Reno Personal Injury Lawyer - Medical Malpractice

Nevada Slow to Inspect Endoscopy And Other Surgery Centers

Steve Klearman — Thu, 13 Mar 2008 15:33:01 GMT

The Reno Gazette reports that the State Health Division has fallen behind in inspecting surgical centers for more than 10 years and has failed to inspect half of all centers over the past six years as is called for by Federal guidelines.

More specifically, State inspectors failed to inspect 22 of Nevada's 50 surgical centers over the last six years and at least one center has gone without inspection for 15 years.

The Director of the Centers for Disease Control and Prevention has indicated that it is assessing whether unsanitary practices are occurring at surgical centers nationwide. Interestingly, she noted "tremendous cost incentive" for clinics to skirt proper procedures.

Originally posted at InjuryBoard by Steve Klearman

Reno Surgery Center Situation Different So Far From Las Vegas Hepatitis Scare

Steve Klearman — Mon, 10 Mar 2008 14:56:18 GMT

I've been travelling for depositions the last few days while the story of deficiencies among ambulatory surgery centers has been brewing.

What's clear from the recent publicity regarding surgery centers other than the infamous Endoscopy Center of Southern Nevada is that not so much is clear.

Apparently when the State determined that as many as 40,000 people who visited the Southern Nevada house of surgical ill-repute might be infected with some awful thing or another, the State decided that it might widen its probe. Not completely surprisingly, the State found bad practices elsewhere, including in Reno.

While bad practices are bad practices, it's not clear as of this writing just what the State may have found at locales north, and residents may wish to wait before rushing to judgment. My information is that allegations regarding Digestive Health Center in Reno are misleading and that local press may print clarifications in the coming days. So stay tuned and we'll see what happens.

Here are a few things we know:

First, people who have visited centers that have been cited for deficiencies or have questions about the investigation can talk to an expert by calling the health department's hotline at (702) 759-4636. The hotline can also be used by Northern Nevada residents; there is currently no hotline set up for local calls.

The foregoing was reported by the Reno Gazette Journal, which also indicated that "[f]or now, the state is advising the public to be patient."

Why, though, should the State think that people should or will be patient when the State itself has publicized vague information and directives?

Importantly, there has been no report that I know of that anyone in the Reno or surrounding areas has tested positive for some disease associated with bad practices at any northern Nevada facility. There is no known correlation between the spread of disease and northern Nevada deficiencies. And this distinguishes the northern Nevada inspections from the southern Nevada inspections.

Here are some other things we know:

State police, the FBI and Nevada's attorney general's investigators served warrants today at six southern Nevada medical clinics associated with a facility accused of infecting patients with hepatitis by reusing syringes and vials of medicine. According to the Reno Gazette Journal, police say the raids are part of a criminal investigation of officials at the Gastroenterology Center of Nevada;

Governor Gibbons said today in a news conference that better funding for more inspections of Nevada's out-patient surgical centers likely would not have prevented the unsafe practices that infected six patients with hepatitis C at a Las Vegas clinic. Frankly, this sounds somewhat absurd. Of course more inspections would have been useful. As things now stand, these clinics are inspected sporadically, and inspections occur once every seven or so years. Why wouldn't more inspections serve the public good?

The Nevada Health Department's site isn't especially enlightening, but there is a press release issued as of Friday and I reprint that below. Keep tuning in: I will be watching this story closely and will bring you unadulterated and balanced reports based upon media and independent research. For now, I agree that northern Nevadans should not jump to conclusions.

Here's the State's official press release, which can also be found at State Press Release on Surgery Center Inspections March 7, 2008

SEVERAL ADDITIONAL OUTPATIENT SURGICAL CENTERS
FOUND TO HAVE DEFICIENT PRACTICES

No Further Infectious Disease Reports Identified

Carson City--Nevada Department of Health and Human Services (DHHS) Director
Mike Willden announced today that the Nevada State Health Division, Bureau of Licensure and
Certification (BLC) has found several outpatient surgical centers that have had deficiencies noted
during Focus Surveys currently being conducted. The Surveys are being completed as part of the
State's effort to inspect all fifty Ambulatory Surgical Centers (ASCs) in the state that perform
outpatient surgical procedures.

