The Digestive Disease Center was cited for five deficiencies, including improperly disinfecting or cleaning endoscopy equipment, an inspection report says. Each of the deficiencies was corrected on the spot, Framsted said.

The one deficiency observed at Centennial Spine and Pain was the reuse of a single-dose vial of a medication. That has been corrected, said Vickie Axsom-Brown, chief operating officer of the facility.

The inspections were part of a sweeping probe of medical practices at the state's 50 ambulatory surgery centers.

The probe of surgery centers was sparked by a massive health alert initiated by the Southern Nevada Health District, the Centers for Disease Control and Prevention and the state's Bureau of Licensure and Certification.

The investigation resulted in the closure of the Endoscopy Center's Shadow Lane clinic as well as several other valley facilities operated by the clinic's doctors.

Health inspectors believe disease transmission at the Shadow Lane facility occurred when nurse anesthetists reused syringes on infected patients, contaminating vials of medication that were shared among multiple patients.

As of Friday, 35 of the 50 centers had been inspected.

Inspections for the remaining 15, all in Southern Nevada, are expected to be complete by March 21.

According to the inspection report for Digestive Disease Center, investigators conducted a surprise inspection at the facility Feb. 13. Four endoscopy procedures were observed between 7:40 a.m. and 9:15 a.m.

Among the findings:

• A technician was observed not washing hands or using an antiseptic hand rub between procedures.

• The center failed to properly use the correct amount of solution when disinfecting equipment.

• The center could not show proof that employees had pre-employment physical exams, tuberculosis tests, and annual employee evaluations.

Staff at the Digestive Disease Center said no one was available for comment on Friday, and that the office manager would be in on Monday. The physician who operates the clinic also wasn't available Friday.

Axsom-Brown said inspectors came to the Centennial facility on March 11 and observed four patients undergoing procedures.

She said the drug manufacturer's recommendation is to not administer medications from single-dose vials to multiple patients, or combine leftover contents for later use.

"It was an activity we should not have been doing,'' she said.

Contact reporter Annette Wells at awells@reviewjournal.com or (702) 383-0283.