Las Vegas Clinic May Have Infected Many with Hepatitis C, HIV

[Guest guest]

As the article below states, a Las Vegas clinic was recently shut

down after authorities learned that the clinic had a policy of

reusing dirty needles on patients. As a result, more than 40,000

patients may have been exposed to Hepatitis and HIV. What's even

more alarming is that the clinic's owner, Dipak Desai, own's several

other clinics, and is free to return to his native India before

authorities can get down to the bottom of the scandal. More details

are outlined below in the attached article:

 

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Clinic's reused needles may have exposed 40,000 to hepatitis, HIV

Kathleen Hennessey, Associated Press

 

Thursday, March 6, 2008

 

 

(03-06) 04:00 PST Las Vegas --

 

Nearly 40,000 people learned this week that a trip to the doctor

might have made them sick.

 

In a type of scandal more often associated with developing countries,

a Las Vegas clinic was found to be reusing syringes and vials of

medication for nearly four years. The shoddy practices may have led

to an outbreak of the potentially fatal hepatitis C virus and exposed

patients to HIV, too.

 

The discovery led to the biggest public health notification operation

in U.S. history, brought demands for investigations and caused scores

of lawyers to seek out patients at risk for infections.

 

Thousands of patients are being urged to be tested for the viruses.

Six acute cases of hepatitis C have been confirmed. The surgical

center and five affiliated clinics have been closed.

 

" I find it baffling, frankly, that in this day and age, anyone would

think it was safe to reuse a syringe, " said Michael Bell, associate

director for infection control at the national Centers for Disease

Control and Prevention.

 

One of the infected patients is retired airplane mechanic Michael

Washington, 67, who was the first to report his infection. On the

advice of his doctor, he received a routine colon exam in July at the

Endoscopy Center of Southern Nevada.

 

In September, he started to get sick. He was losing weight fast. His

urine turned dark. His stomach hurt. By January, it was clear what

had happened.

 

Washington describes his virus as a " creeping death sentence " and

worries that others will hear his story and think twice before

getting the preventive care they need.

 

In letters that began arriving this week, patients who received

injected anesthesia at the endoscopy center from March 2004 to mid-

January were urged to get tested for hepatitis B and C, and HIV.

 

Because all three viruses are transmitted by blood, they could have

been passed from one patient to the next by the unsafe practices at

the clinic.

 

The mass notification is the result of a health district

investigation that began in January when officials linked an uptick

of unusual hepatitis C cases to the clinic.

 

Health officials say they are most worried about the spread of

hepatitis C, which targets the liver but shows no symptoms in as many

as 80 percent of infections.

 

Hepatitis C results in the swelling of the liver and can cause

stomach pain, fatigue and jaundice. It may eventually result in liver

failure. Even when no symptoms occur, the virus can slowly cause

damage to the liver.

 

Officials estimate that 4 percent of the patients already had the

virus when they entered the clinic, compared with 0.5 percent for

hepatitis B and less than 0.5 percent for HIV. Hepatitis C also is

easier to transmit than HIV, they said.

 

" You put the two together, and hepatitis C is really our big

concern, " said Brian Labus, senior epidemiologist at the Southern

Nevada Health District.

 

Health inspectors say they observed clinic staff using the same

syringe twice to extract anesthesia from a single-dose vial, which

was then used to treat more than one patient. The practice allows

contaminated blood in a used syringe to taint the vial and infect the

next patient.

 

Of the six patients so far diagnosed with acute hepatitis C, five

received treatment at the clinic on the same day in late September.

 

Since 1999, the CDC counts 14 hepatitis outbreaks in the United

States linked to bad injection practices.

 

The largest outbreak occurred in Fremont, Neb., where 99 cancer

patients were infected at an oncology center from 2001 to 2002. At

least one died. The doctor involved in the case acknowledged reusing

syringes and settled scores of lawsuit. But he never explained why

the syringes were reused.

 

Bell said such improper procedures appear to be more common in

outpatient surgical centers like the endoscopy center. Unlike

hospitals, such centers often do not have employees whose sole

responsibility is to monitor and educate staff on best practices.

 

In Las Vegas, clinic staff told inspectors they had been ordered by

management to reuse the vials and syringes. Labus described the

practice as an unwritten but long-practiced policy.

 

Investigators were told the practice was an attempt to cut costs,

according to a letter of complaint from the city, which revoked the

facility's business license Friday. Five other facilities affiliated

with the Endoscopy Center of Southern Nevada also had their licenses

revoked.

 

The clinic's majority owner, Dipak Desai, a political contributor and

member of the governor's commission on health care, has refused to

comment on the allegations.

 

He released a statement expressing concern for the patients and

assuring the public the problems had been corrected. He later took

out a full-page ad in Sunday's edition of the Las Vegas Review-

Journal insisting that needles had not been reused and that the

chances of contracting an infection at the center in most of the last

four years were " extremely low. "

 

http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2008/03/06/MNACVECHH.DTL