The thousands of medical records from the Gastroenterology Center of Nevada being held as evidence are proving hard to sift through, presenting a significant hurdle for patients, attorneys and investigators seeking access to them as the fallout continued from the largest health notification in U.S. history.
"Close your eyes and imagine looking for a record in 2,200 boxes of records," said Michael Walsh, director of administration for the Southern Nevada Health District, which is looking at spending hundreds of thousands of dollars to organize the records.
Police spokesman Jose Montoya was more succinct: "It's a big mess."
Local, state and federal authorities seized the records in March from six locations of the Gastroenterology Center of Nevada, including the Endoscopy Center of Southern Nevada on Shadow Lane, where the health crisis first surfaced.
The records are now in the custody of the Metropolitan Police Department. The point was to secure them against tampering or destruction as the case against the clinics unfolds, but those seeking access to the records have faced unexpected hurdles.
"Since we recovered them from different locations, some of them are catalogued by date, some by doctor's name, some by location," Montoya said. Finding and making copies of records for people -- there have been about 200 requests so far -- is "a tedious process for us."
It's also a tedious process for the Nevada State Board of Nursing and the health district, which want to review records but can't because they are in the hands of Las Vegas police.
It's a significant obstacle, considering a health notification went out to 40,000 former patients of the Shadow Lane office after investigators linked six cases of acute hepatitis C to patients visiting that facility. Officials reported that unsafe injection protocols at the clinic put patients at risk for blood-borne diseases.
There's another case that could be connected to the Desert Shadow Endoscopy Center, an affiliated clinic on Burnham Avenue, but even if health officials wanted to do a notification, they'd have to be able to find the patients in the seized records.
The records also figure in the investigation of six nurse anesthetists who relinquished their licenses in the days following the initial disclosures.
Debra Scott, executive director of the Nevada State Board of Nursing, said the regulatory board has interviewed some of the nurse anesthetists, but the board doesn't have any "hard evidence" and is still waiting to review the records held by police. Scott said the board is also waiting for information regarding which nurse anesthetist reported being told to reuse syringes and other medical equipment.
"None of the nurses has requested a hearing nor their licenses back," Scott said Tuesday. "But we are still getting information and conducting interviews.''
Some former patients have reported not being able to find their records because, for example, they're filed by date instead of patient name, and the patients don't remember the date of their procedure.
In many cases -- but not all -- patients were referred to the clinics by their primary care physician, who would also have patients' records on hand, Walsh noted.
Now the health district is rushing to get a contract before the Southern Nevada District Board of Health at its April 24 meeting so an outside company can begin organizing the records using a uniform system.
"The records all have to be organized, and the successful vendor will be able to fill the requests of people looking for their records," Walsh said.
An initial assessment put the price tag at $491,000 to index and alphabetize the records, although Walsh said the health district would try to negotiate a lower price.
Some of that cost could be covered by a $500,000 fine collected from the clinics' owners Monday by the city of Las Vegas, which held a hearing to revoke the business license of the Shadow Lane office.
The city is also looking at paying for blood tests recommended for the 40,000 former patients included in the health notification.
"Our goal is to ensure that the money is spent to support the victims of the crisis," said Las Vegas City Manager Doug Selby, who's supposed to recommend a spending plan to the council May 6. "To do this, we need to carefully weigh our options for getting the most benefit to those impacted."