A Henderson physician who is a top health care adviser to the governor is seriously considering buying two of three clinics owned by Dr. Dipak Desai, whose gastroenterology practice is at the center of a massive hepatitis alert.
If Dr. Rudy Manthei goes ahead with the deal, he said the physicians who worked for Desai will be encouraged to practice at the two facilities.
"Until the medical board (the state board of medical examiners) has determined wrongdoing, it would be inappropriate to treat them any differently," Manthei said Tuesday. "They need to have due process. We are talking about some excellent physicians."
Manthei, the founder of Nevada Eye & Ear and principal owner of Seven Hills Surgery Center, said his interest in buying the clinics is simple -- the people of the Las Vegas Valley need the treatment facilities.
"We had 25,000 endoscopic procedures done in this area last year and we'll probably have that many again," said Manthei, who remains an adviser to Gov. Jim Gibbons after serving as chairman of the governor's health care transition team. "You just can't get rid of three clinics when you have such a need."
What Manthei is considering disgusts Dr. Julian Lopez, a local gastroenterologist not associated with Desai's practice.
"None of those physicians in that group should ever be allowed to practice again," he said. "I see patients running scared every day because of them. These people don't know who they can trust any more. Everybody in that medical group knew what was going on. They used to go around and brag about how many procedures they could do. That's how they got compensated, for how much they could do."
Former Desai patients have complained to the Review-Journal that the physician's clinics herded them through procedures like cattle.
While Manthei said he doesn't agree with how Desai's clinics were run, he did say that no one has accused the Desai centers of doing unnecessary procedures.
However, the Review-Journal spoke with a former physician at the Endoscopy Center of Southern Nevada who said unnecessary biopsies were routinely done to run up patient charges.
Manthei, who was trained as an opthalmologist, said that because he is in negotiations with Desai, whom he described as "devastated by what happened," he can't divulge what the cost of the clinics would be.
"I'll know in a week whether I'm going to go forward," he said, adding that Desai and his partners, whom Manthei wouldn't name, "turned to him" for the business deal.
Manthei, who served on Gibbons' transition team with Desai, said he would be buying equipment and assuming the leases at Desert Shadow Endoscopy Center on Burnham Avenue and the Spanish Hills Surgical Center on Rainbow Boulevard.
"I am not buying the buildings," he said, adding that he is also not buying either patient or physician referral lists.
Manthei said he has no desire to buy the clinic on Shadow Lane because it is not "free standing," meaning it had uses other than a surgical center.
Nearly seven weeks ago, some 40,000 letters were sent to former patients of Desai's Endoscopy Center of Southern Nevada on Shadow Lane by health care authorities urging them to be tested for blood-borne diseases including hepatitis C, an incurable, potentially fatal condition that attacks the liver. Six cases of acute hepatitis C have been traced to that clinic, and a seventh is linked to the Desert Shadow sister clinic on Burnham.
Health care authorities said syringes and single dose vials of medication were reused.
Desai's entire practice and its 14 physicians remain under investigation. Investigators are uncertain which practitioners worked at which clinics for Desai, who voluntarily agreed not to practice until the investigation is completed.
Another local gastroenterologist, Dr. Frank Nemec, said a lack of facilities for endoscopic procedures isn't the problem in Las Vegas. "We have a manpower problem," he said.
But Lopez said the problem goes beyond the number of physicians and facilities.
"I can't believe this is going to happen when we've lost the public trust. Believe me, this isn't the way to regain it," he said. "All this guy (Manthei) is doing is trying to make a financial advantage for himself. We have hospitals and plenty of places to do this work."
One former patient of the Shadow Lane clinic, Cecilia Avila, said it would take a lot more than a new owner to bring her back to any of the associated clinics.
New doctors and nurses would have to be part of the equation, she said. Most of the clinics' employees, she believes, knew about the substandard practices yet failed to report them.
"Why didn't they come forward?" she asked.
Manthei, who is also one of the founders of the Desert Canyon Rehabilitation Hospital in Las Vegas, said he understands that public confidence in medical treatment in Las Vegas must be restored. He said that could partially be done by having licensing and accreditation for the facility in order.
"The way you get the public's trust is by doing things the right way," he said. "There are no exceptions."
He said he would hire a medical director, probably an anesthesiologist, to oversee the operation. He would also hire office staff and a nursing director, who would in turn hire nurses. Physicians who used the center, he said, would hire their own anesthesiologists.
Manthei added that surgical centers devoted to a speciality can be more cost effective for both patients and insurance companies. By doing just colonoscopies and other endoscopic procedures at a surgical center, Manthei said, treatment can actually be better than in hospitals because medical professionals are focused on just one discipline.
Lopez said Manthei really doesn't care about re-establishing public confidence in the medical profession in Las Vegas.
"He's just trying to help those guys (former Desai doctors) survive," he said. "He wants them to invest in the clinics one day."
Manthei said that if all goes well he would like to eventually see the doctors working at the clinics invest in the business.
"This guy (Manthei) is part of the problem we have in Las Vegas," Lopez said. "He's just trying to help these physicians who shouldn't be practicing anymore re-establish themselves."
Manthei said he was by no means limiting use of the clinics he might buy to former physicians of Desai. "I would hope many physicians would show up," he said.
Billie-Marie Morrison, an attorney for Craig P. Kenny & Associates, which is representing nearly 300 clients who claim they contracted hepatitis C at the Shadow Lane clinic, said she worries about an opthalmologist running a gastroenterology center.
"I'm sure he's a great opthalmologist but he's not somebody I would want to pin my hopes on rebuilding the public trust when it comes to gastroenterology centers," she said.
Morrison said that if Manthei goes forward and has former Desai doctors working there, people should remember who they are.
In addition to Desai, at least 13 other doctors practiced at his clinics: 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.
"It's up to people if they want to buy a house from a builder who's had his last 10 houses fall down," she said.
Manthei said he understands that people are now terrified of surgical centers, but that fear could be hurting them.
"In our screenings here, we were picking up 1,500 colon cancers a year," he said. "But now people aren't being screened."
Review-Journal writer Brian Haynes contributed to this report.
Contact reporter Paul Harasim at firstname.lastname@example.org or 702-387-2908.