City shuts clinic, with harsh words for owners Official: Staff told to reuse vials, syringes to save money

Turns out, it was greed.

Dr. Dipak Desai, one of the state’s most prominent physicians, willfully chose to “mortally hazard his patients for profit” by operating an endoscopy clinic fraught with cost-cutting sloppiness, a Las Vegas city official said Friday.

Desai, who was a member of Gov. Jim Gibbons’ transition team in 2006, is the majority owner of the Endoscopy Center of Southern Nevada, the source of a disease outbreak that’s caused the largest hepatitis C scare in the country, according to health officials, who said 40,000 people who received anesthesia while undergoing endoscopic procedures there, including colonoscopies, must be tested immediately for hepatitis B, hepatitis C and HIV. The clinic was one of the busiest of its kind in Nevada.

When Jim DiFiore, manager of the city’s business services decision, suspended the facility’s license Friday, he cited previously undisclosed findings by health investigators who inspected the clinic in January.

DiFiore said in a letter to the clinic’s owners that Desai ordered his nurses to reuse syringes and reuse single-dose vials of medication when administering anesthesia to patients who received endoscopic procedures. The practice, which allowed cross contamination of patients’ blood, caused six people to become infected with hepatitis C.

Desai did it to save money, DiFiore said.

The state Licensure and Certification Bureau, which oversees the ambulatory surgical center, allowed it to stay open because the dangerous procedures were corrected.

But DiFiore quoted a health investigator who said, “It’s very hard to believe that they won’t do it again,” when explaining why he was shuttering the clinic.

“The fact that, once caught, you have agreed not to engage in a technique well known to the medical community to subject patients to death or serious illness again does not persuade me that you won’t do it again,” DiFiore wrote.

Desai and the other Endoscopy Center owners would not comment for this story, on the advice of their attorneys, Abran Vigil and Alan Sklar.

DiFiore, who referred to the investigators from the Southern Nevada Health District, the Licensure and Certification Bureau and the Centers for Disease Control and Prevention as a “tiger team,” said he was told by a CDC officer that the Endoscopy Center practices were so obviously dangerous it was like “driving the wrong way down the freeway.”

“I do not believe that there is any department of motor vehicles in this country that would not immediately revoke the driving license of a driver when given credible evidence that the driver had driven the wrong way down the freeway every day for the past four years,” he wrote.

Citing more information provided by the health investigators, DiFiore said many nurses knew the technique was dangerous to patients, but they were ordered by administrators, mainly Desai, “to engage in the practice in order to save money.”

Some followed Desai’s orders and risked contaminating patients with life-threatening diseases, while others disobeyed him, DiFiore wrote.

Desai used to sit on the Nevada State Board of Medical Examiners, which has now launched an investigation into the clinic, which is also owned by Dr. Vishvinder Sharma, Dr. Eladio Carrera and Dr. Clifford Carrol.

Dr. Jim Christensen, an allergist who is on the board of the Health District, said the allegations in DiFiore’s letter elevate the situation from malpractice to criminal behavior.

District Attorney David Roger promised “a massive investigation” into what occurred at the clinic.