who had several Las Vegas-area outpatient clinics. The two clinics have surrendered business licenses and paid a total of $500,000 in fines.

State Health Committee Tackles Hepatitis Outbreak

Melissa Duran, Reporter Las Vegas Now Updated: April 21, 2008 08:15 PM

State lawmakers are working to make sure the valley is not faced with another health crisis like the one currently effecting Las Vegas.

The state hearing took all day and in the end, lawmakers left with several ideas on how to make sure the public's health is no longer put at risk. These ideas are for lawmakers to work with, no change in law can happen until the next legislative session.

"Your problem is not that you don't have the laws, you have the laws, the problem is the board itself and how you get on it and, until you solve that problem, you are going to continue to have this problem," said Dr. James Tate.

Tate was one of a few valley residents who showed up for public comment at today's meeting.

Lawmakers say they want to get ideas on how to fix the current health system. They say the deeper this problem gets, the more problems they find.

The Southern Nevada Health District had a few recommendations. They told the committee they want to have the power to temporarily shut down a facility if they feel public health is being put at risk.

They also want to see stronger lines of communication between health agencies and medical boards.

In addition, lawmakers say the health division's Bureau of Licensure and Certification, which regulates facilities like the Endoscopy Center of Southern Nevada, needs a complete overhaul.

"We're looking at inspections, how boards function and the ongoing education of our professionals. So it's not an easy problem to solve, but we have to do it in order to get the public confidence back," said health committee chair Assemblywoman Sheila Leslie.

Metro also spoke before the committee saying their criminal investigation into the clinics is ongoing. By the end of the week, they also hope to have hired a company to organize the thousands of files they seized from the clinics as part of evidence.

Metro says the cost of hiring a company to come in and organize the patient files will be at least $400,000.

Doctors Associated With Hep Scare Open New Clinic

Adrienne Augustus, Reporter April 17, 2008 08:06 PM

Two of the doctors associated with the Endoscopy Center of Southern Nevada have now opened their own office in Henderson. Doctors Albert Mason and Carmelo Herrero got their business license for South Hills Gastroenterology Wednesday.

The two physicians were partners with Dr. Dipak Desai, who owned the Endoscopy Center of Southern Nevada.

A city official said it was their understanding the two physicians never performed procedures at the Endoscopy Center offices, but they have information saying that may not be true and they are planning to investigate.

40,000 people may have been exposed to hepatitis and HIV because staff at the Endoscopy Center reused syringes and vials over a four year period. Six people are thought to have contracted hepatitis C.

A Henderson city official says Doctors Herrero and Mason don't plan on doing any procedures at their new office.

Nevada lawmakers are being told harsher fines, tougher inspections and better communication among regulatory agencies are needed in the wake of the hepatitis crisis. Mandatory accreditation of ambulatory facilities might be required as well.

The ideas came up during a legislative commission meeting.

Currently, the accreditation of ambulatory surgery centers is voluntary. Of the 50 ambulatory surgery centers in Nevada, 32 are accredited. Federal guidelines call for them to be inspected every six years, but some hadn't been visited by a state inspector for more than 15.

This Saturday, the Southern Nevada Health District will hold a community forum to answer the public questions about hepatitis C. It will take place at the health district at 625 Shadow Lane.

There will be a number of speakers and opportunities for questions and answers in the two sessions. The hepatitis C community forum is free and open to public.

Metro Says Investigation Hampered by Health District

Reporter Aaron Drawhorn Las Vegas Now April 22, 2008

The criminal investigation into the hepatitis C crisis has hit a roadblock and Metro says the health district is at fault.

That accusation comes as the health district confirms another case of hepatitis C linked to the clinics said to have reused syringes and vials on patients. There are now 8 hepatitis cases linked to the clinics run by Doctor Dipak Desai.

Many showed up Monday to get the latest on the investigation and they learned their medial records are still not ready. In a letter to the health district and to city and county leaders, Metro says they are now three weeks behind in getting 1,400 patient requests filled.

Police seized 2,000 boxes of medical records from clinics, like the Endoscopy Center more than a month ago. Sorting through all that paperwork continues to be a long process, but police push on.

"It's been difficult, to say the least," said Capt. Al Salinas.

When police started seizing medical files in the wake of the hepatitis scare, they got more than they bargained for -- some 100,000 medical files, all now evidence.

"Rather than see those files altered or destroyed, we felt it necessary to take possession of them, to safeguard them, and of course, they are part of our criminal investigation," said Capt. Salinas.

But managing those files and patients requests for records has not been easy.

"This is very costly. Funding is an issue, but the sheriff has made the decision to move forward with this," said Salinas.

Meantime, Eyewitness News has learned Sheriff Doug Gillespie even fired off a letter expressing Metro's frustration with the health district when it comes to dealing with these records.

That letter has not been made available to the public yet.

Bottom line, Metro, not the health district as first thought, will now contract with a company to organize these seized files.

"In researching the legal issues that are tied to this, because we are looking at protected patient information, we did determine that we just didn't have the legal authority to actually take on possession or liability for these records," said Jennifer Sizemore with the Southern Nevada Health District.

Metro testified before a legislature committee that the delay in indexing the records has been long. Delay or not, the criminal investigation is still on.

"The primary charge that we're looking at right now is criminal neglect of patient," said Clark County District Attorney David Roger. "Who knows how many people who may have suffered some harm as a result of the alleged conduct?"

Police hope to have a contract with this medical records company by week's end. The goal is to have all of the medical records indexed in 30 days. So far, only 50 records have been released to patients.

County Manager Virginia Valentine reacted to the pending contract with the medical records company. "For the people affected, this can't happen soon enough. We certainly wish that this could have been addressed sooner. And we still believe the health district is the proper agency to enter into this contract," Valentine said in a statement to Eyewitness News.

"The health district is the agency with the regional authority and jurisdiction on health issues that affect this community. The cities and county have exercised the full extent of their authority in closing the clinics. This may be new territory for them, but I would hope they could fulfill this role to address the health records issue," said Valentine.

Reporter Aaron Drawhorn

Eighth Case of Hepatitis C Reported in Las Vegas Medical Scare

April 21, 2008 11:04 AM Channel 4 KRNV.com

Public health officials said Monday they've identified an eighth case of hepatitis C involving a patient at a Las Vegas endoscopy center named as the source of other recent cases of the potentially fatal liver disease.

The Southern Nevada Health District says the patient underwent a procedure in June 2005 at the Endoscopy Center of Southern Nevada and developed symptoms of acute hepatitis C nine weeks later. The patient had no other reported risk factors for the illness and has since recovered, officials said.

The Nevada state Legislative Committee on Health Care is holding hearings Monday in Las Vegas about unsafe injection practices that led to a hepatitis C outbreak among patients at several Las Vegas-area outpatient clinics formerly headed by Dr. Dipak Desai.

Health administrators have advised tens of thousands of former patients at the clinics to be checked for exposure to hepatitis strains C, B and HIV.