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twitterOfficials: Clinic procedures put thousands at risk
Headed by a prominent Nevada doctor, its flawed care may have spread hepatitis
Thursday, Feb. 28, 2008 | 2 a.m.
Sun Archives
The medical director and majority owner of the Endoscopy Center of Southern Nevada, where apparent negligence has triggered the largest hepatitis C scare in Nevada history, is one of the state’s most prominent physicians.
He is Dr. Dipak Desai, a former member of the Nevada Board of Medical Examiners who has served as chief of gastroenterology at local hospitals and taught at the University of Nevada School of Medicine.
Desai was not present when the Southern Nevada Health District announced during a news conference Wednesday that his staff members had contaminated patients with the blood of others.
Health officials said the staff commonly used the same syringe more than once on a single patient while administering anesthesia and used single-dose vials of medicine on more than one patient.
This flawed process could allow a virus from the first patient to contaminate the vial and then be transferred to another patient who received medicine from the same vial.
At the news conference to notify patients of the risks, Desai’s business was represented by three doctors and a public relations expert.
More about Hepatitis
Hepatitis is an inflammation of the liver. Several different viruses cause viral hepatitis. Hepatitis C and Hepatitis B viruses are the two concerning Las Vegas and state health officials.
Hepatitis C: This virus is spread through contact with infected blood. Less commonly, it can also be transmitted through sexual contact and childbirth.There is no vaccine for hepatitis C. The only way to prevent the disease is to reduce the risk of exposure through infected needles, or sharing personal items such as toothbrushes, razors and nail clippers with an infected person.
Hepatitis B: This virus is spread through contact with infected blood. There is a vaccine for hepatitis B. Persons infected with acute hepatitis B usually recover on their own. Very severe cases can be treated withlamivudine.
HIV: Stands for human immunodeficiency virus, which weakens the body's immune system. The virus may pass from one person to another when infected blood, semen or vaginal secretions come in contact with an uninfected person's broken skin or mucous membranes, including the mouth, eyes, nose, or other body cavities. An infected pregnant woman can pass HIV to her unborn baby during pregnancy, delivery or through breast-feeding. HIV destroys a certain kind of blood cell (CD4+ T cells), which weakens the human immune system and can lead to AIDS, which stands for acquired immune deficiency syndrome.
Sources: The National Institutes of Health
Desai did not respond to the Sun’s request for comment. The question that would have been asked of him: How, in the era of AIDS and extreme concern about contamination of patients through the use of needles and syringes, could his employees have allowed the transgressions that will now require that 40,000 patients be notified that they should be tested for hepatitis C, hepatitis B and HIV, the virus that causes AIDS.
Patients are most at risk of hepatitis C, officials said, a disease that presents symptoms in only about 20 percent of the people infected. The symptoms include nausea, jaundice and vomiting, and may lead to cirrhosis of the liver or liver cancer, even if no symptoms are present.
Patients who have been given anesthetic at the Endoscopy Center from March 2004 are at risk. Hepatitis C can linger in a body for years undetected. The flawed practices have been corrected, officials say.
The outbreak came to light when three cases of acute hepatitis C were reported to the Health District in January, and through an investigation the district found three others. Typically only two cases of the disease are reported to the Health District a year.
Each of the six patients had procedures done at the Endoscopy Center.
The investigation, conducted by the Southern Nevada Health District and the Nevada Licensure and Certification Bureau, did not determine why workers at the Endoscopy Center were reusing the single-dose vials. But the practice was widespread, said Brian Labus, senior epidemiologist of the Health District.
“It was one of those policies where the staff members told us this was what they were told to do — they admitted this is what (they) have been doing,” Labus said. “It wasn’t any one particular staff member. It was something that was basically seen across the clinic as a common procedure.”
The sloppy practice has been reported in other states, officials said, but the patient notification effort that began Wednesday is the largest of its type in the nation.
Desai is board certified in gastroenterology and internal medicine. A medical graduate of Gujarat University in his native India, he has served as chief of gastroenterology for both University Medical Center and Valley Hospital Medical Center in Las Vegas.
