A letter sent by Dr. Lawrence Newman to 150 of his patients takes "complete responsibility" for putting them at risk for HIV and hepatitis because of his breach of infection control.
The Monday letter, obtained Thursday from one of Newman's patients who had a prostate biopsy , said the information the physician had been operating under, that endocavity needle guides could be reused after processing "with a high level disinfectant," was "incorrect."
On Wednesday, Doug Cooper, executive director of the Nevada State Medical Board, said the urologist recently reported himself to the board and began notifying his patients after he realized that he had been doing for three years "the same thing" as Dr. Michael Kaplan. Cooper said Newman remains under investigation.
Kaplan, whose license was summarily suspended in early March, stopped using single-use needle guides only when they became "too bloody," according to authorities.
A medical professional, who received one of Newman's letters and asked not to be identified, was none too pleased with the physician.
"I feel like I've been violated, abused and taken advantage of," he said. "He tarnishes the whole medical profession. My wife sells medical devices, and she found it incredible that he (Newman) would go against what the manufacturer said in its instructions. I trusted the guy and here he is cutting corners so he can save $10 on buying a new device. He better get suspended, too. "
According to Kaplan's attorney, Dominic Gentile, his client reused the single-use medical devices after a vendor from Providian Medical said the needle guides manufactured by CIVCO Medical Solutions could be reused.
A source familiar with the state's infection control efforts said Newman, like Kaplan, told authorities a vendor had said the plastic needle guides could be used more than once.
Newman's letter to patients does not say where he got his misinformation.
Gentile also said a Providian vendor told an investigator for his law firm that CIVCO officials said the needle guides could be reused.
On Thursday, CIVCO officials wasted few words in denying that anyone in the company ever represented that the devices could be used more than once.
But the maker of medical devices that are distributed worldwide did not deny that a distributor could be misrepresenting its product.
"Our disposable is clearly labeled single use only and we have never said otherwise," a statement released by the company said. "We cannot speak for others involved in its distribution."
What Providian officials had to say Thursday does not rebut allegations that an employee could have misrepresented how a single use device should be used.
"We are working to gather more information so that we can understand the facts of this situation," a company statement reads.
"We want to understand completely the facts involved so we can determine what course of action may be warranted. We are fully committed to compliance with all government regulations and safety standards."
Mark Brager, a spokesman for AdvaMed, a manufacturers' trade association, said Thursday a physician should never take the word of a vendor over instructions from a manufacturer.
"If the doctor has a question, he should contact both the manufacturer and the FDA," Brager said.
According to the Veterans Affairs Southern Nevada Healthcare System, Newman also sees VA patients under a contract with the government. Dave Martinez, a VA spokesman, said patients seen by Newman at a clinic in the past need not worry.
He said the local VA health system has never reprocessed or reused single-use items and that no physician working for the VA "engages in reprocessing of equipment."
"Any eligible veteran who may have seen an outside physician on their own can visit their assigned primary care provider in the VA to discuss if testing is necessary," Martinez said.
In his letter to patients, in which he said their "safety and well-being are of utmost importance to me," Newman said he understood that it had to "very disturbing and disappointing" for them to learn that they were now at risk for blood-borne diseases.
He tried to reassure them: "Based on similar incidents that have occurred in other states (as well as in Nevada), it is believed that the risk of contracting a disease is very low."
The medical professional who had a prostate biopsy done by Newman was angered by such a generalization.
"Try telling that to patient in Dr. Dipak Desai's clinics who got hepatitis" after reuse of single-use syringes and vials of medicine, he said.
"What's the matter with doctors in this town? You'd think after all the pain and suffering caused by those clinics that they would be extra careful about infection control."
Newman, who was unavailable for comment, apologized in his letter to patients, which said:
"I extend my sincere and deepest apologies to you for any inconvenience this will cause you. It has always been my goal to provide quality patient care and I hope to continue to ensure that all of my patients receive safe medical care in the future. ... I will personally be available to answer any and all of your questions to the best of my ability."
Contact reporter Paul Harasim at firstname.lastname@example.org or 702-387-2908.