Improvised H1N1 shots raise officials’ eyebrows

By Marshall Allen

Thursday, Dec. 17, 2009 | 2 a.m.

A low-income clinic in Las Vegas improperly administered the H1N1 vaccine to 21 children, but state health officials said they corrected the problem so no harm was done.

At the height of the H1N1 panic in late October, the vaccine was in short supply and was not being delivered in dosages for children under the age of 4 at the Martin Luther King Family Center, just north of the Interstate 15-U.S. 95 interchange.

Michelle Agnew, head of operations at Nevada Health Centers, the nonprofit organization that runs the clinic, said the pediatrician at the clinic decided to use half of a dose that should be used for older children — and then saved the remainder of the dosage in a syringe. The plan was to use the syringe on the same child 28 days later.

The quantity of vaccine was appropriate, but the improvised method of administering it was not, health officials said.

Nevada State Health Division officials became alarmed Nov. 6 when they had a phone conversation with staff at the center. The potentially unsafe procedure had gone on for about a week. Health officials reported three problems to the Nevada Board of Medical Examiners:

• The dosage the clinic had received was not licensed for children under age 4.

• The vaccine in the prefilled syringes did not contain a preservative, which meant it could pass bacteria to children if it was readministered.

• Reuse of syringes is not allowed because it could spread infectious diseases.

Medical board investigators went to the clinic immediately and corrected the practice. The initial dosage was the correct amount, health officials said, and the second dose was never administered. Instead, the clinic had received the appropriate dosage in individual vials by the time the children returned to the clinic.

Agnew said the flurry of activity around the H1N1 virus caused confusion in the initial distribution of the vaccine, but most of the confusion has cleared up now that the vaccine is more widely available.

Agnew, who did not name the doctor, said the medical board closed its investigation without disciplining the physician.

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About 35 senior citizens will be forced to move out of Concorde Assisted Living because it went into foreclosure and declared bankruptcy to reorganize its finances — a ripple effect of the recession.

The owners of the facility notified residents a week ago that they have until Jan. 9 to leave Concorde, at 2465 E. Twain Ave.

David Viens, chairman of the Phoenix-based company that owns the facility, said Concorde had to declare Chapter 11 bankruptcy after its lender took so many losses it could not renew the assisted living facility’s loan.

He said that ALDCO #2, the entity that owns Concorde, has the cash reserves to pay off its loan, but reorganizing the financing made more sense, even though it meant residents would have to be moved.

Viens said the temporary closure is more a mechanical means to get the company’s financing in order after the lender had problems.

Viens said the company plans on reopening the facility under a new name in March, with assisted living and Alzheimer’s facilities.

Concorde has been flagged for poor performance in recent inspections by the Nevada State Health Division. A Nov. 5 report noted Concorde employees had not been given the required physicals, tuberculosis tests and CPR training at the time of their hiring. In addition, the home had numerous problems in its kitchen: a dishwasher being operated without enough detergent, mold on the backsplash of the dish machine (a repeat violation from an earlier survey), dirty cabinets and more.

In addition, the facility was not using the services of a dietary consultant, as the law requires, and was admitting patients with mental illnesses without the proper training for its employees, the report said.

Concorde is licensed for 150 beds and the number of residents is so low because of recently opened competing facilities in the Las Vegas Valley, Viens said. The recession has also played a role, he said. Family members of residents are losing their jobs, which makes them unable to pay to keep their loved ones at Concorde, he said.

Health Division officials said they do not know of any other assisted living facilities going into foreclosure or bankruptcy in Las Vegas.

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Health issues related to Nevada’s legalized prostitution are in the national spotlight as a result of last week’s state health code changes to accommodate a Beatty brothel’s plans to begin offering the services of male prostitutes.

“The phone has been ringing off the hook — Denver, Florida, New York, Chicago, just about any place you can name,” said Karen, who was answering the phone at the Shady Lady Ranch on Wednesday afternoon because the owner of the business, Bobbi Davis, was busy filming an episode of CNN’s “The Joy Behar Show.”

“Wanda Sykes wants Bobbi to come on her show too,” Karen said.

Davis made the first-ever request to have the Nevada State Board of Health add urethral exams to the guidelines. That allows male sex workers to be tested for sexually transmitted diseases. Men were previously barred from the oldest profession because codes specified that prostitutes must undergo “cervical” testing for sexually transmitted diseases. The board unanimously approved Davis’ request for the amendment.

Davis still needs the approval of the Nye County Commission and is to take her plan before commissioners Jan. 5.