In Desai’s absence, another doctor from his practice, which sees about 60 patients a day, read a statement that said, in part: “We are on a mission to maintain the trust our patients have had in us.” Two doctors stood beside him, silent. Their lawyers would not allow them to answer questions, the statement said.
Desai also founded the Gastroenterology Center of Nevada, which has six locations and shares an office at 700 Shadow Lane with the Endoscopy Center of Southern Nevada. In 1996, the state alleged Desai was advertising the practice of medicine in a false, deceptive or misleading manner by falsely stating that members of his medical group were board certified gastroenterologists. He agreed to pay a $2,500 fine.
Lisa Jones, bureau chief of the Licensure and Certification Bureau, said the findings announced Wednesday were severe enough that authorities would have closed the business if they had not been corrected immediately.
The state can fine the Endoscopy Center a maximum of $1,000 for each of three types of violations, Jones said, but licensing agencies such as the Board of Medical Examiners and the Nevada State Board of Nursing could investigate the problems to penalize the various providers.
In a finding unrelated to the hepatitis C outbreak, the Licensure and Certification Bureau found that technicians were not discarding cleaning solution after cleaning each endoscope, nor were they adding the proper amount of detergent.
Sun reporters Steve Kanigher and Mary Manning contributed to this story.
Discussion: 34 comments so far…
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I can't believe that the people involved (management and employees) haven't been arrested for attempted murder. If the employees were instructed to re-use medical devices,they should have said no. (If my boss asked me to burn down our building, I would be guilty of a crime if i did so.)
Noone could be so STUPID as to re-use a device. This is obviously a result of our flawed for profit medical system. Private health care for profit does not work and is dangerous. Can you imagine if we had private police, fire departments, or military?
I repeat it again. Arrest everyone that knew or participated in this potential tragedy. And close the center. This is fraud and attempted murder.
(BY THE WAY, I have a friend that is one of the 40,000 that has to be tested. Their entire family is a wreck.)
I agree 100 percent with tvangrove--every employee that participated in this unethical and dangerous cost-savings mandate should serve time in jail.
I think we established at Nuremberg that committing a criminal act under non-negotiable orders is still a punishable crime.
How can so many people be so moronic as to follow these ridiculous orders? I cannot even begin to grasp what was going through these people's heads.
In the year 2008, it is unacceptable for something like this to occur. We all know better and anyone working in the medical profession should especially know better.
Lock them all away.
Amen to that one. My Aunt is one of those people, and if that isn't bad enough, they screwed up a surgery on her almost 2 years ago, by perforating her bowel by accident. So it required a colostomy bag, then a reversal of that procedure to put everything back to normal, now for the rest of her life she will have to worry about this. And let me add she was never compensated in any way for the error of butchering her during surgery. I would like to hear from an attorney who is interested in speaking to my aunt and uncle. I am thoroughly appalled and disgusted.
I would like to know what the Nevada Medical Board plans to do about this. Will the doctor be allowed to get away with this because he was a former Board member? My heart goes out to those who now have to live in fear. I agree, this is attempted murder and medical malpractice cases should be filed for policy limits for each and every physician involved.
The Nevada Medical Board need to take their licenses away, and the District Attorney's office should hand down indictments against these doctors at this Endoscopy Center.
I am one of those that has been terrorized by these people. Having had a procedure last spring at this facility, now I'm at risk and am in awe that this facility is still open. HOW CAN THIS BE? I don't care if they have changed their practices. They are not professional medical care givers and should not be able to endanger any more people. This is ridiculous. I am now waiting for my test results with such anxiety I can barely breathe. No one should be able to practice such dangerous and unprofessional procedures let alone that they are illegal. They should be held accountable in every way for all of us that have been exposed!
I am one of the patients. He will pay for his lack of supervision, or his greed to save a few bucks. I will be watching for the first attorney that solicits patients for a lawsuit.
This is really unbelievable. It makes Vegas look like a 3rd world country medical wise.
They need to pull this clown's license. He can't even teach his staff but he is going to teach new doctors?
To all the patients out there...
I would like to get everyone together on this issue.
My Aunt is affected, as well as the rest of you.
If all of you join together, numbers speak loudly.
If you are interested in doing something about this, please contact me, start talking with each other, and make your voices heard!
