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PUBLIC HEALTH CRISIS: Criminal inquiry starts

Prosecutors, police take preliminary look at clinic



Photo by Clint Karlsen.

Las Vegas police and county prosecutors opened a preliminary criminal investigation Monday into the Las Vegas clinic accused of shoddy medical practices that exposed patients to potentially deadly infections.

The investigation joins inquiries by the FBI and the Nevada attorney general's office into practices at the Endoscopy Center of Southern Nevada, which health officials have said put people at risk of contracting HIV, hepatitis strains B and C and other blood-borne diseases.

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  • "This will be a broad-based investigation. We will be looking at every aspect which may involve criminal wrongdoing," District Attorney David Roger said.

    Detectives will meet with health officials and review their findings before deciding whether to pursue a full-fledged criminal investigation, Deputy Chief Kathy Suey said.

    "Right now we're looking at everything," she said.

    Meanwhile, Nicole Moon of the attorney general's office said the agency's insurance fraud and Medicaid fraud units have been reviewing the case. And Lisa Jones, chief of the Nevada State Board of Licensure and Certification, said Monday that FBI agents contacted her department about its investigative report detailing problems at the clinic.

    Also on Monday, Nevada lawmakers called for wide-ranging state investigations and for funding to help patients pay for the blood testing being recommended by the Southern Nevada Health District.

    Sen. Randolph Townsend, chairman of the Legislative Commission, sent letters to Gov. Jim Gibbons and several state boards and agencies seeking a broad inquiry into the problems discovered at the Endoscopy Center of Southern Nevada, at 700 Shadow Lane.

    In the letters, the Reno Republican asked for an immediate investigation into "the facts surrounding this outrage," which "may well be the largest breach of public trust in the history of the state."

    Townsend said the agencies and boards should use all of their statutory and regulatory authority, including subpoena power, to get to the bottom of how the problems occurred.

    An investigation made public Wednesday clinic found that staff reused syringes, contaminating vials of medication, which risked spreading disease.

    Clinic staff told health investigators they were ordered by administrators, principally majority owner Dr. Dipak Desai, to reuse supplies and medications to save money, according to a letter by Las Vegas Business Services Manager Jim DiFiore, who suspended the clinic's business license Friday.

    Health officials have confirmed that six patients who contracted hepatitis C at the clinic. The investigation was ongoing, and officials have urged blood testing for 40,000 patients who visited the clinic between March 2004 and Jan. 11 of this year.

    Assembly Speaker Barbara Buckley, D-Las Vegas, said state lawmakers want to ensure testing for people regardless of whether they have insurance or can afford it. The clinic should pay those costs, but a plan is needed immediately to ensure testing is available, she said.

    The Legislature might be able to help with those costs, with the Southern Nevada Health District and others, Buckley said.

    Assemblywoman Sheila Leslie, chairwoman of the Legislative Committee on Health Care, said Monday she was "beyond appalled" by what happened at the clinic. Her committee will meet 9 a.m. Thursday at the Sawyer Building to discuss how to prevent such a scenario from reoccurring.

    "We want to know what licensing boards are going to do," the Democrat from Reno said. "If the medical staff did this knowingly, they should lose their licenses and be pursued criminally."

    Leslie said the maximum fine that can be issued the state Board of Licensure and Certification -- $1,000 per violation -- is "woefully inadequate."

    "I want to see if our laws are substandard on a national level," she said. "We need more teeth in our regulations."

    Larry Matheis, executive director of the Nevada State Medical Association, said it's probably easier to shut down a restaurant for health code violations than temporarily suspend the medical or nursing licenses of the health care workers responsible for the hepatitis C outbreak.

    The "law is on their side," Matheis said.

    Under Nevada's law, regulatory agencies must provide evidence that a medical care provider is a threat to the public.

    Fred Olmsted, counsel for the Nevada State Board of Nursing, said his office had received a complaint about nurses at the Shadow Lane facility, but as of Monday, there was no evidence that they posed an "immediate threat'' to the public.

    "If the board finds that there is immediate danger to the public, we can summarily suspend someone's license,'' he said. "However, since such a suspension would be in violation of (the nurses') constitutional rights, we have to have a hearing promptly so that they may tell their side of the story.''

    An emergency meeting would have to be held within 30 days of the complaint, but no such hearings had been scheduled as of Monday.

    "People are presumed not guilty until proven guilty,'' Olmsted said.

    Dr. Javaid Anwar, president of the Nevada Board of Medical Examiners, said his agency needs evidence that a doctor is a threat to the public before suspending a medical license.

    He said the board had not received information from its investigators identifying any violations by the doctors who ran the Endoscopy Center of Southern Nevada.

    "Are those physicians posing potential harm to our patients at the center? We don't have the information from our investigators to make that determination,'' Anwar said.

