Unsafe cost cuts 'common practice'

When public health officials announced last week that dangerous medical practices at a local medical center had exposed Southern Nevadans to potentially lethal viruses, the center announced it had hired a consultant to help "ensure that it will never happen again."

The consultant, a former scientist with the Centers for Disease Control and Prevention, spoke Monday on the issue for the first time.

She said that if dangerous medical practices were commonly undertaken at the Endoscopy Center of Southern Nevada, she feared she knew why: "My guess is they did it to save money."

In a long-distance phone call from her office near Charleston, S.C., Dr. Janine Jason, a Harvard-trained physician who served for 23 years as a senior CDC epidemiologist, said that unsafe cost-cutting is a "common practice in a lot of places."

"It's a matter of minimal risk versus no risk," said Jason, the CEO of Jason and Jarvis Associates. "They've got these vials of medication, and they're not going to use them on just one patient. It should never happen, but it does. Money is a factor."

An investigation by medical investigators in Las Vegas determined that the center's reuse of syringes in a manner that contaminated vials of medication, and the reuse of vials intended for a single patient, had exposed patients to viruses such as hepatitis B and C and HIV.

Jason said that because of scheduling problems, she has yet to meet with medical personnel in Las Vegas. She has never talked to the medical staff, she said, only to a law firm, Lewis and Roca, employed by center doctors. She was surprised to learn Monday that the city last week had shut down the endoscopy center.

Nathalie Daum, a spokeswoman for the law firm, which has offices in Las Vegas, Reno, Arizona and New Mexico, declined to comment. The firm's Web site said specialities include defense of public corruption, consumer fraud, health care fraud and abuse and first-degree murder.

At first, Jason said, she thought the center wanted to hire her only for public relations purposes, just to make it look like the center was taking steps to remedy a problem.

"But they seemed so nice and sincere, I decided that wasn't the case," she said. Her recommendations to the center could include having an infectious-disease specialist on staff and revising the training of employees.

She said representatives of the firm let her talk by phone with some public health care officials in Las Vegas, whose names she could not remember.

"I told them it would have been nice for them to check out other places there to see how widespread the practice is" involving reuse of syringes and vials.

Had they spread their "net out even further," she said, she is sure they would have found more health care practitioners guilty of unsafe practices.

But the public announcement and news coverage, she said, ensured that other health centers would curb their unsafe practices.

She isn't sure the hepatitis outbreak of six cases -- now traced to two days at the center in 2007, July 25 and Sept 21 -- warranted notifying 40,000 former patients.

"That's not how they do it elsewhere," she said.

Jason said it is possible that unsafe practices were used only on those days.

She hopes, she said, that is the case.

"It could be just a foolish mistake, just like not washing your hands is," she said. "They certainly know not to reuse the Propofol (anesthetic)."

But health officials observed the unsafe practices at the clinic in the aftermath of the hepatitis outbreak as part of their investigation.

Jason said that if she determines the staff were purposely cutting corners to cut costs and putting lives at risk, she would find that "unconscionable."

"I may have to give them a lecture on not doing what they know they shouldn't have done," she said.

Contact reporter Paul Harasim at pharasim@reviewjournal.com or (702) 387-2908.