Patients chose to forgo anesthesia at Desai clinic, nurse says

During her year and a half as a registered nurse at the Endoscopy Center of Southern Nevada, Peggy Tagle watched about a dozen patients undergo colonoscopies without first being sedated.

That was their choice, said Tagle, who has a military background and matter-of-factly answered questions Thursday regarding the cleanliness of Dr. Dipak Desai’s clinics and the medical techniques used by nurse anesthetists and physicians.

“They were brave,” Tagle testified. “Didn’t move, didn’t flinch. It was like drinking water for them.”

Tagle’s testimony contradicted that of anesthetists and other nurses who told jurors that Desai sometimes began colonoscopies before the anesthesia set in and patients spoke or moved in pain.

Desai, 63, and co-defendant, nurse anesthetist Ronald Lakeman, 65, face more than two dozen charges, including murder, in connection to the 2007 hepatitis C outbreak that infected six Las Vegas Valley residents and killed a seventh.

Based on health investigators’ findings, prosecutors contend the deadly virus was spread through unsafe injections of the anesthetic propofol. They believe Desai encouraged hasty procedures and was stingy with medical supplies so that his profit margins would balloon.

Tagle acknowledged Thursday that although she has worked as a nurse for 30-plus years, she had never assisted with colonoscopies or upper endoscopies before starting at Desai’s clinics in 2006.

Unlike previous state witnesses who described Desai’s examinations as extremely fast, Tagle said she noticed little difference between Desai’s pace and that of other physicians.

“I never worked in a GI (gastrointestinal) clinic before so I basically went with what I saw,” Tagle said. “I didn’t know what the standard time period was for a colonoscopy. When I was taking the time (on charts) I noticed he was a little faster than some.”

Tagle never witnessed medical staff misuse propofol, she said. When questioned about a “heated discussion” between a nurse anesthetist and Desai over propofol, she could remember little about the argument that broke out in the procedure room. Upon reading her statements to police five years ago, Tagle still could not recall what the discussion entailed.

Tagle assessed the patients prior to the procedures and if they were not prepared for the exams, the physician would not move forward.

“If they were not efficiently prepped, we’d tell the anesthetists and physicians … sometimes they would have them (patients) go to the waiting area for three hours until their stomach was empty. If it was a colonoscopy, they would have to reschedule because their bowel was not clean.”

The examination rooms were not expected to be sterile, but simply clean, she said. When asked to explain the difference, Tagle said: “Like you wash your dishes; your dishes are clean, they’re not sterile.”