Getting answers in health care mess requires help from patients, lawyers

The messages are almost everywhere: If you were treated at the Endoscopy Center of Southern Nevada in recent months, contact the law offices of this attorney or that law firm.

Local trial lawyers have scrambled to round up clients in the wake of revelations associated with the center, and they're getting competition from courthouse gunslingers from out of town. Lawsuits have already been filed, at least one with more than 50 plaintiffs who might have been exposed to deadly viruses such as hepatitis C and HIV because of substandard medical practices at the clinic.

With its historical neglect of its state regulatory agencies, Nevada has been asking for a frenzy of plaintiff litigation, whether the subject is medical centers or mortgage companies. So the presence of so many attorneys so close to this story shouldn't be surprising.

The question is: Is super-aggressive behavior by some trial attorneys slowing the ongoing FBI and Metro investigation?

That's what I'm hearing from several veteran legal community sources: At least one local lawyer has instructed clients not to cooperate with authorities.

Whether it's an attempt to protect former patients, refine litigation, or keep opposing counsel from poaching, the lawyer reportedly has instructed his clients to keep quiet. Competition is one thing, but this borders on obstruction.

Local authorities I spoke with on Tuesday were quick to encourage the center's former patients to step up. While their health is at risk, and in some cases their lives might have been irreparably harmed, the medical community's credibility is at stake. And if citizens no longer have confidence in their physicians, the fallout from not seeking treatment would surely be far more damaging to the public health than the worst-case scenario at the center.

The community's future hangs in the balance.

"I would be very disappointed with people in the community if they didn't step forward and help police and prosecutors bring these people to justice," District Attorney David Roger said Tuesday. "We need witnesses to come forward. If attorneys are telling clients not to cooperate with law enforcement, I think they would be doing the community a great disservice."

For U.S. Attorney Gregory Brower, citizen cooperation is an essential part of the investigative process.

"It's important for citizens to understand that they really do need to talk to law enforcement whenever they have information regarding a crime that may have been committed, or in response to law enforcement's questions," Brower said.

"By definition, law enforcement is interested in talking to somebody when there is a public safety, a public health, or a public welfare issue at stake. Therefore, it's important for people to cooperate and answer questions."

Although state health licensing officials might yet prove to the public they're capable of adequate regulatory oversight, only a thorough law enforcement investigation will provide the kind of answers many citizens seek. Whether criminal charges one day materialize isn't as important as shoring up the wobbly public trust.

And it all starts with a free flow of information from patients to investigators, said Mark Doh, acting special agent in charge of the FBI's Las Vegas office.

"It is imperative that the FBI receive full cooperation from patients in health care fraud investigations," Doh said. "It's virtually impossible to effectively run a health care fraud case without the cooperation of the patients."

While at least one trial lawyer is trying to block his clients from speaking with the police and FBI, attorney Robert Massi is taking a different approach.

Massi, who represents about 50 former patients at the endoscopy center, has instructed clients to write DA Roger to "express their outrage and, in fact, if these people are criminally culpable that they should be prosecuted appropriately under the law."

Like other attorneys interviewed for this story, Massi has heard about at least one lawyer who has silenced his clients.

"This is not about money for most of these people," Massi said. "As a matter of fact, most of the people who have come to me, even those who have tested negative, have made the statement that they want these people held accountable under whatever law that applies."

For that to happen, all the lawyers representing those patients-turned-clients will have to cooperate with investigators.

Nothing less than the community's future is at stake.

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