EDITORIAL: Impotent oversight - Opinion

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Mar. 06, 2008
Copyright © Las Vegas Review-Journal

EDITORIAL: Impotent oversight

If medical boards won't act now, why do they exist?

The discovery of a disease outbreak and its link to reckless practices at a local clinic are prime examples of the legitimacy of government regulation in matters of public health and safety. If a business has already harmed citizens and represents an imminent threat to others, it is appropriate for authorities to intervene, investigate and, in extreme circumstances, shut down a facility.

What has unfolded in the Las Vegas Valley over the past week certainly qualifies as extreme. The Endoscopy Center of Southern Nevada's habitual re-use of syringes and vials infected six people with hepatitis C, prompting the largest patient notification campaign of its kind -- some 40,000 people who underwent procedures at the clinic over a four-year period now need to be tested for hepatitis B, hepatitis C and the virus that causes AIDS.

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Officials have closed the clinic, along with four other affiliated practices.

The cities of Las Vegas, Henderson and North Las Vegas and Clark County's government moved swiftly to suspend the business licenses of these offices.

In contrast, the state's vast medical regulatory structure has been alarmingly impotent in addressing the biggest public health scare in Nevada history.

The Nevada State Board of Licensure and Certification, which helped the Southern Nevada Health District investigate the Endoscopy Center of Southern Nevada, fined the clinic $3,000 and declared confidence that all deficiencies had been corrected. And what of the licensed professionals who carried out the day-to-day business of these practices? Letters to the editor have been pouring into the Review-Journal since last Friday, demanding to know why Dr. Dipak Desai, who ran the endoscopy center, and other physicians and clinic nurses haven't at least had their licenses suspended.

Dr. Javaid Anwar, president of the Nevada Board of Medical Examiners, said his agency needs more evidence before it can take action against any doctor involved in this travesty.

"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," he said. "We need to let them come up with what exactly is the problem."

Fred Olmsted, counsel for the Nevada State Board of Nursing, said his agency has the authority to "summarily suspend someone's license" if the public's health is at risk, but that right now there is no evidence of an "immediate threat" to the public.

Forty thousand Southern Nevadans are being urged to undergo immediate blood testing for potentially deadly diseases, and six confirmed cases of hepatitis C have been traced to a single clinic. Investigators with another state agency have pinpointed the exact cause of the outbreak -- re-used syringes and vials -- and clinic personnel have indicated they were trained to do their jobs in a way that puts the health of patients at risk. How much more evidence do Dr. Anwar and Mr. Olmsted need? Bodies in a freezer?

Anyone faced with the loss of their livelihood deserves due process protections. But if what has transpired over the past seven days isn't enough to get the Nevada Board of Medical Examiners and the Nevada State Board of Nursing to make a few phone calls and schedule hearings immediately for all persons involved in this disaster, there is no point in their existence. Are these boards really nothing more than protection rackets?

