WASHINGTON -- The health crisis created by unsafe practices documented at the Endoscopy Clinic of Southern Nevada has commanded public attention in Las Vegas. But as far as grabbing the lapels of Congress, that is quite another thing.
More than a month after warnings went out to 40,000 patients to be tested for HIV and hepatitis strains, Nevada lawmakers are trying to persuade colleagues to take note of the largest notification of its kind in U.S. history.
But efforts to interest House and Senate committees to sponsor hearings on the episode in the context of others where questionable activities by doctors led to disease outbreaks have yielded no fruit so far.
If anything, the inquiries have raised questions as to whether Congress should have any investigations role at all in the matter, several lawmakers said Wednesday.
Rep. Shelley Berkley, D-Nev., has discussed hearings with Rep. Frank Pallone, D-N.J., House health subcommittee chairman, and has written to investigations chairman Rep. Bart Stupak, D-Mich.
Berkley said she is awaiting a decision from Pallone. But the chairman has asked some surprising questions.
"Is this situation particular to Southern Nevada? It was particularly egregious and we all agree about that but does it have national implications? Does this happen in other clinics across the country, and how much authority does Congress have in regulating these issues?" Berkley said. "That is the gentleman's question.
"When I spoke to (Pallone) initially, he said this was an issue he tried to move forward a few years ago and he got zero interest," Berkley said. "He wanted to know why now would there be more interest in Congress."
Sen. John Ensign, R-Nev., said he has received the same reception in the Senate.
"They think it is a Nevada problem," Ensign said.
Ensign did not say who told him that. He declined through his staff to elaborate, and a spokesman said he was still working on it.
"We hope it is not a national problem, and that is why there has been some pushback," said Sen. Harry Reid, the Senate majority leader. "Until there is more evidence this is a national problem, I don't think you are going to have a lot of members of Congress diving into this."
So far, seven cases of hepatitis C have been traced to practices at the Endoscopy Center's Shadow Lane clinic and other ambulatory surgical centers operated by Dr. Dipak Desai.
Among unsafe practices, investigators found personnel were reusing syringes and were using single-use vials of anesthesia medication on multiple patients.
The Centers for Disease Control and Prevention, which has been assisting state, local and federal authorities, considers the Las Vegas clinic practices an issue with broad implications, spokeswoman Christine Pearson said, citing comments by the agency's director, Dr. Julie Gerberding.
In a March 3 telephone call with reporters, Gerberding said the hepatitis C outbreak in Las Vegas may be just a glimpse of safety problems around the country.
"Unfortunately we have seen other large-scale situations where similar practices have led to patient exposures," Gerberding said. "Our concern is that this could represent the tip of an iceberg and we need to be much more aggressive about alerting clinicians about how improper this practice is."
Dr. Sidney Wolfe, a health care activist and director of Public Citizen's Health Research Group, questioned whether federal hearings would be warranted on an issue of medical malfeasance that, if anything, should be more closely regulated by authorities in Nevada.
"For better or worse, states regulate doctors," Wolfe said. "There are enough issues here in Washington that clearly are in the domain of federal legislation that Congress should be holding hearings on.
"It is hard to justify to hold a hearing they have no jurisdiction over."
In letters to Pallone and Stupak, Berkley contended the Las Vegas clinic scandal "is far from an isolated case."
In 2002, 99 patients at a cancer clinic in Fremont, Neb., became infected with hepatitis C, the largest such outbreak to date.
The Nebraska incident received a fresh wave of media attention in February, prompting Rep. Jeff Fortenberry, R-Neb., on Feb. 25 to request House hearings on medical errors that lead to disease spread.
In the past year, 4,500 patients in New York City were advised to be tested for hepatitis C as a result of the practices of an anesthesiologist who participated in their endoscopy procedures.
Also in New York, testing recommendations were issued to 10,400 patients who got treatment at a pain management clinic in Plainview. The health department discovered problems in January 2005 but delayed in broadcasting the warnings.
In Grand Rapids, Mich., the Kent County Health Department notified 13,500 patients of a local dermatologist that syringes had been reused and other unsanitary practices had been discovered.
Days before the Las Vegas clinic was exposed, Rep. Anthony Weiner, D-N.Y., coincidentally petitioned for House hearings to examine accidental hepatitis infections associated with misuse of syringes and multi-use vials.
Berkley said her request for hearings has been hampered by House scheduling and she expects a decision now that Congress has returned from a two-week recess.
Richard Urey, Berkley's chief of staff, said he heard talk that the Las Vegas health alert "is so egregious that it could only be in Nevada."
"We don't believe that is true but we have to find out," Urey said. "If we know of Nevada and Minnesota and Seattle, and if we know it is in New York, how many don't we know about? To say this is only in Nevada and that is why we are not having hearings, that is bullshit."
Contact Stephens Washington Bureau Chief Steve Tetreault at email@example.com or (202) 783-1760.