Jury seated, opening arguments begin in Las Vegas hepatitis C trial

A former endoscopy clinic owner and an employee were responsible for a Las Vegas hepatitis C outbreak that sickened at least seven people, killed one, and raised fears of infection for more than 50,000 patients who were told to get tested for blood-borne diseases in 2008, prosecutors told a Nevada state court jury in Las Vegas on Monday.

After fighting for five years to reach trial, prosecutor Michael Staudaher told 12 jurors and six alternates seated for the case in Clark County District Court that former Dr. Dipak Desai and former nurse-anesthetist Ronald Lakeman emphasized speed over safety and pinched pennies so much that the incurable liver disease was spread from patient to patient at Desai's clinics.

Desai and Lakeman have pleaded not guilty to 28 charges that could send them to prison for life if they're convicted. The counts include criminal neglect of patients, reckless disregard of persons, theft, obtaining money under false pretenses, insurance fraud and murder.

Their lawyers are scheduled to make opening statements Tuesday.

Court officials say the trial could take six weeks or more.

The outbreak became public in February 2008 when the Southern Nevada Health District notified more than 50,000 Desai clinic patients to get tested for blood-borne diseases, including hepatitis and HIV. Health investigators later determined that nine people contracted incurable hepatitis C at two Desai clinics, and that hepatitis C infections of another 105 patients may have been related.

Most charges stem from the infections of six people who health investigators say contracted hepatitis C through unsafe injection practices on Sept. 21, 2007, at one Desai clinic, the Endoscopy Center of Southern Nevada. Another patient was infected on July 25, 2007, officials said.

The murder charge was added last year after infected former patient Rodolfo Meana died in the Philippines at age 77. Meana, a former Philippine military officer, had become a naturalized U.S. citizen after emigrating from the Philippines in 1997.

Desai's defense attorneys maintain Desai is unfit for trial because he is so incapacitated by strokes and other physical ailments that he cannot assist in his defense.

The trial was delayed for years for competency hearings, but defense attorney Richard Wright has been unable to persuade Clark County District Judge Valerie Adair or the Nevada Supreme Court to postpone it for another round exams.

Staudaher alleged that Desai was "malingering" and exaggerating his ailments to avoid prosecution.

Desai, 63, has been escorted to court daily by his wife, Kusam, and family members. He sits at a defense table next to Wright and co-counsel Margaret Stanish, generally staring straight ahead.

Lakeman's attorney, Frederick Santacroce, argues that his client was a competent nurse-anesthetist who performed more than 50,000 outpatient medical procedures over many years without a complaint.

Lakeman, now 65, quit working for Desai after the hepatitis outbreak became public, but was nevertheless swept into "public hysteria" surrounding the case, his lawyer said.

A former co-defendant, Keith Mathahs, 77, pleaded guilty last December to five felony charges — including criminal neglect of patients resulting in death, insurance fraud and racketeering. He is expected to testify against Desai and Lakeman. Mathahs could get up to six years in state prison, or probation.

The criminal case is separate from civil lawsuits that yielded jury findings that held drug manufacturers and the state's largest health management organization liable for hundreds of millions of dollars in damages to plaintiffs.

A federal criminal trial that had been scheduled to begin May 7 for Desai and his former office manager, Tonya Rushing, has been postponed until Aug. 20. In that case, Desai and Rushing have pleaded not guilty to conspiracy and health care fraud charges. They're accused of overbilling for anesthesia and medical procedures at Desai's three clinics: Endoscopy Center of Nevada, Gastroenterology Center of Nevada and Desert Shadow Endoscopy Center in Las Vegas.

Desai has declared bankruptcy and surrendered his medical license.