As Desai case shows, Devil is in details of regulatory oversight

The Devil and Dr. Dipak Desai were waiting to get on an elevator at the Regional Justice Center the other day.

Satan was hard to spot with so many attorneys milling around , but Desai was easy to identify. After spending months in the news as he battled civil and criminal allegations in association with his scandalous Endoscopy Center of Southern Nevada, Desai’s grimace like an Easter Island icon is well-known . That unemotional gaze probably gives nightmares to victims of his shoddy medical practices. It sure has given me the creeps.

As an avid reader of the daily news, the Prince of Darkness recognized Desai but to my surprise kept his distance in the crowd of charcoal suits .

“Nice weather we’re having,” he said to an apparent stranger, but to Desai he said nothing .

I thought the Devil would have put his arm around Desai’s shoulder. Instead, he seemed uninterested.

Perhaps that’s changed now that a jury has convicted Desai of second-degree murder and 26 other charges in connection with a 2007 hepatitis C outbreak at his colonoscopy mill. Desai not only cut corners and reused anesthesia vials, but he processed patients so quickly that he sometimes got fecal matter on the walls of the operating room. The weight of evidence was as devastating as it was repulsive.

Desai made a score, and now he’ll pay the price. No matter the sentence he receives, his finances and reputation are shattered. Desai’s name will forever be associated with dangerous recklessness.

He makes a convenient and fitting devil, but the Desai story illustrates a greater truth about Nevada life that some will be uncomfortable acknowledging. Dramatic growth brought with it many good things, but it helped set the stage for scandal in areas that were supposedly professionally regulated.

In Nevada, oversight has often taken a back seat to political expediency, outright cronyism and skeleton-crew regulatory bodies.

That’s the case at the Gaming Control Board, which has the impossible task of trying to keep track of Nevada’s casino and slot licensees as they joust on the world stage. The rapid expansion of gambling in Macau by Nevada corporations has far outpaced the state’s ability to regulate. The Department of Justice, FBI and SEC are doing the heavy lifting in multiple investigations.

Federal investigators also intervened in the state’s mortgage fraud crisis. Growth far outstripped oversight, and the result was Nevada looked like a veritable robber’s roost of criminal activity.

The investigation of corruption inside homeowners associations and the construction defect industry also illustrates the trouble. The state ombudsman’s office took complaints about homeowners association corruption but wasn’t capable of investigating.

The list is long.

As for Desai and his out-of-control endoscopy mill, I don’t doubt the eyewitness testimony and irrefutable evidence. But it’s also true that Desai wasn’t simply an irresponsible practitioner. Does any practical person believe this was an anomaly that couldn’t repeat itself given the system of professional oversight?

It’s also true Desai was well-connected politically and worked just as hard at courting political insider status as he did at his clinic. He sat on one oversight board that should have been listening for complaints about him.

Devil though Desai may be, he also is a symbol of what challenges Nevada as it experiences its boomtown manic depression and delusions of libertarianism. The road leads back to the courthouse, where Desai pays for his undeniable avarice .

As Desai got on the elevator, he made room for the darkly handsome figure. But the Devil stopped short.

“If you don’t mind,” the Prince of Darkness said, “I’d prefer not to be seen with you in public. You’re bad for my reputation.”

John L. Smith’s column appears Sunday, Tuesday, Wednesday and Friday. E-mail him at or call (702) 383-0295.

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