Latest case undercuts Gibbons’ clinic defense

It is governor who should step down, says one health official he blamed

By David McGrath Schwartz (contact), Cy Ryan (contact)

Wednesday, March 19, 2008 | 2 a.m.

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Gov. Jim Gibbons reaffirms his need for immediate action from the state Board of Medical Examiners.
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Gibbons discusses a statement he made that was reported in the Reno Gazette-Journal.
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Gibbons talks about why it took some time before he took personal action.
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Gibbons discusses budget reductions to the Bureau of Licensure and Certification.
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Gov. Jim Gibbons over the weekend dismissed the crisis stemming from the Endoscopy Center of Southern Nevada, saying if there had been “gross negligence” at the clinic, there would be more cases of hepatitis C linked to unsafe treatment practices than the six reported.

But on Tuesday, the day the Southern Nevada Health District reported another acute hepatitis C case linked to a Las Vegas clinic, officials said they wouldn’t immediately have a clear idea of how many people were infected because of dangerous procedures at the first clinic.

“To get a final number, it’s going to be months,” said Brian Labus, the Health District’s senior epidemiologist.

The contradiction of Gibbons’ statement comes as three members of the Board of Medical Examiners and its executive director continue to defy Gibbons’ call for them to resign.

As soon as the story broke about the six infected individuals and the 40,000 patients of the clinic who were being notified they should seek testing, Tony Clark, executive director of the Board of Medical Examiners, said he assigned an investigator.

Clark said Gibbons, in calling for his resignation and that of three members of the nine-person board, was trying to minimize the fact that Dr. Dipak Desai, the majority owner of the Endoscopy Center, was an election supporter, a campaign contributor and an adviser to the governor when he took office.

“Maybe the governor ought to resign,” Clark said.

Desai voluntarily agreed to stop practicing. But Clark said he could not get the other doctors who worked at the clinic to limit their practices.

Local government, not Gibbons and his administration, closed the clinic.

“We have done everything we could to protect the public,” Clark said. “He is making us the scapegoat for his ineptitude.”

Gibbons said if the board members, who have ties to Desai and have recused themselves from presiding over any disciplinary proceedings stemming from the hepatitis scare, fail to resign, he will look for ways to fire them.

The governor said he wants Clark’s resignation because he did not act promptly in taking disciplinary action against those involved in the clinic.

Gibbons himself, however, seemed to downplay the controversy before he called for the resignations. He told the Reno Gazette-Journal Saturday: “There was no single vial of medication reused. There were no reused needles. Gross negligence when you have far below the number of average (hepatitis C) cases listed? That’s trial lawyer-speak to me. I think if you’d had gross negligence, you’d have a higher number.”

On Sunday, he apologized for blaming public hysteria on media “buffoonery.” And on Monday, he said he’d been incorrectly informed that single-dose vials were not being reused, saying that assertion “may have been a little bit premature.”

He has not, however, backed off his contention that there was no gross negligence at the clinic, using the number of positive tests as evidence.

It was only late last week when the Southern Nevada Health District began seeing test results from those tested after health officials on Feb. 27 announced the unsafe practices at the Endoscopy Center. Health officials notified 40,000 patients that they should get tested for hepatitis C, hepatitis B and HIV, but acknowledged that their list of patients was incomplete.

Investigators will interview those who test positive for hepatitis C to try to determine when they were infected and whether their infections can be traced to any medical procedures, said Jennifer Sizemore, spokeswoman for the Health District. About 4 percent of the clinic’s patient population, officials estimate, would normally carry the hepatitis C virus.

But the acute case of hepatitis C that officials announced Tuesday shows that the system depends on doctors’ and labs’ reporting positive test results to the Health District.

The case was traced to 2006, when an unidentified man underwent a procedure at the Desert Shadow Endoscopy Center of Nevada.

Blood work done before his procedure showed he was not previously infected with hepatitis C, Sizemore said.

When he tested positive in 2006, his hepatitis C case was not reported to the Heath District by his doctors or the laboratory that performed his blood work, Sizemore said.

“That case was never reported to us,” Sizemore said. “It’s something we’re looking into.”

She said the infected man called the Health District himself after the news broke last month about the Endoscopy Center.

The Health District relies on doctors and labs to report cases of certain diseases, such as hepatitis C.

On average, the agency gets 20 to 30 reports of positive hepatitis C cases daily. Most are “chronic” hepatitis C cases, meaning there are no immediate symptoms.

The number of positive hepatitis C tests has been “at the high end of the normal range” so far, Labus said, though he would not release specific numbers on the results of the tests stemming from the notices to the 40,000 Endoscopy Center patients.

Six cases of acute hepatitis C — which may come with symptoms such as loss of appetite, nausea and jaundice — have been linked to the Endoscopy Center of Southern Nevada. Normally, Southern Nevada has only one or two cases of acute hepatitis C annually.

Discussion: 6 comments so far…

By Judy

3/19/08 at 8:29 a.m.

Suggest removal

I think at this point most of Nevada would agree with Tony Clark that this baffoon Gibbons should step down. We need a governor that does not operate at the end of a string like a wooden puppet.

The lack of action on this matter, then placing the blame on the media, and then minimizing the number of cases of HepC -

NEVADA - SHOW THIS BAFFOON THE DOOR!
By ZeddyBear

3/19/08 at 9:53 a.m.

Suggest removal

I agree it's time for Jimbo Gibbons to step down. His lack of intelligence is really showing.....

The doctors on the Board are doing what they should do... recuse themselves.. But to call for their resignations is a bit much. Again, we can see that Jimbo is not thinking before he speaks. I can understand why Dawn wants to divorce this Bozo..... We need to recall this idiot before he does another stupid thing... and that should be in a few minutes from now.
By encyclopedia

3/19/08 at 4:46 p.m.

Suggest removal

The gube is living proof that Nevada's
CORRUPT video game voting Scam.. is working.
It sounds like this Clark character is on
to something. He should have spoken up
about 14 months ago.. along with the folks
at this brilliant website:
http://votegibbonsout.blogs.com/votegibb...
By localcitizen

3/19/08 at 6:56 p.m.

Suggest removal

I believe they're all buffoons. The idiots on the medical board made a deal with Desai that no other doctor in this town could have gotten...an agreement that is nonbinding and nonreportable. That means that he can continue to practice with no black mark on his record anywhere. It doesn't matter that this is all over the news, as long as there is no action against his license, no hospital will take action against him and he will continue to rake in the money. As far as Clark is concerned, why didn't he make this a binding agreement and why didn't he make the other doctors turn in their licenses? Suspend them, do something that puts a mark on their records. They have all put the public at risk. I say get rid of all of them, governor and medical board. Great job they've done in protecting us.
By Beezie

3/20/08 at 11 a.m.

Suggest removal

To localcitizen,
I agree they all need to go. Recused or not. The whole reporitng structure needs to be revamped and apolitical. No one seems to have any authority to do anything. Pitiful.
By janice

3/22/08 at 9:05 a.m.

Suggest removal

too bad gibbons or any of his family members did not go to these clinics for procedures. don't worry "local citizen"..who in the world would go to Desai even if he would practice..you would have to have your head under the sand NOT to know who he and his croonies are..