The bulk of a $500,000 fine levied against the endoscopy center at the center of a hepatitis C outbreak will be used to pay for testing and treatment of affected patients, but it was clear Wednesday that the amount is merely a drop in the bucket.
The money, which was collected by Las Vegas when it revoked the Endoscopy Center of Southern Nevada's business license, also will be used to organize patient records and to defray the costs of prosecuting clinic owners should they face criminal charges.
But while city leaders felt good about their actions Wednesday, Mayor Oscar Goodman had a scolding ready for other public agencies that he said are not pulling their weight in the health scare.
"I haven't seen too many folks in this community and this state step up," he said. "People are saying they can't do this, they can't do that. That's the typical bureaucratic response.
"This is not our problem. It's the community's problem."
The Las Vegas City Council allocated $239,000 of the fine to Nevada Health Centers to pay for testing and treatment of uninsured and underinsured patients from the endoscopy center.
Las Vegas police will get $161,000, which will be combined with a $100,000 state grant to the Southern Nevada Health District to pay for organizing, indexing and storing more than 100,000 patient records.
The records are in police custody but are disorganized and hard to search, which has frustrated patients and stymied investigators.
The remaining $100,000 will go to the Clark County district attorney's office if it brings charges against the people involved and will be used to pay for lawyers and staff.
After investigators documented problems at the clinic's Shadow Lane location, 40,000 people were told to be tested, and officials have said at least another 10,000 also should be tested.
Given the size of the patient pool, the money will not go far, said Dr. Carl Heard, the chief medical officer and interim CEO of Nevada Health Centers.
"It will probably not be enough money," he said, noting that of the 700 people tested by his organization, 40 are positive for hepatitis C and eight for hepatitis B.
Treating a hepatitis C patient can cost as much as $30,000, Heard said.
"This is just overwhelming," Councilman Larry Brown said. "That could be gone on one patient, or one day."
The effort is still significant, Heard said, because it sets up a framework for dealing with the situation and future crises. Physicians have agreed to volunteer services, and Senate Majority Leader Harry Reid, D-Nev., is trying to get $5.2 million budgeted for testing and follow-ups.
It's important to get commitments to the "public health infrastructure" now while the issue is on people's minds, Heard said.
"As a state, we have not yet committed to invest in our public health infrastructure," he said. "If we don't make hay while the sun is shining ... on this issue, then we will not be able to ever pull ourselves up from the bottom of the heap."
Investigators found unsafe injection procedures at the Shadow Lane clinic that could expose patients to blood-borne diseases, and notifications went out telling patients to be tested for hepatitis and HIV.
Officials have linked seven hepatitis C cases to the Shadow Lane clinic and one case to an affiliated clinic on Burnham Avenue.
The clinics are closed now, and Drs. Dipak Desai and Eladio Carrera, two of the four doctors who own the clinic, have had their medical licenses temporarily suspended.
In an interview, Goodman said news reports that the Nevada State Board of Medical Examiners is not turning over records of complaints against Desai "got me insane this morning."
"There are oversight agencies that are dragging their feet. They aren't moving as quickly as they should, and the public is uneasy about that," he said. "And I'm angry about it."
Other entities need to contribute to the costs with investigating the clinics, he said.
"What I'll be encouraged to hear is when the agencies provide money to help the sheriff put together these records, to make sure the district attorney's in a position where he can properly investigate this to see whether criminal charges are valid and warranted -- and do it on a speedy basis," Goodman said.
Contact reporter Alan Choate at firstname.lastname@example.org or 702-229-6435.