Making Hepatitis History Part 1: Propofol, Deadly Drug for Michael Jackson, Strikes Again
Hepatitis C tore through Las Vegas in February 2008, prompting health officials to call for 40,000 people to be tested for the disease. With estimates of more than 100 cases stemming from the outbreak and possibly thousands of infections that went unreported, it was later declared the largest Hepatitis C outbreak in US history, putting more people at risk than all previous outbreaks combined.
The culprit?
Initially, signs pointed toward a careless clinic, the Endoscopy Center of Southern Nevada.
Soon, though, the clinic's management was being blamed for cost-cutting measures. They were telling staff to reuse single-use syringes of the anesthesia drug propofol, the drug that helped kill Michael Jackson. All it took was two infected patients to spread the disease quickly.
Now, a damning and fascinating report issued by the Southern Nevada Health District shows how the center, its staff and its director, Dr. Dipak Desai, took medicine to a new low.
The Las Vegas Sun's Marshall Allen did a nice job summing up the report on Dec. 22:
Staff at the Endoscopy Center of Southern Nevada were ordered to falsify billing records, reuse syringes and other equipment, and doctors rushed procedures to detect cancer, health officials wrote.
Desai has been sued by more than 20 patients, and the center filed for bankruptcy in July 2009. There are possible criminal charges looming, and Desai has been under a court order not to practice medicine since April 2008. Marshall writes:
Metro Police recently turned over its investigation to the Clark County district attorney's office, recommending prosecution of Desai and the nurses who engaged in unsafe injection practices, the Sun has reported. The district attorney's office is still considering the case.
Meanwhile, the FBI and Nevada attorney general's office are investigating whether Desai and his staff falsified records for the purpose of ripping off insurance companies.
This isn't Desai's first brush with trouble. In 1996, he was sanctioned by the Nevada Board of Medical Examiners for claiming that members of his medical staff were board-certified in gastroenterology. That turned out to be fiction.
Desai does not appear to be board-certified in anything, but that didn't stop him from amassing a large team of physicians and a network of clinics throughout the region.
For health writers, hitting a case like this is like hitting a piñata full of public records. Every agency has a paper trail, and the courts will be turning up patients, employees and other potential sources. Here are five sources, some of which might emerge in court records, that should not be overlooked.
1. Sterilization logs for the medical instruments.
2. Bankruptcy records.
3. Staff schedules.
4. Purchasing records.
5. Licensing inspection reports.
I will expand on each of these in subsequent posts. The health district's report is a pleasure to read and is full of great ideas for journalists conducting their own investigations of sketchy health players like the center. Some of the graphic illustrations would be a worth a full-page treatment in a newspaper just to show people, especially other medical professionals, how something as seemingly innocuous as refilling a syringe with the same drug for the same patient can have disastrous consequences.
Related posts:
Making Hepatitis History Part 2: Sterilization logs can help uncover medical negligence
Making Hepatitis History Part 3: Bankruptcy court holds dirty secrets little and large
Making Hepatitis History Part 4: Time stamps can separate medical fact from fiction
Making Hepatitis History Part 5: Purchasing records reveal dangerous penny pinching