He'll pay a fine and be on probation, but a doctor linked to a hepatitis outbreak can once again treat patients in Nevada.
The state Board of Medical Examiners lifted the 13-month suspension of the medical license of Dr. Eladio Carrera, a unanimous decision that infuriated both an infected patient and a state lawmaker.
"The board isn't taking this seriously at all," said 61-year-old Gwendolyn Brown, one of Carrera's patients who became infected with hepatitis C. "You can't believe what you have to go through when you get hepatitis. Don't they realize how sick people get?"
Lyn Beggs, the board's general counsel, said the infections of Carrera's patients "most likely" occurred outside his presence. Carrera was merely the co-owner of the clinic, without control over any policies and procedures that put patients at risk, she said.
"What we're asking you to do is to recognize that Dr. Carrera is not the person who is really responsible for what happened," Beggs told the board.
Under an agreement approved by the board, Carrera will receive 24 months of probation, a public reprimand and a $15,000 fine. If he practices gastroenterology, he needs "an appropriate level of control regarding practices and policies which affect patients."
He also must testify in other malpractice cases filed by the board against Dr. Dipak Desai, the principal owner of the Endoscopy Center of Southern Nevada, and Dr. Clifford Carol, who practiced there.
Assemblywoman Sheila Leslie, D-Reno, whose committee investigated the outbreak in Las Vegas, called the board's action "outrageous."
"The only way to fix the medical board is to shut it down and start over with brand-new people," she said. "There's a culture within the medical board that protects doctors and not the public. They should resign for the good of Nevada."
Board members with identified conflicts have recused themselves on matters related to the outbreak.
Authorities investigating a cluster of hepatitis C cases observed clinic nurses reusing syringes in a manner that contaminated vials of medication and, they believe, infected patients. This dangerous practice, according to city investigators, was done at the direction of Desai and other administrators.
Nine hepatitis C cases have been definitively linked to the clinics, and another 105 cases are possibly related. Tens of thousands of Nevadans were advised by authorities to get tested for hepatitis and HIV, the largest notification of its kind in the history of the United States, according to the Centers for Disease Control and Prevention.
A year ago, Southern Nevada Health District officials used genetic testing to trace infections, linking three to Carrera. Though board members Robert Wiencek and Ronald Kline, both physicians, wondered aloud at the meeting about Carrera being "the captain of the ship" in the operating suite, they were part of the unanimous vote for the settlement.
Wiencek, a cardiovascular surgeon, questioned to what degree a physician can avoid accountability.
"If something happens in the room, I take responsibility," he said. "How far can you step back and not take responsibility?"
Also voting for the settlement were Renee Wester, Van V. Heffner and Dr. Beverly Neyland.
Though his client was a co-owner of the clinic, said David Mortensen, Carrera's attorney, he didn't have any managerial control over employees. He also said that any behavior at the clinic that resulted in infections "occurred outside his presence and knowledge."
Begs and Mortensen said at the meeting that Carrera didn't know what practices might have caused the infections. But Begs said Carrera could be a "definite asset" in the ongoing investigations and "provide much needed context."
Medical Board investigators have had trouble finding witnesses to talk to them because of ongoing civil lawsuits and criminal investigations, Beggs said.
Carrera was not present for the special meeting, called by the board on short notice.
Mortensen said Carrera faced upcoming deadlines regarding his medical privileges at local hospitals and his liability insurance, so he needed a decision on his medical future.
The attorney said Carrera was on a "medical mission" to Uruguay. Silvana Montes-de-Oca, press officer for the Uruguayan embassy in Washington, D.C., said Carrera "was not on an official mission" sponsored by the government. She also said that Carrera's license suspension in Nevada did not hinder his ability to practice medicine in the South American country.
In May of last year, Clark County District Judge James Bixler blocked Carrera from practicing medicine, issuing a temporary restraining order pending resolution of a board complaint against the gastroenterologist.
Desai's license had been suspended earlier. Board action against Desai was delayed after he suffered a stroke.
Mortensen said his client has been unable to defend himself because the Southern Nevada Health District has sealed the depositions of its employees.
Mortensen said he has reviewed medical records and documents and come up with an alternative theory as to how the hepatitis C virus was spread at the clinic. He didn't provide details.
"We believe the health district is abjectly wrong," he said.
Mortensen said Carrera wants to serve primarily Hispanic patients, probably in North Las Vegas.
Gerald Gillock, an attorney for former patient Brown, said what the board did makes as much sense as "give Bernie Madoff one year probation for what he did." But he said the financier did not do anything as serious as what the medical team at Desai's clinics did.
"We're talking about doctors taking away people's health here, not their money," he said.
Las Vegas police officials contacted Wednesday said the criminal investigation into the outbreak is still ongoing.
The state attorney general, the FBI and the IRS also are still investigating.
Said Brown: "I pray somebody does something."
Contact reporter Paul Harasim at firstname.lastname@example.org or 702-387-2908.