Although Southern Nevada Health District officials maintain there is no evidence that the unsafe injection practices they believe led to six people contracting hepatitis C at a Las Vegas endoscopy clinic took place before March 2004, at least one health insurance provider isn't taking any chances.
Anthem Blue Cross Blue Shield plans to alert all members treated at the Endoscopy Center of Southern Nevada at 700 Shadow Lane to speak with their physicians about having tests for blood-borne diseases regardless of procedure date.
Anthem spokeswoman Sally Vogler said Friday that the notification will appear in the form of an advertisement in the Review-Journal on Sunday and on April 20.
She said the advertisement stems in large part from the possibility of patients who were treated at the clinic before March 2004 testing positive for hepatitis C or another blood-borne disease.
Vogler and Anthem's senior counsel Molly McCoy said the insurance provider's advertisement isn't alleging that unsafe injection practices occurred at the Shadow Lane facility before the date set by the health district, or that the health agency is not being thorough in its investigation.
"This is really about covering all the bases," Vogler said.
In late February, the health district sent letters to 40,000 patients who underwent procedures at the Shadow Lane facility between March 2004 and Feb. 11 urging them to be tested for hepatitis strains C and B and HIV, the virus that leads to AIDS.
The notification, now considered the largest in U.S. history with respect to blood-borne diseases, was the result of a cluster of people identified with hepatitis C in January.
All six had been treated at the endoscopy clinic, one on July 25 and five on Sept. 21, health officials said. Each of those patients had undergone procedures with the sedative Propofol, health officials said.
Health district officials believe patients were exposed when nurse anesthetists reused syringes on infected patients and contaminated single-use vials of medicine. The infection spread when the vials were shared among multiple patients.
Lawyer Robert Eglet, whose firm, Eglet Mainor Cottle, represents more than 4,000 clinic patients, said Anthem's ad came as little surprise.
"It's not something that anybody hasn't been saying since Day One," he said.
Of his 210 clients who have tested positive for an infectious blood-borne disease, several had procedures well before the March 2004 date set by the health district, he said.
"March 2004 has always been an arbitrary date," he said, noting that it was chosen because the only records kept in the Shadow Lane clinic went back to that time. Earlier patient records probably are stored elsewhere, he said.
Brian Labus, the health district's senior epidemiologist, said the decision was based on the identification of the unsafe injection practices and the determination that these practices had been the standard practices of the clinic since a remodeling in March 2004.
"We are limited to those dates," Labus said, but he added he didn't think it unreasonable for people to speak to their doctors about being tested even if their procedures occurred outside that time frame. "We just don't have evidence to urge patients prior to March 2004 to get tested."
Eglet said he believes it's only a matter of time until the health district sends notification letters to patients of the Desert Shadow Endoscopy Center, at 4275 Burnham Ave., at which health officials have said a seventh patient probably contracted hepatitis C. Eglet represents the patient, a male, who underwent a procedure in 2006 and tested positive for hepatitis several weeks later within the incubation period for developing illness. The case never was reported to the health district.
Labus said the health district is trying to determine whether any Desert Shadow patients should be notified. Disorganization of medical records being held at the Metropolitan Police Department is slowing that investigation.
Labus said police have received several bids from companies experienced with sifting through medical records, but he said the process is going to take some time to accomplish.
In the meantime, he said, the health district continues to receive positive test results and is interviewing patients with positive tests to determine any link to the endoscopy clinic.
Anthem officials said they haven't received any test claims that show positive results since the health district's announcement. The insurance provider has had a contract with the Gastroenterology Center of Nevada, the umbrella of the Shadow Lane and Burnham Avenue facilities, since the late 1990s.
Anthem also plans to send letters to more than 15,000 of its members who were treated at the Shadow Lane facility between the health district's dates to reinforce testing.
"Because of the time span, we felt it necessary to be absolutely accurate with addresses,'' Vogler said.
Eglet characterized the Blue Cross Blue Shield ad as a good preventive step to help identify infected patients so they can begin treatment sooner rather than later.