Las Vegas Hepatitis Investigation

The Southern Nevada Health District (SNHD) recently notified 40,000 people that the unsafe syringe handling practices of the Endoscopy Center of Southern Nevada may have infected them with bloodborne pathogens. The Health District advised these people to undergo testing for Hepatitis B and C and HIV.

Since the beginning of the investigation in January 2008, the U.S. Centers for Disease Control Since beginning the investigation, CDC and SNHD “have identified a total of six cases of HCV infection among patients who had undergone procedures at the clinic in the 35–90 days prior to onset of symptoms. These patients did not have other risks for HCV infection.”

The Las Vegas Sun reported on the “assembly line” colonoscopy procedures at the clinic:

The Endoscopy Center of Southern Nevada opened in March 2004 in a medical building at 700 Shadow Lane, between two of the city’s largest hospitals — and across the street from the offices of the Southern Nevada Health District, which launched its surprise inspections of the facility in January. The business complements Desai’s Gastroenterology Center of Nevada, which has six valley locations. Although other doctors worked at the high-volume facility, it was Desai’s domain. Appointments were frequently double-booked, leading to two-hour waits in a standing-room-only waiting room, said a nurse who worked there in 2007. In assembly-line fashion, patients were hurried among nurses who would admit them, start an IV in their arm, take them to the room for the procedure, and then walk them to a recovery area before sending them out the door. “He would always say, ‘Time is money,’ ” the nurse said of Desai. “The faster we would go, the happier he was.” The flow of patients sounds impossibly fast, said Phyllis McGregor, a nurse who for 20 years directed the gastroenterology department at Centinela Hospital Medical Center in Inglewood, Calif. She ran three rooms where a total of 30 procedures a day were done, at the most. Desai was doing 60 procedures in two rooms — a pace that McGregor said compromised patient safety.

The Las Vegas Review Journal features a hot topics page on the sad story.

The Endoscopy Center has been shut down by the City of Las Vegas except for administrative activities. The owner has agreed to stop practicing medicine at least until the investigation is completed. Snap inspections by Nevada health authorities and the CDC have disclosed unsafe procedures at other ambulatory surgicial centers in the state. A local columnist opined that “no matter how the Endoscopy Center of Southern Nevada saga plays out, it’s going to be a long time before the Las Vegas community gets back to feeling good about health care here.”