The Nevada Board of Medical Examiners should summarily suspend the licenses of Las Vegas physicians associated with the valley's hepatitis C outbreak and appoint a special counsel to independently investigate the doctors, two lawmakers told Gov. Jim Gibbons in a letter Friday.
In the two-page letter, Assemblywoman Sheila Leslie, D-Reno, and State Sen. Steven Horsford, D-Las Vegas, said what's needed is a "thorough, complete and independent investigation into the conduct" of 14 physicians who worked at the Endoscopy Center of Southern Nevada.
Health officials have linked the Shadow Lane facility to seven cases of hepatitis C and have notified some 40,000 patients to be tested for blood-borne diseases.
The results of the special counsel's investigation, the lawmakers said, should be given to the Board of Medical Examiners, which has been conducting its own investigation into the physicians. In addition, "to the extent permitted by law," findings should also be reported and provided to Gibbons and the Legislative Committee on Health Care.
That committee, which includes Horsford, is chaired by Leslie.
"This is an indication that we have lost confidence both in the board's motivation and ability to conduct the investigation," Leslie said in an interview. "We have heard a lot of excuses for not taking action. I have lost my patience."
The special counsel would not have any power to take action independent of the medical board, but the lawmakers want the investigation to ensure that nothing goes unnoticed.
Ben Kieckhefer, Gibbons' press secretary, said Friday that Gibbons read the letter and has inquired into whether he has legal authority to appoint a special counsel.
"The governor has been active in encouraging the medical board to take strong action, and to do so quickly," Kieckhefer said. "He's been on record about that and his feelings haven't changed."
Tony Clark, executive director of the medical board, said that although neither he nor his staff believes there is any evidence to support summary suspensions of doctors, the board is working with Attorney General Catherine Cortez Masto to take legal action against some physicians who performed procedures at the Shadow Lane facility.
He declined to elaborate on what that action might be, but did say it will not take the form of summary suspensions.
"I can tell you that we're not just sitting around not doing anything," he said.
The culpability of physicians, who have not acknowledged wrongdoing, in the current crisis is unclear.
When the city of Las Vegas revoked the business licenses of Dr. Dipak Desai's endoscopy clinics, the head of the licensing division said health care investigators learned that some doctors had ordered nurses to reuse syringes and single dose vials of anesthesia.
Horsford said the goal behind Friday's requests is to be more responsive to the public than the medical board has been.
He noted that it has been more than eight weeks since state public health officials announced a cluster of six hepatitis C cases. Authorities more recently linked another acute case of hepatitis C to the Shadow Lane facility and one to a sister clinic on Burnham Avenue.
"Having the governor appoint special counsel elevates the importance of this issue," Horsford said. "We need to hold those people who are responsible, accountable. Also, we need to determine if there are doctors under investigation who did not put any patients in harm's way to allow them to move forward and away from this cloud of suspicion over their medical practices."
Adding to lawmakers' sense of urgency were issues raised at a Monday meeting of the Legislative Committee on Health Care and the Southern Nevada Health District's announcement Thursday that 10,000 additional patients need to get tested for hepatitis and HIV.
"Every day that the board fails to act, more evidence comes forward, and we learn that more patients could have been put in harm's way," Horsford said. "People want to know action is being taken. Should there be due process? Absolutely. But more should be done to ensure public confidence."
Don Havins, chief executive officer of the Clark County Medical Society, called the lawmakers' request "an unprecedented action.''
"It certainly puts the Board of Medical Examiners on notice that the legislative commission is not satisfied with its actions to date,'' he said. "I think the governor should look at all options in addressing this public health concern.''
Horsford said lawmakers have learned from public health officials that six of the physicians working within Desai's consulting practice are still practicing in Nevada. It is still unclear where, however. Desai has told the medical board that he would temporarily stop practicing medicine.
In addition to Desai, 13 other doctors were listed on the Gastroenterology Center of Nevada's Web site at the time state licensing officials performed their inspections: Eladio Carrera, Clifford Carrol, Vishvinder Sharma, Dipesh Banker, Snehai Desai, Frank Faris, Carmelo Herrero, David Manuel, Albert Mason, Ranadev Mukherjee, Sanjay Nayyar, Shahid Wahid and Nicolae Weisz.
Herrero and Mason have an office together -- South Hill Gastroenterology at 2625 Wigwam Parkway -- where they are evaluating patients but not doing procedures.
Other former associates of Desai are planning to open offices in the Las Vegas Valley.
According to documents on file with the Nevada secretary of state, Banker, Snehal Desai, Mukherjee and Wahid have formed a medical company known as Digestive Associates LLP in North Las Vegas. Yet to open, it will be at 2031 McDaniel St., near North Vista Hospital.