Keep the comments coming please, victims or not!
More voices need to be heard.
Keep this issue on the front pages.
When Non-anesthesiologists administer "Conscious Sedation", there are inherently more risks to the patients. This is one example. Many Insurance companies will pay for an anesthesiologist for even screening colonoscopies, and those that don't should be urged strongly to do so.
When it comes to your safety, a board-certified anesthesiologist (with more than 8 years of training in medicine, pharmacology and anesthesiology) is better-qualified to oversee the sedation of patients.
Office-based sedation is overseen by the Physician doing the procedure,who instructs a nurse on which drugs to give and how much. This means the physician's attention is divided. He bears the burden of having to deal with unexpected reactions to the medications, decreased oxygen levels, with minimal training on how to do this.
The incentive for the Physician is that they not only bill for the procedure itself, but also bill for the sedation...many Physicians also receive up to 4 TIMES MORE for doing procedures in the office than in a surgery center or hospital!!!Talk about incentive!
This is a terrible tragedy, caused by inattention to detail, because the staff were not focused on the sedation nearly as much as the procedure being performed itself...
I'd like to know if the Center is paying for the testing for these 40,000 patients. I don't imagine that these tests are free and it doesn't seem right that individuals who are at risk through no fault of their own should have to pay for their tests.
Good question, I would bet not.
Well, I am a 25 mother of two little ones. I had to have a procedure there a in 2006. I now may never get to see my children grow up because of these dumb ***holes. Let me say this if I am one that is inffected they are coming down with me. This is not a threat but a promise. I had to pay for my testing they did not even offer. They give you a number to call but was busy for 5 hours. I then gave up!!! please pray for me!!! My family and I need it!!! I am thinking of starting a meeting or group so we can all get together If anyone is intrested please let me know.
Im a Viet Nam era vet and they tried to kill me too...someone let me know which lawyers are acting on this please email me at petethehook@yahoo.com
thanks
Of course the GREEDY doctor,in pursuit of MONEY, has possibly exposed 40000+ people to serious/deadly pathogens. He and his staff NEED to go to prison....They KNOWINGLY perpetrated these crimes and defrauded the patients...He needs his license revoked PERMANENTLY...of course he'll get a high priced lawyer and get off and his staff will do time..That is how it works....He better have lots of insurance coverage because the lawsuits are coming! And rightfully so: this MONSTER purposely mistreated his patients who trusted him and his staff to render proper medical treatment... He better be prepared for the onslaught..And when the center says it has ceased these practices I wouldn't believe him for one second...He's a psychopath/sociopath!!! The sleazy,corrupt,immoral scum bag should rot in prison!!!
I was one of the ones who went there for my tests. I actually had an appointment with my GP this morning, set up before this hit the news, and she got me lined up for the tests on Monday morning. She was very nice about everything and even told me that the chances are small, but I should still get tested. She also told me that now Quest, where you can get tested will be open on the weekends to deal with the blood tests to make sure everyone has the chance to get the work done. Also I learned while at the doc, I overheard the receptionist tell someone that letters would be sent out to people who may have been infected that they need to get tested. I recommond going directly to your GP and have them get you the referral for the blood work.
If anyone knows of any class action suits going on this please let us know so we can all go after the Son of a BXXCH who did this to us.
Good luck to all of us
I am still following this closely, and I will pray for all of you.
Keep speaking out, these people MUST be held responsible for what they have done to each of you and your families. Start writing, collect signatures, do whatever you can to make your local authorities take notice of this violations of your rights. Make enough noise about this your politicians will have to do what is right.
Greed on this level should be criminal.
Why can't Las Vegas get any real doctor's?
Why do we get all the rejects kicked out of other jurisdictions?
As one of the 40,000 at risk, I would like to say this is absolutely inexcusable. Everyone involved should be held criminally liable. It is unbeleivable something like this could happen in America in this day and age. For what? the mighty dollar. Cut costs by reusing vials...I'm sure that adds up to at least a new swimming pool and vacation for the fat cats who view their patients as cattle. For those who don't already know, this is the clinic of referal for military and military retirees for procedures of this nature. It is incomprehensible I endure 20 years of service inlcuding 7 years in a combat zone only to have my life jeopardized within months of retirement by the lowest chop shop bidder. Someone should be doing prison time. Good luck to all of us affected and our families.
