State Medical Board left out of loop

By Marshall Allen

Friday, March 14, 2008 | 2 a.m.

Two weeks ago Doug Cooper read about the massive hepatitis C scare triggered at a Las Vegas clinic where nurses were engaging in dangerous injection practices, apparently at the direction of their boss, a doctor.

Cooper was flabbergasted, but not for reasons you might expect.

Cooper is chief of investigations for the Nevada State Medical Board, which issues licenses for doctors and polices their treatment of patients. He knew nothing about the multiagency investigation that had gone on for more than a month before the Feb. 27 announcement that 40,000 people should get tested for hepatitis B, hepatitis C and HIV.

Since then, Cooper’s life has grown only more complicated.

“Everyone is going on innuendo and rumor and it’s hard to keep focused and keep people focused on what we have to do,” Cooper said. “There is a rush to judgment.”

Indeed, many Nevadans have insisted on suspension of the medical licenses of Dr. Dipak Desai, one of the state’s most prominent physicians, and 13 other doctors. All worked at the Endoscopy Center of Southern Nevada, an outpatient surgery center, and the Gastroenterology Center of Nevada, its related medical practice.

Desai voluntarily agreed to stop practicing medicine while the investigation continues. But the gentlemen’s agreement will not show up on his permanent record. And the other owners of the Endoscopy Center — Dr. Eladio Carrera, Dr. Vishvinder Sharma and Dr. Clifford Carrol — are still practicing.

Dr. Ronald Kline, secretary of the Nevada State Medical Association, which represents physicians, said Thursday that the state’s good doctors have no desire to protect the bad ones. He said he can’t speak for the medical board, but thinks Desai’s license should be suspended.

“Given the charges that were there, it certainly makes sense that (Desai) should not be practicing medicine until the charges are cleared,” Kline said.

Cooper said the medical board is considering suspending the doctors’ licenses. But the politics and reality of such an action are complicated.

First, there are the lawyers. The doctors are wealthy enough — Desai recently started a bank, for instance — to hire teams of attorneys.

Cooper said he must ensure the doctors have their due process so the medical board doesn’t get sued for violating their civil rights.

Also, the medical community is close-knit, so some members of the medical board have close connections to Desai, who ran the largest gastroenterology practice in the state.

Board member Dr. Stephen McBride, the managing partner in General Surgery Associates, shares a medical building with Desai at 700 Shadow Lane. Staff members there would not say whether the two referred patients to each other.

Dr. Javaid Anwar, president of the medical board, has done consulting for Desai through Quality Care Consultants, which he co-owns with Dr. Ikram Khan, Gov. Jim Gibbons’ special adviser on health care. Anwar could not be reached for comment.

Khan said he does not expect connections to Desai and his partners to be a problem in the medical board’s investigation or possible disciplinary action because the Nevada attorney general’s office will force recusal by anyone with conflicts of interest.

Cooper said he has taken steps to protect the investigation from undue influence by board members. He said the investigation is being supervised by three members of the board — two physicians from Northern Nevada who don’t know Desai and a layperson.

Even though two weeks have passed since the revelations, Cooper remains steamed that he was never notified about the investigation by the Southern Nevada Health District, the state Licensure and Certification Bureau and the Centers for Disease Control and Prevention.

Medical board investigators sprang into action when they finally heard the news. Within 18 business hours of learning of the situation, medical board investigators were at the door of the Endoscopy Center with a subpoena, ready to grab the records they needed.

But it was locked. Las Vegas had already shut the place down.

A week later, other law enforcement agencies — the FBI, the Nevada attorney general’s office and Metro Police among them — swept into the clinics with a search warrant and cleaned house, seizing computer hardware and patient files.

If the medical board had known before the public announcement, investigators “would have been so much farther ahead of the game,” Cooper said. The board could have grabbed necessary evidence and developed confidential sources among clinic employees, he said.

Lisa Jones, chief of the Licensure and Certification Bureau, said she thought the medical board had been notified weeks before the announcement. But messages got crossed and fell through the cracks in the chaos, she said.

“My error,” Jones said.

Cooper said the medical board will do a complete investigation, even if it does take more time.

“We will solve this mystery and present to the board a cohesive package of what happened and who did what,” he said.