Citing a need to "protect the public from further harm," the state medical board filed court papers Monday afternoon to temporarily suspend the medical licenses of two doctors connected to the hepatitis C outbreak.
The documents ask a District Court judge to suspend the licenses of Drs. Dipak Desai and Eladio Carrera pending disciplinary proceedings by the Nevada State Board of Medical Examiners, which lodged formal malpractice complaints against both doctors on Friday.
Desai and Carrera, two of four co-owners of the Endoscopy Center of Southern Nevada, each performed medical procedures on three patients who were infected with the potentially deadly liver disease because of unsafe injection practices at the clinic, according to the documents.
The board's action came after weeks of public outcry and pressure from state lawmakers, who as recently as last week publicly questioned the board's lack of action.
"After nine weeks, I'd say it's about time,'' said Assemblywoman Sheila Leslie, D-Reno. "I'm encouraged that they are finally taking action. The sooner the better.''
Irritated with the board's lack of urgency in investigating the clinic's physicians, Leslie and state Sen. Steven Horsford, D-Las Vegas, sent a letter to Gov. Jim Gibbons on Friday urging him to push the medical board to summarily suspend the doctors' licenses or appoint a special counsel to investigate.
That same day, Tony Clark, the medical board's executive director, told Leslie to expect legal action against the doctors this week.
"The Legislature wanted us to do something," said Doug Cooper, the board's chief of investigations, in explaining Monday's legal move.
Medical board Secretary-Treasurer Donald Baepler, through lawyers with the attorney general's office, filed applications for temporary restraining orders and motions for preliminary injunctions against Desai and Carrera.
No hearing dates had been set as of late Monday. A hearing on the restraining order would likely be held within three to four weeks, with a hearing on the preliminary injunction about two weeks after that, according to Robert Eglet, a lawyer representing patients suing the clinic. A judge could also hold both hearings the same day.
Desai's case was assigned to District Judge David Wall. Carrera's case was assigned to District Judge James Bixler after District Judge Jennifer Togliatti recused herself.
In its court filing, the board said suspending the medical licenses of Desai and Carrera was necessary "to protect the public from further harm."
Desai, a majority owner of the clinic at 700 Shadow Lane, performed the July 25, 2007, colonoscopy on a 67-year-old man who was later diagnosed with acute hepatitis C, the court papers said.
Desai also performed colonoscopies on Sept. 21, 2007, on a 37-year-old woman and a 72-year-old man who contracted acute hepatitis C at the clinic, according to the documents. On the same day, Carrera performed procedures on three women, ages 54, 67 and 68, who contracted acute hepatitis C, according to the documents.
Lawyers for Desai and Carrera could not be reached for comment.
Hepatitis C is an inflammation of the liver caused by the hepatitis C virus, which is usually spread by blood transfusions, blood dialysis and needle sticks. The damage it causes can lead to cirrhosis and liver cancer.
Investigators with the Southern Nevada Health District believe the six patients contracted the disease when nurse anesthetists reused syringes on infected patients and contaminated single-use vials of anesthesia that were used on multiple patients.
The outbreak led public health officials to notify 40,000 clinic patients of possible exposure to blood-borne diseases, including hepatitis and HIV. Health officials have since linked a seventh hepatitis C case to the Shadow Lane clinic and an eighth case to an affiliated clinic, the Desert Shadow Endoscopy Center at 4275 Burnham Ave. Officials have yet to issue a patient notification with the Burnham clinic because they haven't gained access to the needed medical records.
Health district officials announced the outbreak on Feb. 27 and filed a formal complaint with the medical board a week later.
In early March the state Board of Nursing announced that six nurse anesthetists had surrendered their licenses pending an investigation. About 20 other registered nurses and licensed vocational nurses who worked at the endoscopy center have since been interviewed and could be disciplined for failing to report unsafe practices, said Debra Scott, the nursing board's executive director.
In an informal agreement brokered by medical board president Dr. Javaid Anwar, Desai voluntarily agreed to stop practicing medicine during the board's investigation. Desai, a longtime friend and business associate of Anwar, was allowed to keep his license and potentially practice outside Nevada.
No action was taken against 13 other doctors who worked at the clinics and affiliated medical practice, the Gastroenterology Center of Nevada.
At last week's legislative hearing, lawmakers grilled Clark about the medical board's lack of action against the doctors. Clark said the regulatory board couldn't summarily suspend the doctors' licenses because they weren't an "immediate threat" to the public.
"We just never felt we had enough evidence for a summary suspension after the city and county shut the clinics down," Clark said.
Clark said he had asked Chief Deputy Attorney General Christine Guerci-Nyhus "three or four weeks ago" to look into taking Monday's legal action. By late last week, the evidence "finally came together to take action," he said.
Clark would not comment as to whether more doctors would face disciplinary action.
"I don't understand why it took so long," Leslie said. "I think when you have a crisis of this nature, you have to reassure the public that action is being taken.''
That thought was echoed by Monica Ashby, who believes she contracted hepatitis C during her May 2005 colonoscopy with Desai at the Shadow Lane clinic.
"Why didn't they do this a long time ago?" she said. "Thank God they have finally taken action."
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