I know several people just from work and two of my family members have been exposed. It makes me sick to my stomach. I myself being in the medical profession this is just plain common sense. It's always about patient safety. This is not just a pay check these are people's lives you are dealing with. Error happens but in this case it's plain negligence. 40,000 people I believe this number and for several years, give me a break and noone stood up for what is right? Most people with a carrier in the medical field have more than one job. If this is there practice in this institutions they could have done this in there other job. The public should have a right to know these people's names. They should all have there licenses suspended, have this clinic shut down for good, have this owner's other clinic investigated and watched closely, and he should pay for everyone's lab work. While he's worried about losing his mansion and his nice car everyone else is worried about there lives. My prayers for everyone that's going thru this right now.
My mother refused to see doctors in Las Vegas for over 30 years - always traveling to Santa Barbara for any illness or checkup. She finally gets up the nerve to start seeing LV doctors and what does she get for her trouble - heartache and an appointment to have bloodtests done thanks to her visit to Shadow Lane's house of horrors.
As others have said, this is criminal. We aren't talking some minimum wage tech making mistakes, but a blatant failure from the top down. Trained and board certified physicians cutting corners to save a buck on a half empty vial, not to mention the second allegation of improper cleaning of the endoscopic equipment. How much do you think they saved over the years? Tragic. I hope this company and these doctors are ruined.
Thank you Mayor Goodman for finally shutting the clinic down on Shadow Lane. That butcher DeSai needs to be criminally charged and have his license to practice medicine taken away. He's nothing but a money hungry ingrate with no regard for patient care. Three years ago he killed my father-in-law after perforating his bowel and now my husband is waiting for his blood test result after having had a colonoscopy done at DeSai's clinic last year. I only hope DeSai rots in jail.
What has happened in this setting is incomprehensible. I am a registered nurse who works at an endoscopy center in another state. While it is unclear from the information whether this center used anesthesiologists to administer anesthesia or if it used registered nurses administering concious sedation, narcotic records are in place and the amount of narcotic given to any one patient from a single-dose vial is recorded along with the waste of any unused portion. I find it hard to believe that single-dose vials were used on multiple patients since 2004 and this was never discovered or reported.
That's what brings in the criminal element don't you think?
Lets be realistic...if Mr.Desai uses clean syringes in his clinics(@.15cents a piece) how will he be able to pay the mortgage for his 5 million dollar mansion and have ownership in a Las Vegas bank (Bank of George) and be a director of in an insurance company that insures doctors against malpractice insurance (NEVADA MUTUAL INSURANCE COMPANY, INC.), not to mention his various real estate investments throught The Valley...he wont be able to make enough money !!!
What about the failure of the state officials who were suppose to be surveying and checking regularly on these clinics? Why have they failed
to detect these problems going back 4 or more years? Has corruption been occuring on the state level? Something is very wrong. Recommend a Federal investigation of the state licensing individuals who were suppose to protect the public be started immediately and the Governors office should also investigate these employees.
The Indian medical mafia doctors of Las Vegas are rich and powerful. They have friends in high places. They are beyond the reach of the law. There will be no monetary penalty or meaningful sanction for Dr. Desai. Remember the recent Las Vegas Sun reports about Dr. R.D. Prabhu and the other doctors who abused the J1 visa waiver system ? NOTHING happened to any of them !!!
Money makes the world go around.
Money makes the bad things get passed over.
Money makes the authorities look the other way.
Who suffers?
The poor, the weak, the people with little voices.
Did you know there was a $50,000 cap for medical malpractice in Nevada. This law was put into effect 2 or 3 years ago after doctors petitioned and paid high dollars for legal representation/counseling to get this law passed. Don't let that high dollar payment fool you. That cost saved them not only millions of dollars, but it saved them the requirement and necessity of being mindful and responsible in our health care. This law means that each individual affected by this negligent catastrophy can only recoup $50,000 from each doctor involved in the careless, wreckless greedy manner in which their health was taken from them. How far do you think $50,000 is going to go for these people? They are going to be so ill they will not be able to work for income, they will need very expensive medication, some will even need liver transplants, and some will possibly even die leaving their family with no financial support. What is going to happen to these people?
