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FacebookQuestions on everyone’s mind
Hepatitis scandal raises many issues without ready answers
Steve Marcus
Las Vegas City Councilman Gary Reese, left, and Mayor Oscar Goodman attend a news conference on the decision to revoke the Endoscopy Center of Southern Nevada’s license.
Tue, Mar 4, 2008 (2 a.m.)
Hepatitis Hearing
Sun Archives
- How hepatitis probe led to clinic (3-2-2008)
- City shuts clinic, with harsh words for owners (3-1-2008)
- Hepatitis scare malpractice cases already in works (2-29-2008)
- On death’s door (2-29-2008)
- Large-scale hepatitis alert has no precedent (2-29-2008)
Beyond the Sun
The widespread outrage surrounding the clinic that put 40,000 people at risk of infection with hepatitis B and C and HIV has focused on several questions.
The answers may not satisfy the gut-level cries for justice.
Virtually everyone in Las Vegas knows someone who needs to be tested for infectious diseases because of the injection practices at the Endoscopy Center of Southern Nevada, where improperly shared vials of anesthetic medicine were tainted with patients’ blood and then used on other patients.
Health officials say six patients became infected with hepatitis C, and many more are at risk. So as the story unfolds and thousands of valley residents await the results of blood tests, here are answers to three of the most commonly asked questions.
How long did investigators observe nurses engaging in dangerous injection practices before they stopped them?
It was an unfolding discovery process.
Brian Labus, senior epidemiologist for the Southern Nevada Health District, said that after a day of reviewing charts, investigators on the morning of Jan. 11 began observing the nurses and doctors conducting various procedures, taking note of every step of the process to determine any instance where disease could have been transmitted. They didn’t know exactly what they were looking for.
Among the practices they observed were how the certified nurse anesthetists were using syringes and drawing medicine from the vials. During lunch they discussed among themselves what they saw, and it became clear in hindsight that the injection practices were the probable cause of the outbreak.
After lunch the team ordered the staff to no longer draw anesthetics from a vial with a previously used syringe — which could contain back-flow of a patient’s blood. The staff also was instructed to not share vials among patients because of the fear the anesthetic could be contaminated by the infected blood of previous patients. Later, nurses confirmed to investigators that they had been reusing syringes and vials, saying they’d been doing what they were told to do.
Why did it take so long to alert the public?
The health investigators’ mid-January visit to the clinic lasted about a week, but that was not the end of the probe. Health officials sent to the Centers for Disease Control and Prevention blood samples from clinic employees to make sure they weren’t the source of the outbreak, and samples from the infected patients to determine if the disease could be genetically linked to the clinic.
It took about three weeks to get results, which confirmed the connection between the outbreak and the clinic.
Investigators also made repeated visits to the clinic to examine records, talked to health officials in other states who had to do similar patient notifications, and crafted a letter to patients and literature to inform the public. During that time the clinic was open for business, having corrected the deficiencies.
On Feb. 7 health officials requested a contact list for the clinic’s patients in the past four years so they could be notified of the need to be tested. It took until Feb. 22 to get the mailing list of 40,000 patients from the Endoscopy Center. The announcement came five days later.
The letters were mailed Wednesday and Thursday.
If what has been reported by officials is true, why didn’t any clinic workers blow the whistle on how the clinic was cutting corners — and putting patients at risk — to save money?
Good question. No one from the clinic is answering questions, and health officials did not make motives the focus of their investigation.
But it is clear that if anyone at the Endoscopy Center knowingly endangered patients, they committed a severe breach of medical ethics. State Board of Nursing attorney Fred Olmstead said Nevada law says licensed nurses and certified nurse assistants are obligated to report to the nursing board any wrongdoing at medical facilities. Failure to do so can result in revocation or suspension of nursing licenses or certification, he said.
Larry Matheis, executive director of the Nevada State Medical Association, which represents doctors, said “the first responsibility of every one of them is to patient care.”
The Nursing Board and the Nevada State Medical Board of Examiners are investigating and could revoke licenses, if necessary. Metro Police and the Clark County district attorney’s office are also talking about a criminal investigation.
Sun reporter Steve Kanigher contributed to this report.
Discussion: 17 comments so far…
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The CDC said this is only the tip of the iceberg and they are looking into yet another endoscopy center that used similar unsafe practices. It comes down to this: anyone who has hepatitis and visited those clinics will have a claim against them. The problem is not enough $ to go around for damages and for testing. I only know from experience that those who file first will receive a bigger piece of the pie. My advice: FILE NOW.
