Centers still break safety protocols

Despite massive media attention in recent months about unsafe medical practices, state and federal health officials have identified breaches in infectious disease control policies during a second wave of inspections at some Nevada ambulatory surgery centers.

The problems, however, aren't as serious as those found at the Endoscopy Center of Southern Nevada at 700 Shadow Lane, where as many as 84 people may have contracted hepatitis C due to unsafe injection practices.

Some of the breaches may involve a failure to sterilize equipment or to properly keep records, said Martha Framsted, spokeswoman for the Nevada State Health Division.

However, Nevada health officials said Thursday they would be releasing information today about a specific Las Vegas facility with serious infection control problems that could lead to the spread of disease.

"There are still some ambulatory surgery centers that are not following protocol; they just didn't get it,'' said Jack Cheevers, spokesman for the Centers for Medicare and Medicaid Service's Region IX office.

Cheevers wouldn't specify what issues were identified and at how many of reinspected facilities. The state's Bureau of Licensure and Certification hasn't completed its inspection reports of all the facilities. But he did say a third wave of "surprise" inspections should be expected.

If CMS continues to identify problems, "the hammer will come down and they will be at risk of losing federal dollars,'' he said.

The state's licensing bureau has a contract with CMS to conduct surveys of ambulatory surgery centers, as well as other medical care facilities.

In January, the licensing bureau, along with the Centers for Disease Control and Prevention and the Southern Nevada Health District inspected the Endoscopy Center of Southern Nevada as a result of six suspected cases of hepatitis C.

During the inspections, bureau surveyors documented several infectious disease- control deficiencies, including the reuse of single-dose vials of medication. The center was fined $3,000 for those deficiencies.

As a result of the outbreak, and due to unsafe practices documented at several other ambulatory surgery centers, Gov. Jim Gibbons told the licensing bureau to inspect all of Nevada's 50 ambulatory surgery centers.

Those inspections took place from March into early April. At the end, inspectors found that 24 facilities had no deficiencies, 17 had minor deficiencies and seven had major infection-control deficiencies.

In late March, Pam Graham, acting chief of the state's licensing bureau, announced that a team of federal and state health surveyors planned to re-inspect about 20 of Nevada's ambulatory surgery centers.

Since the bureau would not divulge which clinics would be re-inspected, they were considered surprise inspections. Graham said eight federal health surveyors from CMS would team with state surveyors to inspect the facilities.

One facility -- the Lake Tahoe Surgery Center at Round Hill -- was issued a "cease patient care" order in mid-April after the second inspection found unsafe infection-control practices.

The Tahoe facility went through an initial survey in mid-March, and was told that improvements were needed to prevent problems such as the spread of disease or infection.

Contact reporter Annette Wells at or 702-383-0283.