Endoscopy Center doctor to testify against colleagues

By Marshall Allen

Saturday, July 4, 2009 | 2 a.m.

The Nevada State Board of Medical Examiners is relying on the help of one of the minority partners of the Endoscopy Center of Southern Nevada in disciplining Dr. Dipak Desai and another physician believed to be responsible for last year’s hepatitis C outbreak.

The medical board’s agreement this week to punish Dr. Eladio Carrera only lightly comes with a major condition: Carrera must provide the medical board with testimony against Desai, majority owner of the clinic, and Dr. Clifford Carrol, who is accused of causing the outbreak through his careless treatment of a patient with hepatitis C.

As part of the agreement, Carrera will pay a $15,000 fine — the maximum of $5,000 for three counts of bringing the medical profession into disrepute — and be placed on probation for two years. He gets his medical license back immediately.

“Our investigation shows he has a substantially different responsibility for the infections than the other two physicians involved,” said Louis Ling, executive director of the medical board. “He is willing to testify truthfully against the other two doctors and give us a context for the case that nobody else can give us.”

Ling said he could not comment on the details of Carrera’s promised testimony.

It’s believed the disease was transmitted from one of Carrol’s patients, who was known to be infected, when nurses reused syringes and single-use medicine vials. That reuse contaminated the anesthetic that was given to other patients. It’s believed that about 100 people picked up hepatitis C from the clinic, and in February 2008, about 50,000 people who had procedures at the clinic were told to be tested for hepatitis B, hepatitis C and HIV.

A temporary restraining order and injunction that prevented Carrera from practicing medicine is lifted as part of the agreement.

Ling said the settlement is necessary because the medical board “can show the public what happened, who is responsible and hold the parties responsible for the acts.”

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Two Assembly bills born of the public outrage over the hepatitis C outbreak became effective Wednesday.

One new law prohibits discrimination against nurses and doctors who blow the whistle on unsafe medical practices, and the other includes expanding the authority of the state Health and Human Services Department.

Las Vegas officials reported when they shut down the endoscopy center that a nurse accused Desai, owner of the clinic, of ordering them to reuse syringes and single-use medicine vials, which caused the infection to spread. That revelation caused widespread dismay that licensed nurses would not turn in any medical provider who ordered them to do something unsafe.

The whistleblower law was also spurred by a 2007 Sun investigation into foreign medical doctors who were afraid to complain about their exploitive bosses because the employers sponsored their visas. The subject of whistleblower protection became a theme during the interim legislative session and then rapidly gained momentum after the hepatitis C outbreak.

Assembly Bill 206 expands the powers of the state health division by allowing inspectors to issue cease-and-desist orders in cases where there is concern about the spread of infectious disease. The law also allows the health officials to obtain medical records during investigations into unsafe medical practices and requires surgery centers to better report “sentinel events,” unexpected outcomes that cause serious injury or death.

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More than $3 million was released by the federal government for community health centers in Nevada as part of the American Recovery and Investment Act.

Nevada Health Centers, which operates 29 clinics and mobile centers in the state, will receive about $2 million to pay for capital improvement projects and to help cover the increased need for its services. As the recession worsens, more Nevadans are depending on community health centers for affordable treatment.