Clinics pay up, avoid facing angry patients

By Joe Schoenmann (contact)

Tuesday, April 8, 2008 | 2 a.m.

There were no beads of sweat from twitchy witnesses. No one was sworn in only to take the Fifth to avoid self-incrimination. And there were no tough questions from accusatory lawyers, no grandstanding by politicians.

And that left Kevin Rexford, one of many hoping to see that and much more, “less than satisfied” with Monday’s special Las Vegas City Council meeting to bore into the allegations against the Endoscopy Center of Southern Nevada and its affiliated medical practice, the Gastroenterology Center of Nevada.

Health officials say the Endoscopy Center infected six people with hepatitis C and warned 40,000 to be tested for blood-borne diseases.

Rexford has incurable colon cancer, discovered in 2005 after a trip to the Endoscopy Center. And though he settled a lawsuit against the center for an undisclosed amount recently, viewing the roughly half-hour meeting Monday afternoon still made his “stomach turn.”

“I don’t think they were held to task,” said Rexford, 46.

In the end, the clinics forked over $500,000 and had their licenses permanently revoked.

To Rexford and others, that was not nearly enough. To some, it looked as if the city had cut a deal that allowed the doctors who own and operated the clinics to avoid a public grilling. And with that lost opportunity went any chance to get quick answers about allegations that nurses at the clinics were ordered to reuse syringes and single-patient vials of medication to cut costs and boost profits — potentially exposing patients to fatal diseases in the process.

City leaders said privately, however, that they played their hand as well as possible. The major figure in the controversy — Dr. Dipak Desai, majority owner of the Endoscopy Center and founder of the Gastroenterology Center — was not expected to attend, and other central characters also were likely to skip the hearing because of the lack of legal clout behind the city’s request for them to testify.

So Monday’s hearing could have played out with little more than an unused microphone at the witness table and some predictable grumbling from council members. As it was, the city at least walked away with the clinics’ permanent closure and a half-million dollars — admittedly at the price of delaying crucial answers until later, perhaps much later.

Rexford wished the city had found a way to force the doctors to be there, in person, for the hearing, for the turning over of the money, for the stares they would have gotten from the 80 or so people gathered in the City Council chambers to watch.

“Face the consequences, instead of letting their legal team do it,” Rexford said.

As it was, those 80 people — including six Metro Police officers, six people with video cameras, two still photographers and a few city staff members — saw a meeting that began and ended with barely a whimper.

Mayor Oscar Goodman began the 1 p.m. session recounting how the meeting came to be. After health officials’ announcement of the potential problems at the clinics, the city moved quickly and suspended the licenses of both facilities.

The City Council had set Monday’s hearing in March as a way to get to the facts of the case, the mayor said. Doctors of the clinic were subpoenaed — albeit with subpoenas that could compel their appearance only if later endorsed by a District Court judge.

Still, the city had the right to permanently revoke business licenses and impose fines of up to $1,000 per day for each day the clinics had been found negligent. On a complaint filed against the clinics, the city determined the total number of days to be about 1,400.

That’s a potential fine of roughly $1.4 million.

The thing is, City Attorney Brad Jerbic said after the meeting, leveling fines and collecting them are two different things.

“We fined Crazy Horse Too more than $2 million and still haven’t collected a dime,” he said of a 2006 City Council action against the now-closed strip club.

Money is one thing, but reputations can mean much more to others. Goodman told the Sun in late March that he wanted the city to “lead by example on this one.”

“I’ll be fair, but I’ll be very stern,” he said then. “I just feel that health care has to be scrupulously examined by the regulatory bodies.”

But before Monday’s meeting, Goodman received a call from attorneys representing the accused clinics.

“(They) wanted to know what it would take to avoid a full and complete hearing on this, and what did we want in addition to the license,” he said at Monday’s meeting.

The mayor recommended a $500,000 fine. The clinics agreed. Two checks for $250,000 each were turned over to city Finance Director Mark Vincent during Monday’s meeting.

The city plans to use the money in some way to help the alleged clinic victims. Goodman said it could be spent to offset the cost of blood tests to determine whether the 40,000 people advised to be tested for hepatitis B, hepatitis C and HIV after six endoscopy center patients were found to have hepatitis C.

Goodman also mentioned that it would cost an estimated $500,000 to hire an outside business to organize medical records Metro Police confiscated from the clinic.

That was the highlight of the hearing.

William Henry, senior litigation counsel for the city attorney, went over some detailed information about the case, mentioning witnesses he would have called during a full-blown hearing. A few residents spoke, one of whom said he had a disease and that he had gone to one of the clinics, but not in the time frame being investigated.

Then the room emptied.

Rexford watched. Then he went about his life — his survival.

“I like the fact that they are probably not going to be doing business in Las Vegas again,” he said of doctors associated with the clinics. “I also feel it was a pretty small sacrifice. I think they should have demanded they appear and face the consequences.”

He sighed, then added: “This whole thing, it sickens me every time I think about it.”