    Anwar said the medical board, nursing board and licensure bureau each have to finish investigations.

    "We need to let them come up with what exactly is the problem. In the meantime, that place is closed.''

    Review-Journal writer Paul Harasim contributed to this report. Contact reporter Brian Haynes at bhaynes@reviewjournal.com or (702) 383-0281. Contact reporter Annette Wells at awells@reviewjournal.com or (702) 383-0283. Contact reporter Sean Whaley at swhaley@reviewjournal.com or (775) 687-3900.



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    buRNed wrote on August 02, 2008 12:50 PM: This story is disgusting on all levels, HOWEVER what struck me was Mr. Olmstead. Where were you 10 years ago.

    Things were VERY different then. I was wrongfully accused (proven by Metro 24 hours later). Yet, they "investigated" and devloped an elaborate "scheme" to defraud the State, claiming I'd gone in homes for under 30 minute and charged for over 30 minutes. Not proved or provable. I was GUILTY from the moment they got my name, not allowed to provide witness, or even go to trial as i did not have $35k after being on disability from the TWO SUSPICIOUS beatings that I endured at patient's homes while working. When I went to the board, the first words out of the mouth of the then SHE-DEVIL in charge were,"Can't you put him away on a federal rap". I lost EVERYTHING, my home, money, retirement, and career, and NOTHING was ever proven against me. Nice to know that now you stand behind the nurses EVEN when they are blatantly in the wrong!!!


    buRNed wrote on August 02, 2008 12:49 PM: This story is disgusting on all levels, HOWEVER what struck me was Mr. Olmstead. Where were you 10 years ago.
    Things were VERY different then. I was wrongfully accused (proven by Metro 24 hours later). Yet, they "investigated" and devloped an elaborate "scheme" to defraud the State, claiming I'd gone in homes for under 30 minute and charged for over 30 minutes. Not proved or provable. I was GUILTY from the moment they got my name, not allowed to provide witness, or even go to trial as i did not have $35k after being on disability from the TWO SUSPICIOUS beatings that I endured at patient's homes while working. When I went to the board, the first words out of the mouth of the then SHE-DEVIL in charge were,"Can't you put him away on a federal rap". I lost EVERYTHING, my home, money, retirement, and career, and NOTHING was ever proven against me. Nice to know that now you stand behind the nurses EVEN when they are blatantly in the wrong!!!


    Scared wrote on June 12, 2008 07:28 AM: I have to get several shots before I can start school this fall... I'm petrified to get them. I want to see a new vial and a brand new needle before I let them touch me. I want to break the seals myself. Will they allow that? Probably not. So what do I do? Not go to school because I fear for my health and safety? Or blindly allow myself to be another victim of the medical society? Since I don't know who is running the doctor's office and I don't know the ethics of anyone treating me; I feel I'm putting my life in their hands. I don't like that feeling. Not after this event. I haven't been to a doctor since it happened. Most are cocky and self righteous and get angry when you question them. People are in charge of their own health, doctors are a tool to get there - they don't see that. I've become petrified at the thought of seeing someone about these shots. I truly don't know whether to drop the semester. I'm at my wits end. People shouldn't be this afraid to see a doctor or nurse. Thanks, Dipak Desai and your staff of lackies for bringing medicine to a new low. People should not be forced to get shots under the current Vegas situation. Whom do you trust? I know who I don't anymore. How sad that medicine has been brought to this. I don't even trust eyedrops at the Optho's if the seal hasn't been broken in front of me. If I were a nurse I'd be in an uproar over the stigma they've all been given over these few. I am afraid, truly afraid to get these shots. How sad is that?


    Infuriated wrote on June 12, 2008 07:04 AM: Although I am infuriated with Desai, I am more infuriated with the people who followed his instructions. I don't see how any nurse or fellow MD could or would follow such orders without blowing the whistle in advance of 40,000 people being exposed. Alarms would have gone off in my head and I'd have contacted someone to expose this breach of acceptable practice. That's 40,000 people whose lives have been altered. 40,000 people who probably won't be able to donate blood. 40,000 people who work in casinos, restaurants, and only need to have a cut or open wound that weeps or bleeds on something they've handed you to spread HBV to the surrounding public. Slicing a lemon for our iced tea with a small cut and the figures will increase. I told a nurse I wanted to crack the seal on the needle myself to ensure it's a new needle, she said it's against their practice for me to do so. Oh really? And why should I trust you to give me a new needle? To say this has dramatically changed my opinion of the medical practice is an understatement. Doctors have always put themselves before God. Desai and his have more than proven that since he has condemned 40,000 people. The AMA is equally guilty in harboring a safehaven for them. What nurse is willing to blindly follow such disregard for the safety of her patient? I'd have quit before I would have been an accessory to this. Obviously graduates of the Hitler School of Medicine & Nursing. Like Javaid Anwar is going to do anything against a follow Al Quidan. Chemical Warfare - from the inside - still war isn't it? I put this up there with the Twin Towers. Don't you?