In Northern Nevada, Focus Survey inspections have been done at ten of 19 ASCs. Three
facilities in Reno were found to be deficient due to a lack of using proper antiseptic practices or
for not using proper infectious disease prevention procedures. Five other facilities were found to
have problems that did not pose an infectious disease risk. In all eight cases, immediate
corrective action was undertaken before BLC staff exited the facility. At two facilities, Sierra
Vista Surgery Center and South Meadows Endoscopy Center, no deficiencies were noted.
In Clark County, the Gastrointestinal Diagnostic Center will receive a formal Statement
of Deficiencies on Monday, March 10, from BLC. The deficiencies noted at the facility are
similar to those discovered at the Endoscopy Center of Southern Nevada. The facility will have
ten days to submit its Plan of Correction to BLC (March 21, 2008). Upon further inspection, if
the facility is found to be negligent in adhering to the Plan of Correction, the facility is subject to
summary suspension of its license.

"It is important to note there has been absolutely no known infectious disease reports
associated with any of the facilities that were notified of deficient practices," Willden said.
"Further, the Bureau of Licensure and Certification does not leave a facility whose practices pose
a threat to public health until corrective action is taken."

Willden said the State Health Division continues to work closely with the Washoe
County Health Division and the Southern Nevada Health Division to monitor any reports of
infectious disease any of the three agencies discovers.

Three facilities in the Reno area who were identified as being deficient due to a lack of
using proper antiseptic practices or for not using proper infectious disease prevention procedures
are:

â€¢ St. Mary's Outpatient Clinic at Galena
18653 Wedge Parkway, Reno

Improper sterilization procedures

â€¢ Digestive Health Center
5250 Kietzke Lane, Reno

Improper sterilization procedures

â€¢ Sierra Center for Foot Surgery
1801 N. Carson Street, Carson City

Staff admitted reusing syringes

Willden said the State Health Division will post on its website (http://health.nv.gov)
information about all ASC inspections by BLC. Members of the public may call (775) 684-5900
24 hours a day to receive information about any questions related to the inspections or infectious
disease prevention.

Originally posted at InjuryBoard by Steve Klearman

Nevada Hepatitis Links

Steve Klearman — Fri, 07 Mar 2008 14:13:09 GMT

Here's a great link to the Las Vegas Review Journal's Clearinghouse page of links. Highly recommended!

Review Journal Links on Hepatitis Scarel

Originally posted at InjuryBoard by Steve Klearman

Nevadans Question Vaccinations

Steve Klearman — Fri, 07 Mar 2008 14:09:15 GMT

According to an article from PBS: Newshour Extra dated March 7, 2008, a number of parents are blaming vaccinations for the emergence of autism in their children.

Parents are filing their cases in a "federal vaccine court," which was set up to protect vaccine makers from bankruptcy. If the vaccination companies are found at fault, the award plaintiffs will come from a government fund and not from the industry itself.

The parents claim that thimerosal, a preservative in vaccines that contains mercury, caused their children to have autism. This is a preservative that is common in many of the vaccinations given to young children.

A study conducted by the Centers for Disease Control in 2003 disputes this contention and maintains that there is no scientific evidence to show that the preservative causes autism in children.

Some parents argue that autism levels are rising in the U.S. Only one infant in every 10,000 births in the 1880's was diagnosed with autism while that number rose to one in every 166 births in 2003.

Some scientists argue that the increase in autistic children is actually do to the fact that autism is being used more liberally as a label for any child who is mentally retarded or learning disabled. Using autism as the classification of the illness qualifies the child for financial aid and other education assistance.

Nine test cases in this matter are set to be resolved in June and will set the precedent for thousands of other cases to follow.

Originally posted at InjuryBoard by Steve Klearman

Chinese Take Shot at Nevada Hepatitis Situation

Steve Klearman — Tue, 04 Mar 2008 10:38:07 GMT

I used to live in Taiwan and I've travelled back and forth to Mainland China many times.

The Chinese do things in subtle ways sometimes.

For years now, China has felt the pressure of U.S. criticism of Chinese safety standards.

This is why it comes as little surprise that China is now running stories in the Chinese press about LOW AMERICAN SAFETY STANDARDS. We shoot at them; they seek out hypocrisy and shoot back.

More specifically, the Chinese Xinhua news agency has run regular stories on this event and reports as of today.

In one story, Xinhua notes that:

An outbreak of hepatitis C at a Nevada clinic in the United States may be "the tip of an iceberg" of safety problems at clinics around the country, said the head of the Centers for Disease Control and Prevention.

In another:

Roger Von Bergendorff, who remains in a coma at Spring Valley Hospital, also has had financial problems, filing for bankruptcy in 2000.

