Officials: Hepatitis outbreak highlighted need for changes

By Cy Ryan

Wednesday, Feb. 4, 2009 | 6:21 p.m.

CARSON CITY – The state’s Health Division was ill prepared to deal with the hepatitis outbreak in Las Vegas last year, so it is asking the Legislature to give it more power to react swiftly and forcefully when public health emergencies arise.

“We didn’t have the policies and procedures to take action,” says Richard Whitley, administrator of the state Health Division.

The Legislature will be asked to give the state Health Division authority to immediately shut down any medical facility that is putting its patients at risk, Whitley said.

The proposed legislation also would increase penalties and sanctions and require the facility to cover the costs of the investigation. The legislation would require state inspections every 18 months.

The Southern Nevada Health District discovered the unsafe practices at the Endoscopy Center, where at least six cases of hepatitis C were reported. About 40,000 patients of the clinic had to be notified of the problem.

After that discovery, the state inspected 50 other ambulatory surgical centers and found unsafe practices in 15 of them. Citations were issued to them. The patients were not notified of these 15 because the risk was minimal.

State inspectors found that technicians who were not licensed were failing to follow the directions of the manufacturer to disinfect and sterilize instruments.

In some cases, eight years elapsed between inspections of these facilities, Whitley said.

He said the Southern Nevada Health District acted timely in notifying the patients who may have been at risk. But the law was unclear whether the state had the authority to issue a cease and desist order.

Gov. Jim Gibbons signed an emergency regulation to permit the agency to take action during the hepatitis outbreak and the state Health Board made the regulation permanent.

A quarter of the health division’s positions were vacant at the time. Now the division is fully staffed and that allows the division to do more frequent inspections. It is asking for money to hire 12 more inspectors.

And there’s been a change in behavior in the industry, Whitley said. Now these ambulatory surgery centers are self-reporting any deficiency. He said these centers should not be penalized for self reporting.

But Senate Majority Leader Steven Horsford, D-Las Vegas, questioned the decision not to penalize a center that self reports. He said an incident must be evaluated as to whether it threatened life and safety.

Horsford also asked what other steps the state has taken to give the public confidence that these centers are being properly regulated. Whitley said the state’s Web site posts the information.

Cy Ryan may be reached at (775) 687 5032 or [email protected].