Health district mum on patients in Desai case

The Southern Nevada Health District has played a key role in the criminal prosecution of Dr. Dipak Desai, which stems from the 2007 hepatitis C outbreak.

Its investigators, with the Centers for Disease Control in Atlanta, genetically linked the deadly virus to six patients at Desai's Endoscopy Center of Southern Nevada on Sept. 21, 2007, and to another one on July 25, 2007.

But now, as one of Desai's two criminal cases moves closer to trial, the health district is at odds with prosecutors. It is refusing to turn over the names of 20 patients treated at the clinic on those dates who, for various reasons, may not have been tested for hepatitis C.

On Thursday, prosecutors told District Judge Valerie Adair, who is presiding over the criminal case, that they need the names to help track for the jury at trial the progression of the hepatitis C infections during endoscopic procedures on the days in question.

A total of 128 patients underwent procedures on the two dates.

Prosecutors contend that through unsafe injection practices Desai and nurse anesthetists unlawfully spread the virus on each day from a source patient infected with hepatitis C.

Adair had ordered the health district to turn over the names of the 20 patients, but the district's lawyer, Terry Coffing, filed court papers asking the judge to vacate her order.

Coffing argued that a state law prohibits the health district from giving up the names because of privacy reasons, even if subpoenaed or ordered to do so under a search warrant obtained by law enforcement authorities.

Coffing also contended the law prohibits a judge from ordering the health district to surrender the names.

The health district is making the stand to preserve its credibility with patients, who expect their privacy to be maintained when the agency investigates cases of infectious diseases, Coffing told Adair on Thursday during a half-hour hearing.

"This is their hill to die on," he said.

But Chief Deputy District Attorney Mike Staudaher argued that the health district's interpretation of the state law is overreaching, putting the district outside the arm of judicial and law enforcement review.

"It's essentially placing the health district above the law," Staudaher said. "It makes them search warrant proof."

Under the district's interpretation of the law, Staudaher added, the health district could commit criminal wrongdoing and thwart an investigation.

Adair promised a written decision by Wednesday.

Desai, 62, and two nurse anesthetists, Keith Mathahs, 76, and Ronald Lakeman, 65, face an array of criminal charges stemming from the outbreak.

All are free on bail.

They are to stand trial before Adair on Oct. 22 on charges of racketeering, patient neglect, insurance fraud and obtaining money under false pretenses.

The three defendants also each face a separate charge of second-degree murder before District Judge Stefany Miley.

No trial date has been set in that case, which prosecutors filed earlier this month.

The murder indictment accuses Desai and company of "introducing the hepatitis C virus" into the body of Rodolfo Meana, one of the seven genetically linked victims, during a 2007 colonoscopy.

Meana, 77, died in April from complications from hepatitis C in his native Philippines.

Desai, a gastroenterologist who has since given up his medical license, performed Meana's colonoscopy and other medical procedures linked to infections at his clinic.

Both Mathahs and Lakeman administered the sedative propofol to the infected patients, authorities have said.

Only Mathahs injected Meana with the sedative, but prosecutors were able to charge Lakeman in his death under the theory of the murder charge, which alleges all three defendants were part of the conspiracy that endangered the lives of Desai's patients.

Desai pressured clinic employees into using additional doses of propofol from single-use vials on more than one patient during the medical procedures, contrary to accepted safety standards, prosecutors have alleged.

Contact Jeff German at jgerman@reviewjournal.com or 702-380-8135.