Articles (Las Vegas Endoscopy Clinic)

Articles (Las Vegas Endoscopy Clinic) http://www.hepatitisexposure.com Articles RSS Feed from Las Vegas Endoscopy Clinic en-us All Rights Reserved. © Copyright IBCTV 2008 Wed, 12 Mar 2008 16:35:06 CDT Wed, 12 Mar 2008 16:35:06 CDT Las Vegas Endoscopy Clinic ArticlesRudyrudy@opusviproductions.com Rolling the Dice with patient Health: The Law of Averages Catches Up with a Vegas Surgi-Center http://www.hepatitisexposure.com/site/articles?post_id=618 Las Vegas Endoscopy Clinic Rolling the Dice with patient Health: The Law of Averages Catches Up with a Vegas Surgi-Center 00:00 Rolling the Dice with patient Health: The Law of Averages Catches Up with a Vegas Surgi-Center On February 29th, Nevada state health officials closed the Endoscopy Center of Southern Nevada in Las Vegas after six patients were diagnosed with hepatitis C. These cases were noted in January, and the outbreak was traced back to nurse anesthetists at the Center reusing syringes to draw up medicine from single-use vialsâА"for multiple patients. As a result, in the biggest public health notification in U.S. history, more than 40,000 people have been informed that they should be tested for hepatitis and HIV. "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 Centers for Disease Control and Prevention. To clarify what happened, according to the Southern Nevada Health District... 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. Less than a week after the facility was closed, in an unusual move, five of the nurses involved voluntarily surrendered their licenses. By all indications, the nurses were doing what they were told in administering anesthesia for procedures, and that it was standard practice at the clinic. For its part, the American Association of Nurse Anesthetists (AANA) has condemned the unsafe injection practices. Listen to Wanda Wilson, PhD, president of the 37,000 member AANA: "It is astounding that in this day and age there are nurse anesthetists, anesthesiologists, and other health care professionals who still risk using needles and syringes on more than one patient, or know of such activities and don't report them. Published standards and guidelines dictate that single-use and disposal of these products is the best way to ensure patient safety. Patient safety is our primary focusâА"not cost savings, time savings, or any other factor." "These types of incidents are completely unacceptable, and the AANA is determined to help uncover the root cause and correct the problem." It seems to me that the "root cause" here is nothing more complicated than the owners of the clinic wanting to save a little money, and simply forcing the nurses to do what they knew was improper. There is no possibility that health care professionals would be ignorant about such basic infection control practices. Those involved just did not care. Indeed, in the wake of 2002 hepatitis outbreak in Norman, Oklahoma, AANA had run a survey to learn more about practices and attitudes on needle and syringe reuse. Three percent of anesthesiologists who responded indicated they reuse needles and/or syringes on multiple patients. Nurse anesthetists, other physicians, conventional nurses, and oral surgeons reported reuse at one percent or less. Extrapolating from these findings, we can conclude that approximately 1,000 anesthesia professionals could have exposed more than a million patients to risks of contaminated needles and syringes. While the Southern Nevada Health District is to be commended for its aggressive investigation, one of its statements peripheral to the matter is perplexing. The District emphasizes that "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." This statement is technically correct, but from a patient's point of view, it is a distinction without a difference. Since anesthesia must always be given for these procedures, why even raise this issue? More than that, the traditional concern in endoscopic procedures has always been about the sterility of the scope, which is far more difficult to ensure. Cold comfort to know that the infections were transmitted by pure malfeasance! When was the last time you heard of someone getting hep C from a flu shot, for example? As if any more bad news were needed, Lisa Jones, head of the state licensing bureau, revealed that similar violations have been found at 13 outpatient surgical centers, in addition to the clinic that prompted the investigation. "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. Hospitals have complained for years about the lax oversight given to surgi-centers such as the facilities under investigation, and they surely have a point. One hopes that this case will inspire some big changes, including hard jail time for the perps involved and the national (not just statewide) revocation of their licenses. Michael D. Shaw http://www.hepatitisexposure.com/site/articles?post_id=618 Las Vegas Endoscopy Clinic Two More Las Vegas Clinics Closed in HIV Scandal http://www.hepatitisexposure.com/site/articles?post_id=617 Las Vegas Endoscopy Clinic Two More Las Vegas Clinics Closed in HIV Scandal 00:00 Two More Las Vegas Clinics Closed in HIV Scandal Atlanta, GA 3/05/2008 11:46 PM GMT (FINDITT) Two more Nevada clinics were shut down Wednesday after the medical group that operates them was accused of infecting people with the hepatitis C virus. The closure of Gastroenterology Center of Nevada offices in Henderson and North Las Vegas leaves just one clinic associated with the company still open. That clinic is located on Tenaya Way in Las Vegas. The Southern Nevada Health District says some 40,000 former patients of the group's Endoscopy Center of Southern Nevada on Shadow Lane are at risk of hepatitis C, B and HIV, the virus that causes AIDS. They received treatment at the clinic between March 2004 and last Jan. 11. Center owners can appeal Tuesday's orders to shut down the clinics to the Henderson and North Las Vegas city councils. City, county, state and federal agencies are investigating amid allegations that