Authorities believe they recovered all the ricin in several vials found last week from the motel near the Las Vegas strip where Von Bergendorff had stayed. But they also checked a home in Riverton where Von Bergendorff had lived with a cousin, Thomas Tholen, as well as three storage containers linked to Von Bergendorff.

The FBI said the searches yielded no health threats. Tholen declined to comment Monday when reached by telephone. He said he had not spoken with investigators. Las Vegas police said that firearms, an "anarchist-type textbook" and castor beans were found in the motel room. The book was tabbed at a spot containing information about ricin.

Public records show Von Bergendorff, 57, used at least six addresses between 1983 and 2007 in cities in Utah and California.

He had lived in Riverton for more than a year before moving to Las Vegas about a year ago, said former neighbor Tammy Ewell. He spent the last three months in a camper belonging to a neighbor, John Walster.

Ewell described Von Bergendorff Monday as an introverted man who wore down his hosts by living rent-free and taking advantage of their hospitality.

She said Von Bergendorff wasn't social with neighbors and often didn't return a friendly wave. But while Von Bergendorff could be awkward around people, he loved animals, she said. She said he returned to Utah several times after he moved to Las Vegas to search for a lost cat.

See: xinhuanet.com

Other stories Xinhua is currently running deal with China's efforts to improve rural medical care and U.S. statistics which suggest that use of cosmetic surgery in the U.S. soared in 2007.

Originally posted at InjuryBoard by Steve Klearman

Nevada Hepatitis Doctor Served on Nevada Medical Board

Steve Klearman — Sun, 02 Mar 2008 11:44:58 GMT

This comes to me once again from Susan Gallagher, Associate Professor at the University of Massachusetts:

Dipak K. Desai, M.D., was re-elected to the position of Secretary-Treasurer of the board. Dr. Desai practices in Las Vegas and has served on the board since September 1, 1993, having just been re-appointed by Governor Miller for his second four-year term. In his capacity as Secretary-Treasurer, Dr. Desai will continue to serve as Chair of the board's Investigative Committee.

It appears that Dr. Desai may have left the Board in 2003...

Nevada Hepatitis Doctor Sued Before

Steve Klearman — Fri, 29 Feb 2008 16:12:18 GMT

I discussed Dipak Desai, MD, several blogs ago in some detail.

The following useful article was referred to me by Susan E. Gallagher, an Associate Professor at the University of Massachusetts:

Nevada Law Journal Article on Dipak Desai Medical Malpractice

Back tomorrow with the promised article on why this case of what appears to be plain and substantial medical malpractice reflects what a disaster medical malpractice reform is for Nevadans.

Originally posted at InjuryBoard by Steve Klearman

Hepatitis Victims May Be Duped By Med Mal Insurance Industry

Steve Klearman — Fri, 29 Feb 2008 10:47:48 GMT

Nevadans, you were duped by the medical malpractice insurance industry when you voted for the KODIN Ballot Initiative a few years back.

Now those injured through the sheer negligence and stupidity of a group of Nevada doctors may find that they've limited their ability to collect compensation.

Consider, for instance, that damages for pain and suffering are now capped in Nevada at $350,000.00. Evidence of insurance payments can come into evidence. The statute of limitations is now reduced to a year in many situations. The list of penalties for victims goes on and on.

If you got Hepatitis or HIV as the result of medical negligence do you think that $350,000 (before attorneys fees and costs) was enough to compensate you?

Call your state representatives and let them know that KODIN is a mistake.

Originally posted at InjuryBoard by Steve Klearman

Hepatitis Exposure in Nevada - Public Health Information

Steve Klearman — Fri, 29 Feb 2008 09:51:43 GMT

The following important public health information is reprinted from the Southern Nevada Heatlh District www.southernnevadahealthdistrict.com

The Southern Nevada Health District is advising patients who received injected anesthesia medication at the Endoscopy Center of Nevada (700 Shadow Lane) of a risk for possible exposure to hepatitis C and other bloodborne pathogens. The health district is recommending patients who had procedures requiring injected anesthesia at the clinic between March 2004 and January 11, 2008, contact their primary care physicians or health care providers to get tested for hepatitis C as well as hepatitis B and HIV.

Why is the health district making these recommendations?

The health district received notification of three acute cases of hepatitis C in January 2008 and has identified a total of six cases to date. Five of the cases had procedures requiring injected anesthesia on the same day.

Following a joint investigation with the Nevada State Bureau of Licensure and Certification (BLC) and with consultation from the Centers for Disease Control and Prevention, the health district determined that unsafe injection practices related to the administration of anesthesia medication might have exposed patients to the blood of other patients.

