Health district sends 101 letters advising HIV, hepatitis tests

The Southern Nevada Health District on Monday sent letters to 101 patients of urologist Dr. Michael Kaplan, advising them to get tested for HIV and hepatitis B and C.

In suspending Kaplan's medical license eight days ago, authorities said that Kaplan for three months re used what should be single-use-only plastic needle guides for prostate/rectal biopsies, discarding them only when they became "too bloody."

"As of March 21, we have not identified any cases of disease related to the procedures at Dr. Kaplan's office, and based on similar incidents that have occurred in other states, the risk of contracting a disease is believed to be very low," Dr. Lawrence Sands, the district's chief health officer, advises in the letter.

The notification comes three years after Las Vegas was rocked by an unrelated hepatitis outbreak traced to reuse of syringes and single-dose vials of anesthetic at Dr. Dipak Desai's endoscopy centers. More than 40,000 of Desai's patients were warned of possible exposure to hepatitis and HIV, the largest such notification in American history. At least 100 men and women are thought to have contracted hepatitis.

While smaller in scope, Monday's notices still generate much concern.

"Of course, I'm worried and angry about getting hepatitis and HIV because a doctor didn't follow directions," said Alfred Slensky, 60, who received a prostate biopsy from Kaplan in January. "How could you sleep good without getting tested?"

According to the letter, at-risk patients either had a prostate biopsy or a procedure that used the needle guide in implanting markers in the prostate to help a radiation oncologist target a cancerous tumor during therapy.

Both are invasive, going through the anus to the rectum, and involve exposure to bodily fluids and blood.

The health district said the Nevada State Board of Medical Examiners and Food and Drug Administration Office of Criminal Investigation "found that Dr. Kaplan's staff attempted to clean and disinfect the needle guides prior to reusing them, but these needle guides were not designed or intended to be reused."

At-risk patients had procedures done between Dec. 20, 2010, when Kaplan started re using the devices, and early this month, when authorities stopped him, officials said.

"At this time we are not aware of any other procedures conducted by Dr. Kaplan that might have put patients at risk, and testing is only recommended for (those) patients," the health district advised, adding that "due to the time it can take for infection to be detected, it is important to be tested soon and then again six months after the date of your procedure(s)."

Jennifer Sizemore, a district spokeswoman, said patients should arrange tests through their personal physicians. The health district is not testing, nor is it paying for tests, she said.

Many urologists favor reusable stainless steel needle guides, which can be sterilized with special cleaning solutions and high-pressure saturated steam hotter than 185 degrees Fahrenheit.

Additional information is available through the health district's help line, 759-4636, its website, www.SNHD.info, or the State Board of Medical Examiners, 888-890-8210.

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