Inspections prompted by hepatitis C outbreak in Las Vegas find more violations at clinics

The unsafe medical procedures that spread hepatitis C among patients at a large Las Vegas surgical clinic may be more widespread and may have resulted in more infections than first believed, health officials said.

Health inspections at 13 other outpatient surgical centers in the Las Vegas area found several violations of standard practices, Lisa Jones, head of the state licensing bureau, testified to a legislative committee on health care Thursday.

"We're finding problems at a variety of different levels — medication reuse, in some cases syringe reuse in different procedures and functions. That's why one of our very first actions is the need to get the word out on the street," Jones said.

She would not comment more precisely on the nature of violations in other surgical centers.

The public hearing was the first investigating an outbreak of the hepatitis C virus traced to the Endoscopy Center of Southern Nevada. Six patients have been diagnosed with acute hepatitis C. The surgical center and five affiliated clinics have been closed, and five nurses have surrendered their licenses.

In the largest patient notification effort in U.S. history, nearly 40,000 people treated at the center from March 2004 to mid-January were sent letters telling them they are at risk for exposure and should be tested for hepatitis, strands B and C, and HIV.

Legislators also were told that some patients have not been notified because the Endoscopy Center did not provide a complete list of patients and investigators can't be sure when the unsafe practices began.

Hepatitis is a potentially fatal, blood-borne virus that causes inflammation of the liver and can lead to stomach pain, fatigue and jaundice. It goes undetected in as many as 80 percent of cases.

Health officials believe the virus was spread when clinic staff regularly reused syringes and vials of anesthesia intended to be used on one patient. Clinic staff told inspectors that the practice was ordered by management.

Inspectors also saw staff members inappropriately cleaning two scopes in one solution, officials said.

Health District chief Lawrence Sands said those practices are "unacceptable" and "should never have happened." Sands said reusing syringes and vials of medication was a well-known violation of common safety standards, and he called for better oversight, whistleblower protection and education within the medical community.

The clinic's majority owner, Dipak Desai, has refused to comment.

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 past four years were "extremely low."

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On the Net: Southern Nevada Health District: http://www.southernnevadahealthdistrict.org/