The exposures did not result from the medical procedures performed.

How were the cases discovered?

The cluster of illnesses came to the attention of the health district in January 2008.

These cases were reported to the health district by area physicians.

Nevada law requires that medical providers notify public health officials when they identify a number of different diseases, including hepatitis C.

The common link between cases was identified through the routine investigation of the cases reported by medical providers, which includes an interview of the patient.

Why did it take several months for this to come to the attention of the health district?

Most people infected with hepatitis C virus do not develop symptoms and do not know that they have been infected. As a result, these infections would not have been reported to the health district.

An infection with hepatitis C that results in the patient developing symptoms (acute disease) is rare so it is an unusual occurrence that brought this problem to the attention of the health district.

On average, two cases of acute hepatitis C are reported each year in Clark County. Six cases have been identified in relation to this investigation.

How were patients exposed?

A syringe (not a needle) that was used to administer medication to a patient was reused on the same patient to draw up additional medication.

The process of redrawing medication using the same syringe could have contaminated the vial from which the medicine was drawn with the blood of the patient.

The vial, which was not labeled for use on multiple patients, was then used for a second patient (with a clean needle and syringe).

If that vial was contaminated with the blood of the first patient, any subsequent patients given medication from that vial could have been exposed to bloodborne pathogens.

How did you determine the link between these cases?

Of the six known cases, five had procedures on the same day. Genetic testing on four of the cases from that day has identified they likely came from a common source.

The patient that had a procedure on a different day does not share a common source as the other four. This indicates the problem that allowed disease transmission to occur was not a one-time event, but had recurred over an extended period of time.

Investigation of the clinic practices identified common practices, which would allow disease to be transmitted in this manner.

What actions have been taken to correct the unsafe injection control practices?

The unsafe injection practices associated with these cases were identified during the investigation conducted in mid-January. The injection practices that lead to the exposure have been corrected, so no new patient exposures should be occurring.

As it can take several months for the symptoms of hepatitis C to appear, additional cases might be identified despite no ongoing transmission of disease.

Who performed the investigation?

The response was led by the Southern Nevada Health District, and the team included members of the Nevada State Bureau of Licensure and Certification and the Centers for Disease Control and Prevention.

Why is the health district also recommending testing for hepatitis B and HIV?

The investigation revealed practices that could have exposed patients to the blood of another patient. Although hepatitis C was the focus of the investigation, hepatitis B and HIV can be transmitted in the same manner.

How many people will be diagnosed with hepatitis C, B or HIV from this investigation?

It is unknown how many people were infected at the clinic. Hepatitis C, B and HIV are routinely found in the population. A significant number of people might have been infected prior to their procedure. Although testing can determine if a person is infected, it cannot determine the source of the infection.

How serious are these illnesses?

Hepatitis C, B or HIV can result in a range of disease severity, and can eventually result in death.

It is important that patients speak with a physician or health care provider if you have one of these diseases. A physician will be able to address specific risks for serious illness and develop a plan to monitor your health.

How many cases of hepatitis C are reported to the health district each year?

On average, two cases of acute hepatitis C are identified each year in Clark County.

Most people who become infected with hepatitis C initially have mild or no symptoms and do not know that they have been infected unless they are tested by a doctor. Only a small percentage of people infected with hepatitis C develop acute disease and have any outward signs of infection.

What is the Southern Nevada Health District's role in the response?

The Southern Nevada Health District is responsible for investigating reports of illness in our community in order to take steps to protect the health and well-being of the public.

Once notified of a reportable disease the health district begins an investigation and works with the appropriate agencies to address any issues identified and make recommendations to help prevent this type of situation from occurring again.

As a patient how can I protect myself when getting these types of medical procedures?

It is important to remember the transmission of the disease in these cases were not related to the medical procedures, but rather to the anesthesia administered to the patient.

When proper injection practices are followed, medical procedures, including colonoscopies or similar procedures, are generally safe.

All health care professionals and medical facilities should follow safe injection practices and infection control procedures. Patients can and should ask their medical providers about the practices used in their facility.
Are these types of medical procedures safe?

Preventive medical procedures are an important part of protecting yourself against the development of diseases, including cancer. If recommended by your physician, there is no reason why you should avoid undergoing these types of medical procedures.

Although this investigation focused on a center that performed endoscopies, the source of the exposure was the way the anesthesia was administered.

What is being done to prevent this from happening again?

