Sun editorial:

Blind contract

County did not question UMC’s agreement with doctor at center of hepatitis crisis

Friday, March 14, 2008 | 2:08 a.m.

University Medical Center on Tuesday canceled its contract with Dr. Dipak Desai, whose past medical decisions and procedures in his private practice are being investigated by health and law enforcement authorities.

Desai is majority owner of the Endoscopy Center of Southern Nevada, the now-closed Las Vegas clinic that health officials in January linked to a hepatitis C outbreak.

The public hospital could not continue with Desai after state inspectors observed unsafe medical procedures being performed by staff at his clinic, setting off a scare that as many as 40,000 patients could have been exposed to diseases.

But was the Desai contract appropriate in the first place? It is hard to know. As reported this week by the Las Vegas Sun’s Tony Cook, the Clark County Commission, which oversees UMC, never discussed it.

Desai had long held contracts with UMC for providing stomach and intestinal services before canceling the contracts (with 90 days’ notice) in March 2007. There were four separate contracts for himself, for two other doctors in his gastroenterology group and for his gastroenterology group itself.

Those contracts cost the hospital $210,000 annually.

UMC publicly sought proposals from other providers after Desai bowed out. Only two responses were received, from Desai and one from another medical group whose staff, the hospital decided, was too small.

In October, acting UMC Chief Executive Kathy Silver recommended recontracting with Desai, this time for one four-year contract at an annual cost averaging $1.05 million.

But was Desai’s new contract worth five times more than what the hospital had been paying the only option? Was the hospital being gouged by Desai because he had cornered the local market for gastroenterology services? Could the contract have been less by dividing it among smaller medical groups?

These are some of the questions the County Commission could have asked, but chose not to, in approving the contract. In this case the commission failed in its responsibility to act on behalf of taxpayers who pay the hospital’s bills.