The hepatitis outbreak case is now before a grand jury, Clark County's top prosecutor confirmed Thursday.
District Attorney David Roger wouldn't say who the possible defendants would be should an indictment be returned, but a Las Vegas police investigation centered around Dr. Dipak Desai, who ran the clinics where health authorities said nine people contracted hepatitis C because of unsafe injection practices. An additional 106 cases were "possibly related" to the clinics, officials said.
Police also suggested charges for at least four other medical workers from the clinics.
Roger would only say that "several people" are being targeted by prosecutors.
"We will not be identifying the targets at this time. As the evidence goes forward we may consider other people. But we have several people who have received notices at this point," Roger said.
A notice informs a target that he or she is the subject of a grand jury investigation. Indictments could come as early as next week, Roger said.
The grand jury witness list included several clinic patients whose hepatitis C infections have been genetically linked to other infected patients, said attorney Ed Bernstein, who had two clients testify Thursday.
Bernstein said his clients each spent about 15 minutes testifying before the grand jury.
"They're just glad to see that the state hasn't forgotten about prosecuting Dr. Desai," he said.
Prosecutors are considering a multitude of charges including patient neglect, insurance fraud and theft, Roger said.
Desai came under scrutiny in February 2008 after the Southern Nevada Health District linked several cases of hepatitis C to the Endoscopy Center of Southern Nevada, 700 Shadow Lane, where he was majority owner.
Officials notified 40,000 former clinic patients about possible exposure to blood-borne diseases because of unsafe injection practices.
More notifications followed to patients of a sister clinic, Desert Shadow Endoscopy Center.
Investigators blamed the outbreak on nurse anesthetists reusing single-dose medicine vials among patients.
Clinic staff told health investigators they were ordered by administrators, principally Desai, to reuse supplies and medications to save money, according to a city of Las Vegas letter suspending the Shadow Lane clinic's business license.
Desai's attorney, Richard Wright, was out of town, his office said. He did not return a message left on his cell phone.
The police investigation ended late last year. Hundreds of former patients have sued Desai, his clinics and the manufacturers of the anesthetic, propofol, which was used during their colonoscopies.
Attorneys for some of the patients, Bernstein and Robert Eglet, said the criminal case will have little, if any, effect on their lawsuits.
But Bernstein said the criminal case could be beneficial to the civil cases because it would make some police documents and reports available.
Also, clinic workers who refused to testify during depositions for fear of self-incrimination might be willing to talk once they've been given immunity for their cooperation in the criminal case, he said.
"This may turn out to be a positive," he said.
Review-Journal reporter Brian Haynes contributed to this report.