The doctors and nurse anesthetists at the Endoscopy Center of Southern Nevada would have exposed fewer people to life-threatening illnesses if they had been mashing up castor beans.

Yet here we are, with 40,000 people who had sought to stay healthy through preventive care left with a possible death sentence.

The city of Las Vegas absolutely took the right step Friday in suspending the center's business license. It should remain closed indefinitely.

But the state's Bureau of Licensure and Certification has suggested it might be better for the center to correct its actions and remain open. Like everything in Southern Nevada health circles, there's also a shortage of facilities to perform colonoscopies and endoscopies.

Not only do 40,000 patients get the news that they may have been exposed to hepatitis C, hepatitis B or HIV, they get the added insult of having to pay for blood tests to find out for sure. There's no fund from which the public health agencies can draw to provide free testing.

Already, six patients -- one last July and five others last September -- have contracted hepatitis C thanks to the shoddy practices at the center.

If the bean counters were so concerned about saving what amounts to cents on the dollar, you know they were booking their days full. It'll be a miracle if only six people were infected.

There's a reason 40,000 patients are receiving letters from the Southern Nevada Health District. With a time line stretching up to Jan. 11 of this year, it would appear the negligence continued unchecked for years.

Now roughly 40,000 people are being told they have to foot the bill for their own tests. And while plastic syringes are relatively cheap (assuming the center bought in bulk, they're less than a dime apiece), the tests are not. Patients are being quoted up to $400 for the three tests. Peace of mind sure takes a piece out of the budget.

And the only recourse -- the one actually being suggested by doctors -- is to hook up with a trial lawyer.

Let's say a patient's insurance actually covers all or most of the testing costs. It would seem to me that in this day and age, contracting HIV or hepatitis C usually occurs through risky behavior. Perhaps just seeking an HIV test would lead some insurers to consider risky behavior a pre-existing condition worthy of denying future claims.

We certainly haven't come anywhere near the end of this mess.

And what does this say to anyone whose doctor is advising a colonoscopy?

The health district insists the procedures are an important part of protecting yourself against the development of diseases, including cancer. "There is no reason why you should avoid undergoing these types of medical procedures," the district's Web site states.

But there are at least six people who likely would have bypassed a cancer screening had they known it might have caused them to contract a potentially fatal disease.

I wonder if the endoscopy center penciled out liver transplants. Those really are expensive, and you can bet an insurer will be able to find a pre-existing condition to deny coverage.

Once again, the patient's only recourse appears to be in the courts. But how is someone supposed to get healthy with the added stress of litigation?

Patients are asked to do a lot these days.

Hospital patients are now supposed to ask if a doctor or nurse has washed hands since visiting the patient in the room next door. Does the criminal behavior at the endoscopy center mean I should now be asking lab techs whether they're reusing syringes when I go for a flu shot?

And should I now ask if the needle is new when I get my annual cholesterol check?

On Oct. 1, Medicare will stop paying hospitals for eight preventable things (such as infections). One is objects left in a patient during surgery. Are patients now supposed to wake up in the recovery room and ask the nurse: "Did the doctor take out all the clamps?"

The medical system isn't supposed to employ caveat emptor. But sadly, as the malpractice at the Endoscopy Center of Southern Nevada shows, nothing can be taken for granted when medical licensees would jeopardize patient health to save a few bucks.

Contact Erin Neff at eneff@reviewjournal.com or (702) 387-2906.