Thankfully the Desert Shadow Endoscopy Center has been shut down. Obviously with the same administration, the same dangerous practices occurred there also. It would be negligent at this point to not notify patients exposed at this facility that they also need to be tested. I underwent a colonoscopy at this clinic in Jan. 2007. Just prior I had been hospitalized with diverticulitis and was in extreme pain in the recovery room. A nurse was sent in to speed up my recovery and free up the bed and she pushed, shoved, and rolled me around exacerbating the pain until I could not stand it any more and just said "let me go -- I'll be fine" -- just in an effort to get her to stop. Dr. Desai's name is all over my paperwork. And now to find out they did not even properly cleanse the endoscopy equipment. How can medically trained personnel intentionally inject innocent patients with contaminated vials of drugs knowing they may be injecting a fatal blood borne virus. How did they go home and sleep at night? Why did no one have the integrity to step up to the plate and report these practices as the law requires them to do? Absolutely criminal!! And shocking!! And sickening!!! The "evidence" required for this facility is obvious. Simply because the investigation took place at the Shadow Lane clinic and the investigators "observed" what was being done there -- it would indeed be niave to believe that the Desert Shadow clinic did any different. Sun City Anthem resident
It’s been days since the story broke and I am still angry and in shock over the outright greed and audacity of this group of physician. My thoughts are with the patients and their families at this incredibly stressful time. Although I never worked for this practice, I have worked in the medical profession and am currently a pre-med student. Whether you are a medical assistant, phlebotomist, a nurse or a physician, you are taught explicitly the standards and practices involving the use of these devices and the consequences of failing to follow the proper protocol. The trite, public apology this practice offered was sickening. It was akin to “Oh sorry, my bad.” Their breech of protocol is beyond horrendous. It’s glaringly obvious this practice chose not to use the standard protocols and endangered thousands of people, their families and other health care workers who subsequently might have to treat patients from this practice. In my opinion, the revocation of their licenses will not be enough and hopefully they will face criminal and not just civil charges. To add insult to injury, no department or licensing bureau at the county or state level could take appropriate action soon enough due to funding, personnel or red tape etc. to close this practice even thought the docs from this practice claim they’ve corrected the errors found. It took the revocation of the business license? Well,thank god for that otherwise those greedy dopes would still be seeing patients today. How very sad it is for Clark County residents that the public health or licensing agencies did not have the resources to do this. Frankly,they seem impotent. For a county that hosts people from all over the world and has corporations earning billions we sure suck at being able to handle a public health crisis. Let’s face it folks, Nevada does not have the best reputation in terms of medical care-be it truth or myth-however, this incident does not bolster anyone’s faith in the quality of medical care or governance of such entities in this state.
Unfortunately, those greedy doctors are still seeing patients and making money. They are on the staffs of local hospitals and nothing has been done to terminate their privileges. Their private practices are still open; they are still seeing patients, just not doing endoscopies. Again, where is the Medical Board? These doctors violated the law, committed criminal acts, and the president of the Board stated the Board needed evidence that a doctor was a threat to the public before suspending a license. Perhaps it's time to appoint a new Board.
To patient2008: You're right. Where the hell is the board? And what about the hospitals? They could suspend privilages but perhaps no one seems to have the cajones or they just lack plain old common sense. Does anyone know if the board or the hospitals have been contacted? I can tell you if I were an officer of the hospital I would be extremely concerned these doc are still seeing patients and leaving the hospital open to potential litigation.
I was one of the ones who had the colonoscopy during that time. As of right now I have gotten my HIV test back, NEGATIVE, thank Goodness, still no answer on the hepatitis test, but honestly I can deal with hepatitis, it would be horrible, but not the death sentence that HIV/AIDS is. I can only pray for everyone who might be affected. I also want to know what the board of health and the CDC is going to do when 5000 plus letters come back because people have moved, died, gotten married or divorced and have changed names and unable to be found? So someone who lived here in 2006 had the colonoscopy, got married and moved to Idaho and now has hepatitis or worse, but doesn't hear about this scare and then in 5 years they show up to the doctor wondering why they are sick. What about the people who had the test, died and due to age no autopsy was done and never knew they had hepatitis and still was being a "loving spouse" and the still alive spouse got it and now has remarried, and don't forget the 30 something year old couple who had the test and then found out they are going to have a baby. The couple doesn't want to raise a kid in Vegas and they move to Texas, and etc...
I am sure you get my point. I hope everyone is safe, and all I want is to see these SOB's in jail!
Good points raised pained_girl. I have wondered the same thing, there is no way of knowing truly how many people have been affected. And if this is serious enough to close the several clinics doors, then the medical board should stop them from practicing, pending further investigation at the very least. I would NOT go to any of the doctors who are affiliated with these clinics.
