The thousands of Southern Nevadans who want to see Dr. Dipak Desai behind bars could get their wish.
In their final report submitted to prosecutors, Las Vegas police recommended criminal charges for the doctor and others for their roles in the hepatitis C outbreak blamed on unsafe injection practices.
"Dr. Desai is definitely at the top of the list," said Capt. Al Salinas, head of the Las Vegas police Organized Crime Bureau.
In the case file submitted Tuesday, police recommended Desai and at least four clinic workers be charged. Among the recommended charges was criminal neglect of patients, a felony that carries a one- to six-year prison sentence.
The investigation culminated in a final report that was nearly 100 pages with more than 10,000 pages of supporting documents and medical files, Salinas said.
"One of the biggest undertakings that we've ever had to handle," he said of the investigation, which began shortly after health officials announced the outbreak in February 2008.
District Attorney David Roger said no decision on filing charges probably will be made until January.
Not only do prosecutors have to review the massive amount of evidence, but the two-man unit that will handle it is preparing for the trial of Lacy Thomas, the former chief of University Medical Center charged with giving illegal hospital contracts to his friends.
Prosecutors might ask police to conduct additional investigation before moving forward. They could also take the case to a grand jury because of all the evidence that must be presented.
"It's going to be a while," Roger said.
Desai's lawyer, Richard Wright, said he would not comment on the police report.
"They didn't send me a copy," he said with a laugh.
Investigations by state and federal authorities were ongoing.
Desai came under scrutiny nearly two years ago after the Southern Nevada Health District linked several cases of hepatitis C to the Endoscopy Center of Southern Nevada. Desai was the majority owner of the clinic at 700 Shadow Lane.
In announcing the outbreak, health officials notified 40,000 former clinic patients about possible exposure to blood-borne diseases because of unsafe injection practices at the clinic.
Investigators blamed the outbreak on nurse anesthetists reusing single-dose medicine vials among patients. The vials, they said, became contaminated when nurses used a syringe more than once on the same patient.
Clinic staff told health investigators they were ordered by administrators, principally Desai, to reuse supplies and medications to save money, according to a Las Vegas letter suspending the clinic's business license last year.
Health investigators have since linked a total of nine hepatitis C cases to Desai's clinics and said another 105 cases were "possibly related."
Hundreds of former patients have sued Desai, his clinics and the manufacturers of the anesthetic, propofol, that was used during their colonoscopies.
The first trial among those cases is scheduled to start in April.
Lawyer Will Kemp, who represents some former patients, said the criminal case could have a positive effect on the civil litigation.
Most potential witnesses have pleaded the Fifth Amendment against self-incrimination to avoid giving depositions in the civil case. If those witnesses avoid criminal charges as the investigation ends, they might not be allowed to use that argument and be forced to testify, he said.
But there could also be a negative effect regarding the pool of money available to patients.
If Desai and others are found guilty, their malpractice insurer, Nevada Mutual Insurance Co., might void their coverage because the actions were criminal, he said.
Kemp said most insurance contracts include such language.
Contact reporter Brian Haynes at firstname.lastname@example.org or 702-383-0281.