Pricey Desai dumped by hospital

By Tony Cook

Wednesday, March 12, 2008 | 2 a.m.

University Medical Center on Tuesday canceled its contract with Dr. Dipak Desai, whose clinic is at the center of the nation’s largest hepatitis C scare.

While that means the man who oversaw unsafe medical practices that resulted in at least six patients being infected with hepatitis C is no longer getting taxpayer money, the history behind the lucrative contract — under which Desai and his company received nearly $1 million a year primarily to accept referrals from UMC to Desai’s clinics — leaves lingering questions.

Those clinics — the Endoscopy Center of Southern Nevada and the Gastroenterology Center of Nevada — are under criminal investigation. Health inspectors say nurse anesthetists at the endoscopy clinic used syringes multiple times on patients, a practice that could allow vials of anesthetics to become tainted with infected blood from the first patient and then passed on to other patients.

Six patients contracted hepatitis C at the clinic and 40,000 have been notified they should get tested for infectious diseases.

Desai, majority owner of the endoscopy clinic, has directed UMC’s gastroenterology department for years. Hospital officials say such unsafe practices did not occur at the hospital, where standards are higher and physicians, not nurses, administer anesthesia.

Desai scored an enormous raise for himself and his associates last year by canceling his UMC contract midstream and then asking the hospital for a hefty raise.

UMC spokesman Rick Plummer said that when Desai canceled his contract in March 2007, it left the hospital in a lurch. UMC solicited proposals from other physicians to take over the work, but only Desai and another group responded.

Desai, who had been making $84,000 a year under his previous contract, and his company asked for $1.85 million a year. The competing group, Digestive Disease Specialists, offered to do the work for $960,000 a year, but the hospital determined the group did not have enough physicians to cover the patient load, Plummer said.

That left only Desai’s group.

“To tell you the truth, UMC was held hostage,” Plummer said.

UMC negotiated the price down to $990,000 for the first year of the contract, a payment that would increase each year after that for an average annual cost of $1.05 million. That’s more than 12 times what Desai had been making under his previous contract.

UMC Interim Chief Executive Kathy Silver recommended approving the deal in October 2007. County commissioners did so on their consent agenda, a list of dozens of items that they pass in a single vote. There was no discussion about the contract’s price tag at the commission meeting.

Plummer said the cost disparity between the old and new contracts is misleading because the newer contract actually covered several doctors in Desai’s practice who had held separate contracts of their own to provide professional medical services at UMC.

But even if those other contracts are added to Desai’s previous deal, they total only $210,000 annually, nowhere near the $990,000 the group was receiving until Tuesday.

Despite the pay boost, Desai performed no procedures at UMC itself in 2007, Plummer said. Instead, UMC referred 1,481 patients to Desai and his clinics that year. On top of payments that Desai and his company received from UMC, they also were allowed to bill those patients.

Plummer said UMC had to pay a provider for the service because doctors wouldn’t accept many of those patients if they lacked insurance. He said Tuesday he didn’t know how many of the patients referred to Desai and his clinics did not have insurance.

The Sun left messages for Desai’s attorneys and at his clinic, but the calls and e-mails were not returned.

Clark County commissioners are expected to sign off on the cancellation of Desai’s contract at their March 18 meeting.

Plummer said Desai agreed to cancel the contract after being approached by the county.