Pained_Girl: It's gpod to hear that your HIV test came back negative. My mother, who had a colonoscopy at the clinic in 2005, is having her tests done today, so, I totally can sympathize with your and others' anxieties while waiting for results.
I do, however, have to comment on a couple of things. HIV is no longer the death sentence it used to be. It is still a horrible, opportunistic disease, but the latest drugs have allowed thousands to live with the disease for many years. In fact, there are some that were infected in the early 80s, who are now in their 60s, and are still healthy.
As for former patients who may have moved away, it is likely that they have heard something about this crisis. This story is so horrific that it has made national news. You'd have to completely be detached from all media - Internet, newspapers, television - to not hear about this. I no longer live in Nevada, but I heard about this on MY local news, and it's being covered in national publications as well (like USA TODAY).
Good luck and many prayers to everyone affected by this clinic's malpractice!
Maybe I'm blind and just didn't see anything more to this but HARSH words to the owners? Are you kidding me? How about jail? For life! I have family that is waiting to hear good or bad news and I live 1400 miles away! I grew up in Henderson and love this place, how sad that when I now talk of it, it isn't good. If my family member tests positive, already with health problems and up there in age? Take a guess! I say everyone of the people that worked at this place be put in front of a judge and jury and be judged accordingly to the crime. If someone dies, because of thier ignorance then sentence them to life!
I had a colonoscopy at Desert Shadow Endoscopy on Jan 10, 2008. With that clinic also being closed down and run by the same doctors, is it not in the best interest of all those treated here to be notified for a blood test as well?
I live right here, moved only once in the past five years... Where's my letter... Procedure was done in 06, checked with SWMA, that where they sent me? Had test done myself, not waiting, by the way, is there a list to double check or not??
Those doctors, nurses, medical technicians,and staff, should each be tied down to an exam table and be given an EGD (the test where they put a tube down your throat) and a colonoscopy, at the same time, without anestecia.
These doctors, nurses, and other staff should be injected with both the hepatitus and HIV virus.
These doctors and nurses should have their medical licenses revoked, effective immediately.
I am 1 of the 40,000 people who may be infected by these Joseph Mengala, Adolf Hitler, Saddam Hussein, Osama Ben Laden wannabes.
Wasn't it the U.S. Supreme Court who deemed (with regard to the death penalty) that death by lethal injection is unconstitutional? So, is it fair that innocent people have to endure the possibility that they may have been given a lethal injection?
Affected as well... I was not the one who recieve the proceedure, but just as much at risk. We moved out of Vegas 5 months ago. We found out just Tuesday about this. Yes, first contact was an attorny. This is such big news, however on the east coast nothing more than a blub on page 8C of the local newspaper. I contacted the Health district here. No one had heard. Several hospitals, same. Getting tested outside of Vegas has proven to be reeally a hassle. Scared yes, Mad...oh yeah! I mean even the dirtiest street junkie knows not to reuse...If you are in contact with people who moved, please share the info. Post it on your webpage, myspace account...etc! Get this news out there. The media isn't.
It really hasn't been publicized much outside of Las Vegas. Yes, I saw the initial reports on Fox news and contacted my mom (a victim of Shadow Lane) immediately. However, none of my friends here in Los Angeles had heard about it. I hope that the letters going out to former patients find their way to everyone at risk. And frankly, I've got to assume patients from ALL of Desai and Vishvinder's clinics are at risk, not just those from Shadow Ln.
It really hasn't been publicized much outside of Las Vegas. Yes, I saw the initial reports on Fox news and contacted my mom (a victim of Shadow Lane) immediately. However, none of my friends here in Los Angeles had heard about it. I hope that the letters going out to former patients find their way to everyone at risk. And frankly, I've got to assume patients from ALL of Desai and Sharma's clinics are at risk, not just those from Shadow Ln.
Sorry for the dbl post. I wanted to correct Sharma's name
To pained_girl and others who raised the issue of at-risk people who moved away. That is a concern.....however, 2 weeks ago we were called here in Florida by the Southern Nevada Health Dept. at our "unlisted" number. We arrived here on 2/3/08. They called to see if my husband received his letter. We knew nothing about it, having missed the story on national news. They advised he get tested asap and to advise them if results were positive. I salute them at least on their diligence in tracking us down. Wish they were more diligent regarding more frequent inspections. Due to limited malpractice insurance benefits, many are now seeking damages from the county and state. My husband was just tested on 4/4 and we await the results.