    For Those Who Can't Speak For Themselves wrote on April 08, 2008 09:51 AM: The practices used a the Endo Cntr. are horrific. A license to kill. Nursing homes have that same license to kill and use it daily on people who can not even speak for themselves. Yet the state regulatory agencies for the Long Term Care(LTC) facility to a blind eye to the many violations committed by these homes.WHY? Complaints for these LTC are handled much like the patients at the Endo center. Herded in like cattle, and left to die. The care providers don't even care if the aged jewels get a drink of water. Yes the doctors at the endo cntr. did a lot of harm, but truly we have doctors, nursed, and CNA's that do worse to our aged seniors. Let lower the boom on all facilities in which getting paid in the sole concern.


    A Public Servant Forever wrote on April 07, 2008 02:05 PM: What in the world is going on, I am sitting here watching this Las Vegas City Council Meeting held today, and I really have to say that I expect more from our public officials. The Major, I love the Major, but did he and all those others on this board just sell us all out for $500,000 for the City of Las Vegas. Well, I do hope that you cash that check and quick, because these circumstances are much bigger than $500,000 for the City of Las Vegas. This is about peoples lives, and the blatant disregard for trust that we should have for our physicians, and the role of the physicians and medical staff to do what is right and ethical for the patients. These actions taken today by the City Council are alarming to say the least.


    Ezr2c wrote on March 23, 2008 06:40 PM: It would be helpful if those who test negative could list the date and place of their procedure. No names- of course.Can someone build a website? I had a procedure at the Gastro clinic on Maryland Pkwy. in June of 2004. I am not sick but am wondering if I should be tested since Anasthesiologists travel to different locations.


    A Public Servant Forever wrote on March 21, 2008 05:57 PM: As a former employee of the Bureau of Licensure and Certification whose job was to intake the incoming complaints against the medical and health facilities which fell under the jurisdiction of the bureau in Las Vegas, Nevada, and as a public servant, I could not sit back and not respond in defense of Lisa M. Jones. Lisa Jones is not only an exceptional leader; she has been my mentor for over 5 years. Lisa is dedicated, working diligently and with much overtime, to her duties in her position as Bureau Chief, and I know because I was right there by her side along the way. Lisa Jones is incredibly knowledgeable and highly intelligent in her field. What I have always admired about her is her toughness and ability to stand her ground, and get the job done. When I first started working at the bureau, I was an extremely young and shy employee, but working with Lisa not only taught me how to focus and absorb knowledge, but how to effectively convey that knowledge to others with confidence. I actually learned more from working with Lisa Jones then in all my years of schooling. To me, Lisa is really an exceptional Bureau Chief and Manager, and if given the appropriate resources and opportunity, I know that she will continue to do an excellent job for the bureau and for our state. I have always been a strong supporter of Governor Gibbons, and now I am asking the Governor, as well as the public to reconsider the resignation of Lisa Jones. Lisa Jones has always been a caring, compassionate, and effective leader for our State. Let's give her the support that she deserves.

    Truly,
    A Public Servant Forever


    LeighAnn wrote on March 19, 2008 08:26 PM: There should be no doubt that there is a lot of criminal negligence in this situation. Both the Dr's AND the staff are at fault here. Universal precautions have been in place for 20 yrs now. Why these people chose not to abide by them should absolutely be a criminal offense.

    As for the Governor, he should be impeached for his stupid remarks.

    It sounds to me like Las Vegas and maybe the entire STATE needs to become educated as to what Hepatitis C Virus (HCV) is and does. Also, these idiots not only exposed so many people to HCV, but to Hepatitis B AND to HIV/AIDS!


    Melinda wrote on March 19, 2008 07:26 PM: I was a residant of las vegas for 35 years and am wanting to come back home. I am also very ill. I hope that the medical perfession in las vegas is being monitored,and the mistackes that are made are delt with harshly so that they do not continue to happen. this is a very scary thing for the communitie, we give our trust to doctors and facilities of this type at our most vunerable times. We as a public need to have some securaty, and we need our boards to protect us just as much as they need to protect the doctors. Please remember we the patients are the most vunerable in this situation. maybe the people need to go higher up and have the rights and regulations in thiese cases reexamined.We are just trying to get well and the doctors are the ones saying "please you can trust us". We can't let our guard down for a moment? Who can we trust, if it is not the Doctors, then we turn to laws, and there we aren't being helped, because the doctors and nurses are protected. I can tell you this, I am not a doctor or a nurse but if I was told to reuse anything in this type of occupation I would report it myself. EVERYONE KNOWS THAT IS WRONG!! They should all be heald responcible, and they should not still be alowed to practise medicine if they can't determine wrong from right on there own.


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