Attorneys are out here posting. PLEASE PAY ATTENTION. We, "THE PEOPLE" can't just stand by and take or accept the standard of care this law has brought about us. Let's get involved and support these professionals in any attempt to turn this around. Since this law was passed, health care has become outrageously poor and now more aimed at making money than curing the sick. Diagnosis are not being given, true medical investigation is not happening. Patients are repetitively told to come back or just simply have to go back because their illnesses continue. Insurance companies are paying for these repetitive visits and Employers cost for insurance is rising. Not only are patients left to suffer between these visits, but they suffer adverse reaction of the employers. This is only the beginning, its going to get worse if we don't do something. We all appreciate a good doctor, we all believe they should be paid well for their work IF THEY EARN IT, but this law has allowed so many of those that got in the field of medicine for the money to take advantage with no consequence for outright negligence. This $50,000 cap has got to go!
In that same token, attorneys need to take the small medical malpractice cases as well. The reason behind not taking the small cases is also about money. It is not enough money, therefore it is not worth the time. If these cases were brought out, the wrong doers in medical community would have been exposed before it got this bad and the people who over see them would by now have had more of a chance to see that this law is not helping but hurting the public.
This horrid story is no less criminal than holding a gun to a persons head. Desai and every single person involved should be banned for life from having anything to do with the medical "profession" in the United States. Fact, in the long run this is nothing short of a death sentence for several people. Desai should be tried for murder along with his cohorts.
I feel so sorry for the anguish all these patients are going thru right now.
I am still appalled and disgusted. I am still keeping all victims in my thoughts and prayers. Keep talking and speaking out, it is your voices that need to be heard. These victims were VIOLATED. Bottom line. Here are the words of my Aunt whom had a procedure back in 2006:
In her own words, my Aunt faxed this to me today...
"On Wednesday 09-06-06, I went to the Endoscopy Center of Nevada at 700 Shadow Lane for a colonoscopy. Dr. Depak Desai did the procedure. I was sent home in pain after the colonoscopy and through the entire night, I huddled in severe pain. The next day I called the Center and they told me to go in for a belly x ray. I went to the local hospital for all the scans, and they informed me my bowel had been perforated during the procedure. At midnight I was taken by ambulance 65 miles into Las Vegas for emergency surgery, and in the wee hours of the morning a colostomy bag was inserted. I then spent 3 days in ICU, more time in the surgery unit, then on to a rehabilitation hospital. I finally returned home on 09-23-06. I spent a year of pure hell, until another physician was able to reverse the colostomy.
My husband and I contacted the malpractice carriers, and were told sorry, too bad, and also a physician that did not see me gave information, that I believe was inaccurate. Where are the ethics? No attorney would take my case, more I am sorry's, too bad etc. Now that I read all the stories, look at the possible greed involved, and palm greasing, the doctor was very well protected. WHO PROTECTS US, THE VICTIMS, THE PATIENTS. WHO PROTECTS OUR RIGHTS?
Now on top of everything I have gone through, I have to worry about what could have been contracted through more negligence.
I am sorry is not enough this time."
Please people, for yourselves, families, etc., get together, keep the talking, start petitions(both for criminal charges, and financial compensation), the support you are giving each other, the prayers going.
I ... my hands shake so bad as I write this.. I pray for all of you . My mother just called me and told me .. ya know that doctor you took me to in Vegas.. "Oh god " I said.. So, the nurses say it was an " accident?" the doctor wanted to save money? I hope you all sue him ... ya know cuz he saved all that money ya know !!!!! Shame on him ! Shame on him.. how dare he make all of you go through this .. I told my mom she should bill him everytime she goes for blood work. Now listen My husband Firefighter paremedic accidently got poked .. Every 3 months for hep C For ONE YEAR !!!! Dont let this go .. Then its once a year for 3 years after that? Dont let this go . K you guys Keep your chins up. and hang in there.Kingman is my home town... I wont stop till he pays!!!! I gotta lotta time on my hands !!!