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Please enter your name Name: Please enter your email Email: Please enter a comment COMMENTS : (word count limit is 300) You have reached the maximum number of words allowed Current Word Count: Note: Comments made by reporters and editors of the Las Vegas Review-Journal are presented with a yellow background. Report abuse infrederick wrote on March 07, 2008 12:06 AM: The unfortunate truth is that all across the US Boards of Medical Examiners are in fact protective not of public health, but rather of Doctors' privileges and money making. That is the very definition of a racket. Self regulation is always a bad idea when power prestige and money are at stake. We need to alter the structure of regulation so that physicians are regulated by people who are not biased towards protecting physicians at the expense of public health. Report abuse tim wrote on March 06, 2008 06:13 PM: dave your beating a dead horse let it go,man. Report abuse David Johann wrote on March 06, 2008 05:41 PM: Rausch writes: "Is it proven that Dr. Desai or his colleagues instructed or themselves undertook to make repeated reuse of vials on different patients?" No. BUT THE STAFF WAS DOING IT FOR SOME REASON. They must have been encouraged by superiors. Obviously, every staff who who would not go along with this quit, or was fired, or was bullied out of sociopath Desai's system of clinics. Those who remained represent our current cast of social misfits who, because they are social misfits, likely have trouble holding jobs except in exceedingly dysfunctional clinics like Desai's. They may have thought cross contamination was so remote nobody would be caught. That's the workplace dynamic. The fish always rots from the head down. "Is there a memo, a recording, etc, to prove that he is guilty?" No, Desai's a sociopath, not stupid, and not stupid enough to put something incriminating in writing when spoken orders were more than adequate. "Lets assume that he and his colleagues did give this instructions, but then why did the nurses do it." See paragraph one. "There is actually no proof that Dr Desai or Dr Carrera or any of them actually said these or gave these instructions." How do you know? If three employees say otherwise, Desai is toast. "Why would he do something so stupid, that it would tarnish his towering reputation carefully built over the last 30 years?" Because he has sociopathic traits. His reputation certainly doesn't "tower" among those who knew him at UMC where he's regarded by support personnel as a consistently aggressive, condescending bully (another sociopathic trait). " You must make a rational assessment of the situation before levelling such an incredible accusation." Rational enough? In this town anybody with enough money can buy a "towering reputation," at least for a while. Report abuse tim wrote on March 06, 2008 04:43 PM: mark you need to relax,go patrol some bars for them evil smokers,then those regulating agencies can go after dem bad doctors.you,all kin sleep better dat way. Report abuse Mark Schaffer wrote on March 06, 2008 04:11 PM: It from somewhere wrote... nothing. Report abuse Nanny from California wrote on March 06, 2008 03:41 PM: Now, now Marky, you know how mommy worries about your blood pressure. But thank you so much for warning us about smoke. I'll tell all the girls at the bar tonite as I'm sure they don't know about it. It so nice to find someone so concerned about other peoples' activities - you'd make a wonderful nanny yourself. Report abuse Raucsh wrote on March 06, 2008 03:34 PM: Guilty until proven innocent, is this the motto here? Is it proven that Dr. Desai or his colleagues instructed or themselves undertook to make repeated reuse of vials on different patients. Just because a few nurses were caught in the act, and gave the name of their bosses (perhaps to escape personal responsibility) does not mean that the Doctors actually did it. Is there a memo, a recording, etc, to prove that he is guilty. Lets assume that he and his colleagues did give this instructions, but then why did the nurses do it. Please do not tell me the nurses were afraid of loosing their jobs, because it is known fact that the demands for nurses in the market is greater than the supply. Are we to forgive the Nazi generals who complied in the genocide because they were afraid of Hitler! There is actually no proof that Dr Desai or Dr Carrera or any of them actually said these or gave these instructions. Dr. Desai has built his reputation over last 25 years in Nevada as a practising doctor. His patients include some of the who's who of the valley. He could have done this before if he wanted to, but this happened only in the last four years. Why would he do something so stupid, that it would tarnish his towering reputation carefully built over the last 30 years? I understand the rage and emotion of the patients who have been infected with the disease, but I am outraged by the fact that a reputed newspaper's editorial board is indulging in a unbecoming smear campaign. You must make a rational assessment of the situation before levelling such an incredible accusation. Report abuse Mark Schaffer wrote on March 06, 2008 03:26 PM: The idiot who is not a nanny and not from California compacted much stupidity into such a small post. One, it presents a false dichotomy between enforcing health regulations and enforcement of other other health laws as if both cannot occur at the same time. Two, if the health district is that underfunded the solution is to properly fund and equip it. Three, the tacit denial that smoking and second hand smoke are killers on a larger scale than the fiasco at the Endoscopy Institute shows the writer to be just another denialist. Report abuse Nanny from California wrote on March 06, 2008 02:58 PM: Hey! Wait a minute! that's not fair. The health district is overwhelmed regulating bar owners who have ash trays in their bars. It's a matter of priority. Report abuse Staff Infection wrote on March 06, 2008 02:26 PM: RJ readers, don't be fooled. This newspaper has, over many years, promoted the very kind of government non-interference that had led to the medical abuses we're witnessing today. The RJ editors are well known small-goverment, pro-business conservative Republicans. They never miss a chance to rant and rave in support of the privileged few whom they consider the more important segments of society. The doctor at the head of this criminal enterprise, Dr. Desai, was a member of the Gov. Gibbons transition team and we all know how much the RJ rightwing editors love the governor. Readers of this substandard publication shouldn't expect any in-depth, groundbreaking reporting on this story. Leave that kind of actual jounalism to the good folks at the Las Vegas Sun. Read All Comments