LAS VEGAS SUN
Tuesday, March 18, 2008 | 2 a.m.
- Gov. Jim Gibbons reaffirms his need for immediate action from the state Board of Medical Examiners.
- Gibbons discusses a statement he made that was reported in the Reno Gazette-Journal.
- Gibbons talks about why it took some time before he took personal action.
- Gibbons discusses budget reductions to the Bureau of Licensure and Certification.
Gov. Jim Gibbons on the health scare
- March 10: Gibbons says if Las Vegas medical care providers knowingly reused syringes or other items at the Endoscopy Center of Southern Nevada or at other medical facilities, criminal charges are possible. “If they knowingly endangered lives of people, that does constitute a criminal act,” he said.
- March 11: Gibbons questions whether Nevada needs to conduct more frequent inspections of facilities such as the Endoscopy Center, where unsafe practices led to the hepatitis C outbreak and the notification that 40,000 people need to undergo tests for hepatitis B, hepatitis C and HIV. “We do not have enough Highway Patrolmen to stop everybody who makes a mistake. We could inspect (surgical centers) annually and then pretty soon, have we done overkill?”
- March 15: Gibbons lashes out at the news media for coverage of the issue, characterizing it as “buffoonery.” “This hysteria has been created by people not getting the right information,” Gibbons said. “The fact is, they haven’t found more than those six people (who contracted hepatitis C). “There was no single vial of medication reused. There were no reused needles. Gross negligence when you have far below the number of average (hepatitis C) cases listed? That’s trial-lawyer speak to me. I think if you’d had gross negligence, you’d have a high number.”
- March 16: Gibbons apologizes for his “buffoonery” remark. “My intention was to be sure that people were not fearful of seeking medical care because of the intense media coverage,” the governor said. “It was a poor choice of words and I regret it.” Gibbons said he will ask for the resignations of Nevada Board of Medical Examiners President Dr. Javaid Anwar, Vice President Dr. Sohail Anjum and board member Dr. Daniel McBride because of potential conflicts of interest involving the Endoscopy Center. The governor also asked for the resignation of the board’s executive director, Tony Clark, the former adjutant general of the Nevada National Guard. “This in no way questions the integrity of the board’s members,” Gibbons said. “I simply want to be certain that any member of this board can act on public health issues brought before them without conflict.” The governor also instructed state Health and Human Services Department Director Mike Willden to dismiss Lisa Jones, head of the Nevada Licensure and Certification Bureau, the agency that oversees licensing and inspections of the state’s surgical centers.
More from the Sun
Gov. Jim Gibbons and his staff looked Sunday night to take “decisive action” on the health care crisis that was more than two weeks old.
So after a full day of phone calls, a late-night news release called for the resignation of three members of the Board of Medical Examiners, the board’s executive director and the head of state inspections. Separately, Gibbons also asked for his own medical adviser to step down.
Now some of those folks are pushing back, questioning the governor’s actions and whether the right heads are rolling.
Gibbons had assured himself a healthy round of questioning from the media after the Reno Gazette-Journal published an interview with him Sunday in which he defended the Endoscopy Center of Southern Nevada against charges of gross negligence. The governor contradicted findings by state inspectors, proclaiming the center was not reusing single-dose vials of medicine on more than one patient. And he blamed media “buffoonery” for the public hysteria.
On Sunday he apologized for the “buffoonery” swipe. In the same news release, he called for the five resignations.
Tony Clark, executive director of the state Board of Medical Examiners, argues that Gibbons’ request for his resignation is a case of political payback.
The three members of the board reportedly have ties to Dr. Dipak Desai, majority owner of the Endoscopy Center of Southern Nevada, where six people became infected with hepatitis C because of unsafe health practices.
Clark said he has no association with Desai and had nothing to do with the licensing of the clinic.
“This is just payback,” said Clark, former adjutant general of the Nevada National Guard.
He said he replaced Gibbons as vice commander of the Air National Guard after Wing Cmdr. Chuck Chinnock, noting that Gibbons had served 20 years in the Guard, said it was time to let other officers move up the ladder.
“I know how the game is played and what goes around comes around. This was his (Gibbons’) opportunity to get rid of me,” said Clark, who had announced last year he would retire in September after 23 years of service.
Gibbons insisted there was no reason for asking for Clark to resign other than his job performance.
“He did not do his job. Any suggestions that my call for his resignation is anything other than that is patently false and preposterous,” Gibbons said in a conference call Monday.
Gibbons said he was calling for the resignations to restore public confidence in the state’s health care system. He acknowledged he did not have the authority to remove board members, but said he would ask them directly to resign if they did not act.
He also raised the possibility of removing them for “cause.”
Gibbons did not say specifically what he believes Clark should have done when the issue arose.
Dr. Ikram Khan, who resigned as Gibbons’ special adviser on health care after being asked to do so Sunday, told the Sun on Monday that he saw no reason for the request because he played no role in the hepatitis scare or in determining Desai’s future.
Khan said he served only in an advisory capacity to Gibbons and the governor had not sought his opinion.
Khan said the resignation request came simply because he knows Desai socially and has worked for him in the past. Desai once hired the company that Khan and Dr. Javaid Anwar own jointly, Quality Care Consultants, which specializes in health care policy and strategy.
Gibbons’ call for his resignation, Khan said, sullied his reputation after 30 years of practice in Nevada, including eight years on the Board of Medical Examiners.
Khan said he is worried about how the controversy will affect the state’s ability to attract good doctors and, more immediately, doctors for patients who went to Desai’s now-closed practices, but who now are having difficulty arranging for care because investigators have seized their records.
Gibbons called on Anwar, the board’s president, and board members Dr. S. Daniel McBride and Dr. Sohail U. Anjum to resign also. Anwar said he had not made up his mind about whether to resign and did not want to comment further.
Lisa Jones, chief of the state’s Licensure and Certification Bureau, was not taking calls, according to staff members. But others in the state rose to her defense.
“This is a knee-jerk reaction that’s not going to fix the problem,” Assemblywoman Sheila Leslie, D-Reno, said. “This is a systemic problem that’s much deeper than Lisa Jones.”
Angie Silla, a patient advocate and registered nurse, also defended Jones.
“Lisa needs to stay in her position,” Silla said. “She works hard with inadequate amount of staff.”
Gibbons said he called for Jones to be removed because the department “failed to take action in a timely manner.”
The Endoscopy Center was allowed to continue operating until Las Vegas pulled its business license. Although the state has the authority to pull a license from an ambulatory surgical center, it cannot close a business. The center could have continued operating and performing procedures as a doctor’s office, which the state cannot regulate, Deputy Attorney General Linda Anderson said.
In Monday afternoon’s conference call with reporters, Gibbons said he was “focused like a laser on the health care system.”
He also retreated from his contention that single-dose vials of medication were not reused by nurses at the Endoscopy Center.
In the Gazette-Journal’s Sunday story, Gibbons was quoted as saying: “There was no single vial of medication reused. There were no reused needles. Gross negligence when you have far below the number of average hepatitis C cases listed? That’s trial-lawyer speak to me. I think if you’d had gross negligence, you’d have a higher number.”
When the Sun asked him about the single-dose vial comment Monday, he said:
“I was informed that by an individual, a health care professional. It may have been a little bit premature.”
He wouldn’t identify that person.
Sun reporter Cy Ryan contributed to this report.