Sweetheart deal at least requires testimony of endoscopy clinic doctor

The howls of outrage are understandable, even anticipated.

One of the doctors from the Las Vegas endoscopy clinic now best known for allegedly spreading hepatitis between patients received a sweetheart deal from the Nevada Board of Medical Examiners.

Dr. Eladio Santana Carrera gets his medical license back, he's on probation for two years and he pays a $15,000 fine (and costs that will be far larger than that).

Carrera also agreed to testify.

What seems like a deal with a devil is in actuality a deal with a devil who might help the board prove cases against two other devils -- Dr. Dipak Desai and Dr. Clifford Carrol.

Desai and Carrera were partners in the now defunct Endoscopy Clinic of Southern Nevada, where health officials said hepatitis C was spread from one patient to another by reusing syringes in vials of anesthesia, all to cut costs.

The board's decision Wednesday sparked fury statewide. Assemblywoman Sheila Leslie, D-Reno, called for the resignation of all the members of the medical board.

I understand the fury; but after all those years covering federal court, I'm used to deals with devils. That's how you prove cases.

Mobsters do it. Politicians do it. Even strip club owners do it.

Murderer Frank Cullotta snitched against other mobsters. Former Clark County Commissioner Erin Kenny ratted out her fellow crooks on the commission. Ex-topless club owner Mike Galardi told of passing out political bribes like Halloween candy.

It's how criminal cases are built, folks. And the Law of Reality is that the one who cooperates gets a better deal. And whether it's Cullotta, Kenny, Galardi or Carrera, officials need an insider to connect the dots and provide context.

Carrera first approached the medical board in September to play let's make a deal. It was a long negotiating process between his attorneys and the board to reach the agreement; and for 14 months, Carrera couldn't practice because a state judge suspended his license.

Now, the gastroenterologist can go back to work. His attorney, David Mortensen, said the bilingual doctor plans to practice in North Las Vegas.

Louis Ling, the medical board's executive director, said Carrera is the least culpable of the three doctors. Understand, Ling knows (and we don't) what Carrera is prepared to say. And the settlement is clear: If Carrera's testimony against Desai and Carrol is "materially different" than what he has told the board, the board can discipline him further.

"He gives us insider evidence there is no other way to get," Ling said. "How the clinic operated, who was in charge of what, what happened day to day."

The board's agreement doesn't protect Carrera from any ongoing state or federal investigations. He still is exposed to those possibilities, and his settlement with the medical board doesn't require him to cooperate with law enforcement officials. (It's worth noting that the medical board is the first body to take any action in the hepatitis case.)

If Assembly Bill 10 had been in effect, the board might have had to give Carrera immunity without any penalty. That's the bill backed by Assemblywoman Leslie that protects nurses and doctors who become whistle-blowers. While it's a stretch to say Carrera was a whistle-blower, a smart attorney could argue he was.

Three patients are believed to have been contaminated the day they received procedures from Carrera. But Ling said they were contaminated before he walked into the room, because they were contaminated through the anesthesia administered by nurse anesthetists.

That's how Carrera's attorney could tell the board with a straight face that any infection occurred "outside his presence and his knowledge."

Despite that "I know nothing" assertion, Ling said, "He knows enough that this board had to endure what it had to endure the past couple of days and take the risk. The public may not see it today; but when they see what he's got to tell, they're going to be glad."

Trust me. The nine people who contracted hepatitis at the clinic, the 105 others who may have, and the 50,000 people who had to be tested aren't going to be glad. Who could blame them if they wanted to see all three doctors hang by their thumbs?

But since Carrera is the only one willing to talk, he gets the sweetheart deal, even if he's no sweetheart.

Jane Ann Morrison's column appears Monday, Thursday and Saturday. E-mail her at Jane@reviewjournal.com or call (702) 383-0275. She also blogs at lvrj.com/blogs/morrison.