injection practices, including reuse of syringes and vaccines, exposed patients to potentially deadly infections. http://www.hepatitisexposure.com/site/articles?post_id=617 Las Vegas Endoscopy Clinic Dr. Dipak Desai Surrenders License in Hepatitis Scare http://www.hepatitisexposure.com/site/articles?post_id=616 Las Vegas Endoscopy Clinic Dr. Dipak Desai Surrenders License in Hepatitis Scare 00:00 Dr. Dipak Desai Surrenders License in Hepatitis Scare In the fall of 2001 I was leaving on an extended trip and went to the family physician for the usual shots and prescriptions for malaria etc. As I was leaving, he gave me a dozen individually wrapped syringes. If I had to visit a doctor during my travels, he suggested that I use only these syringes. I had never taken this precaution on my earlier travels. When asked, he told me that five of his patients who had recently returned from India had acquired hepatitis (both chronic and acute) and were under his treatment. Hepatitis is a viral inflammation of the liver. It can be acute or chronic. The former last up to six months and the latter lasts longer, sometimes indefinitely. One of the prime causes of its spread is through unclean syringes. And unclean syringes also cause HIV-aids. K. P. Nayyar broke this news story in the Telegraph yesterday: An Indian American doctor is at the centre of what is emerging to be AmericaâАЩs biggest medical malpractice scandal. As many as 40,000 people may have been infected with the deadly hepatitis C virus or HIV from a Las Vegas clinic, owned by Dr Dipak Desai, which has been reusing syringes and medical vials for nearly four years. Local TV crews are now descending on his luxurious home with a swimming pool, spa and multiple fireplaces, for which Desai and his wife paid $3.4 million (Rs 13.6 crore) with what may now turn out to be tainted money. The scandal has created a frenzy among lawyers who have begun chasing ambulances and taking out television and newspaper advertisements seeking out infected patients in what could be a huge class action suit against the Endoscopy Center of Southern Nevada. Desai owns 65 per cent of the medical facility. Nevada authorities have issued a health notification urging thousands of people who have used DesaiâАЩs facilities to get tested for infections. So far, six cases of hepatitis C have been confirmed. Six of his facilities have been closed. Dr. Desai is a politically savvy operator who owns several medical facilities in Nevada, is a contributor to both Democrats and Republicans and is friendly with the Nevada Governor, and sits on the Governor's Commission on Healthcare. According to AP: 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." In bulk purchase a syringe costs less than 10 cents each! "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. While Dr. Dipak Desai does not show up on this list of prominent NRI Indians his activities would cast a long and dark shadow over the vast majority of law abiding Indians in the U.S. But that damage can be alleviated. What cannot be undone is the harm done to individuals and families. Some of them would have to pay with their lives for this penny-saving short cut. The FBI has launched a probe into alleged Medicare fraud, and the Nevada State Board has announced that Dr. Dipak Desai has "voluntarily agreed to stop practicing medicine, at the boardâАЩs request until the boardâАЩs investigation into the operations and allegations concerning the center has been completed." http://www.hepatitisexposure.com/site/articles?post_id=616 Las Vegas Endoscopy Clinic Las Vegas Closes Clinic Connected To Hepatitis C Outbreak http://www.hepatitisexposure.com/site/articles?post_id=615 Las Vegas Endoscopy Clinic Las Vegas Closes Clinic Connected To Hepatitis C Outbreak 00:00 Las Vegas Closes Clinic Connected To Hepatitis C Outbreak Washington, DC (AHN) - The City of Las Vegas has closed down the Endoscopy Center of Southern Nevada last Friday after health officials reported six patients had contacted hepatitis C virus through shoddy practices. The clinic was reusing syringes and vials. Officials are urging 40,000 patients who gets treatment at the center from March 2004 to January 11, 2008, to get tested for hepatitis C, hepatitis B and HIV. Senate Majority Leader Harry Reid, D-Nev and CDC head Dr. Julie Gerberding strongly denounced the said practices at the clinic and should never occur in recent health care organizations. "This is the largest number of patients that have ever been contacted for a blood exposure in a health-care setting. But unfortunately we have seen other large-scale situations where similar practices have led to patient exposures," Gerberding said. Dr. Dipak Desai, head of the clinic post an open letter in the Las Vegas Review-Journal on Sunday, conveying his deepest sympathy to all patients and their families for the fear and uncertainty that naturally arises from the situation. Another unidentified local woman who now knows that she has hepatitis C said that she believed she acquired this virus after undergoing underwent treatment at the Endoscopy Center two years ago. Hepatitis C can cause liver inflammation that is often asymptomatic, but ensuing chronic hepatitis can result later in cirrhosis (fibrotic scarring of the liver) and liver cancer. It is spread by blood-to-blood contact with an infected person's blood. Cecilia Arceo - AHN http://www.hepatitisexposure.com/site/articles?post_id=615 Las Vegas Endoscopy Clinic Vegas Hepatitis Exposure List Incomplete http://www.hepatitisexposure.com/site/articles?post_id=614 Las Vegas Endoscopy Clinic Vegas Hepatitis Exposure List Incomplete 00:00 Vegas Hepatitis Exposure List Incomplete LAS VEGAS (AP) âА" 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 Thursday. 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. "We're finding problems at a variety of different levels âА" 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." By KATHLEEN HENNESSEY http://www.hepatitisexposure.com/site/articles?post_id=614 Las Vegas Endoscopy Clinic