Desai clinic recognized as ‘model unit’ prior to hepatitis c outbreak

In an attempt to clear up the perception that Dr. Dipak Desai operated filthy endoscopy clinics where medication was misused and feces remained on the walls after colonoscopies, defense lawyers revealed Friday that the Shadow Lane facility received a prestigious national rating in October 2007.

Just months before the Center of Disease Control and the Southern Nevada Health District announced that hepatitis C viruses were passed onto patients treated at the clinic, it received the highest possible grade from the Accreditation Association for Ambulatory Health Care.

In his second day of testimony at Desai’s trial, Dr. Clifford Carrol told defense attorney Richard Wright that the inspection before the rating was thorough and detailed.

Carrol testified that representatives for the association said the clinic was a “model unit,” after spending days sifting through paperwork and records, observing how medication was administered and stored and witnessing endoscopy procedures.

Desai, 63, and nurse anesthetist Ronald Lakeman, 65, face more than two dozen charges, including second-degree murder, criminal neglect of patients, theft and insurance fraud. Carrol signed an immunity agreement and is testifying on behalf of the government.

Desai’s clinics were shut down in 2008 after health officials discovered that the same single-use vials of the anesthetic propofol were being used on different patients and that syringes were not always changed.

Carrol acknowledged to Wright that he never believed the clinic was responsible for the hepatitis C outbreak that infected seven patients, one of whom died.

Carrol said 2 percent of Americans carry the virus and most of them are Baby Boomers born between 1945 and 1965. Not everyone who carries the virus feels symptoms, and it can take years, if ever, before the virus becomes acute or chronic.

“It’s a combination of the crazy behavior in the ‘60s and ‘70s and lack of knowledge about surgical procedures,” Carrol said.

Wright jumped on Carrol’s theory, saying the majority of patients who visited Desai’s clinics for upper endoscopies or colonoscopies were Baby Boomers. They could have had the virus before receiving treatment at the facilities.

Carrol said he protested the decision by the CDC and Southern Nevada Health District to announce the epidemic publicly and request that some 50,000 patients who underwent procedures at Desai’s clinics from 2004 forward be tested for hepatitis C.

He suggested they instead take sample pools of patients. If the number of infected patients exceeded the national average of 2 percent, then perhaps there was an issues at the clinic, Carrol testified.

“I was shocked and I didn’t believe it because I had never heard of it before. I had never heard of a transmission in an endoscopy center before,” Carrol said.