Slap on the wrist

In a unanimous decision Wednesday, the Nevada Board of Medical Examiners lifted the 13-month medical-license suspension of Dr. Eladio Carrera, co-owner of the Endoscopy Center of Southern Nevada, ground zero for an outbreak of preventable hepatitis C infections that has set back the cause of routine colonoscopy screenings in the valley, perhaps for years.

The wrist-slap punishment received by Carrera, who will receive a public reprimand, be on probation for 24 months and pay a modest $15,000 fine, appears to mimic the plea bargains sometimes handed out to small-time crooks who agree to testify against their associates -- as part of his deal, Carrera must testify in other malpractice cases filed by the board against Dr. Dipak Desai, the principal owner of the endoscopy center, and Dr. Clifford Carol, who also practiced there.

Authorities investigating the 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 investigators, was done at the direction of Desai and other administrators.

These well-established sanitary procedures were apparently violated, systematically, in order to speed up the cattle-call operation, in order to generate extra hundreds of thousands of dollars in profits -- a number that dwarfs Carrera's pathetic fine.

Lyn Beggs, the board's general counsel, said the light punishment was just because 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, according to Ms. Beggs.

What? Presumably people with medical degrees have an easier time getting licensed to run a medical clinic than would some homeless guy or aluminum siding salesman. Who's responsible for setting policies that require routine sterile safeguards to be followed at a medical clinic if not the doctors who own the place?

This punishment -- a slap on the wrist; a financial fine amounting to less than a month's worth of the profits obtained through the health-endangering shortcuts he had to know about, and a "try to do better the next time" -- is laughable.

Though board members Robert Wiencek and Ronald Kline, both physicians, wondered aloud at this week's meeting about Carrera being "the captain of the ship" in the operating suite, they both still joined the unanimous vote for the settlement.

Assemblywoman Sheila Leslie, D-Reno, whose committee investigated the outbreak, 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."

Perhaps that can wait till we find out what good comes of Carrera's promised testimony against his former associates -- and how seriously the board treats their offenses, if proved.

For now, though, it sure does appear the message of the state Board of Medical Examiners is: Write "too many" painkiller prescriptions for patients who are actually in chronic pain and we may very well yank your license. But if you choose to knowingly put your patients at risk of potentially deadly infectious diseases in order to make a couple hundred grand per year in extra profits, what the heck, business is business, we'll say "Naughty, naughty," fine you a couple weeks' pay, and send you right back to work.

And that's appalling.