The Southern Nevada Health District, the Nevada State Health Division and the Bureau of Licensure and Certification are providing technical bulletins and educational materials to medical facilities and providers in an effort to educate the health care community and prevent these types of incidents from happening in the future.

What are the recommendations for people who test positive for hepatitis C, B or HIV?

Options for disease management and possible treatment options, as well as regular health monitoring, should be discussed with a physician, who can determine the appropriate next steps for the patient.

Originally posted at InjuryBoard by Steve Klearman

Nevada Hepatitis Warning - Endoscopy Center of Southern Nevada Malpractice

Steve Klearman — Fri, 29 Feb 2008 08:52:46 GMT

Alright, let's get into this.

The subject of controversy is an entity known as Southern Nevada Endoscopy Center.

The Nevada Secretary of State indicates two limited liability companies registered under that name, both active:
The first reflects that Clifford Carrol, MD and the Hari Om Limited Partnership are officers.

The second company, which has the same name but is listed as Endoscopy Center of Southern Nevada II, lists Dipak Desai, MD and Vishvinder Sharma, MD as officers.

There are two entries at the Nevada Secretary of State for Hari Om Limited Partnership.

The first lists Dipak Desai, Kusum Desai and Dilip Patel as partners.

The second, Hari Om II, LLC, shows that it was dissolved on February 7, 2008.

The Nevada Board of Medical Examiners Site does not show disciplinary action for Dr. Carrol. He has had his license here since 1997.

The State Board has disciplined Dipak Desai, MD and the State site provides as follows:

FORMAL DISCIPLINARY ACTION TAKEN BY THE NEVADA STATE
BOARD OF MEDICAL EXAMINERS:

SEPTEMBER 13, 1996

The Investigative Committee of the Nevada State Board
of Medical Examiners filed a formal complaint against
Dr. Desai, the managing partner of Gastroenterology
Center of Nevada, alleging that he was advertising the
practice of medicine in a false, deceptive or misleading
manner by stating that certain members of the medical
group are Board Certified Gastroenterologists when in
fact they are not board certified in Gastroenterology.
Copies; Complaint 12 pages

OCTOBER 23, 1996

The Nevada State Board of Medical Examiners
accepted the Stipulation for Settlement and it was
Ordered that Dr. Desai, the managing partner of
Gastroenterology Center of Nevada, pay the sum of
$2,500 as disgorgement of payments which may
have been received by the group as a result of false
advertisment.

Copies; Order 4 pages Stipulation for Settlement 8 pages

Kusum Desai has been a licensed Nevada doctor (scope of practice listed as critical care, internal medicine and pulmonary disease) since 1980 and has no listed disciplinary actions.

The Board site does not pull up a listing for Dilip Patel.

An advanced search in Google reveals many Dilip Patel's, including an attorney, but it is not clear which Dilip Patel is listed with the Secretary of State.

A Clark County District Court inquiry shows one lawsuit in the mid 90s against a Dilip Patel (perhaps the same individual) in which Mr. Patel is listed as a defendant. This case went to arbitration

For more on the District Court case, see District Court Information on Patel Case

Vishvinder Sharma, MD is listed with the State, is licensed since 1994 and the Board lists no disciplinary actions.

This mess gained intial attention in January 2008 and widespread publicity as of yesterday.

The health district received notification of three acute cases of hepatitis C in January 2008 and subsequently identified a total of six cases to date. Five of the cases had procedures requiring injected anesthesia on the same day.

There seems to be fairly universal acknowledgment that the malpractice that may have exposed as many as 40,000 to serious disease stems from the reuse of a syringe (not a needle) that was used to administer medication to a patient was reused on the same patient to draw up additional medication. The process of redrawing medication using the same syringe could have contaminated the vial from which the medicine was drawn with the blood of the patient. The vial, which was not labeled for use on multiple patients, was then used for a second patient (with a clean needle and syringe). If that vial was contaminated with the blood of the first patient, any subsequent patients given medication from that vial could have been exposed to blood borne pathogens.

The Southern Nevada Health District has an extensive question and answer on this subject on its site at Southern Nevada Health District and I will reprint that in another blog today.

IF YOU TEST POSITIVE FOR HEPATITIS C, B OR HIV, AND YOU WERE EXPOSED BY VIRTUE OF TREATMENT AT THE ENDOSCOPY CENTER OF SOUTHERN NEVADA, CHECK OUT OUR CREDENTIALS AND CONTACT US THROUGH INJURYBOARD.

Originally posted at InjuryBoard by Steve Klearman