Two nurses reject plea deals in hepatitis C case, may face murder charges

The two nurse anesthetists charged with Dr. Dipak Desai in the hepatitis C criminal case on Thursday rejected plea deals offered by prosecutors.

Keith Mathahs, 76, and Ronald Lakeman, 65, had considered the offers, made earlier in the week, to avoid being charged with murder in the death of a victim in the 2007 hepatitis outbreak.

Defense attorneys Michael Cristalli and Rick Santacroce, who represent Mathahs and Lakeman respectively, said prosecutors indicated they would present murder evidence against their clients to a county grand jury if plea agreements weren't struck this week.

"I viewed it as a threat that if we didn't take the deal, we would be charged with murder," Cristalli said.

Added Santacroce, "I'm very disappointed in the deal that was offered."

Neither lawyer would discuss details of the offer, but Santacroce said his client was still open to negotiations.

Cristalli said it's hard for him to fathom that his client now is facing murder charges in a criminal case that really is "nothing more than a medical malpractice case."

Chief Deputy District Attorney Mike Staudaher said Cristalli first asked him about a plea agreement.

"The state was originally approached by Mr. Cristalli about the possibility of dealing the case to avoid an indictment," Staudaher said. "An offer was formulated, and out of fairness the same offer was made available to Mr. Santacroce. The state did not coerce anybody."

Staudaher declined further comment.

On Thursday morning, Staudaher and Chief Deputy District Attorney Pamela Weckerly showed up for an unrelated court proceeding in the high-profile case expecting to hear whether Mathahs and Lakeman were ready to enter guilty pleas. Desai, 62, was not in court.

When it became apparent no agreements had been reached, both sides spent an hour negotiating in a small witness room outside the courtroom of District Judge Valerie Adair while waiting for the case to be called. But the lawyers emerged without deals.

District Attorney Steve Wolfson made an appearance, but he left without commenting as the talks appeared to break down.

After the hearing, Weckerly and Staudaher left the courtroom through a back door without commenting.

The Las Vegas Review-Journal first reported Wednesday that Desai and the nurse anesthetists received formal "Marcum" notices informing them that they were targets of a grand jury murder investigation into the death of Rodolfo Meana, a former Desai patient.

Meana, 77, died of complications from the virus in his native Philippines on April 27.

His infection was among seven the Southern Nevada Health District genetically linked to Desai's main clinic, the Endoscopy Center of Southern Nevada on Shadow Lane.

Meana and five other patients contracted the virus through unsafe injection practices on Sept. 21, 2007, health officials concluded. Another patient was infected on July 25, 2007.

The patients, all of whom testified previously before a grand jury, are named as victims of criminal patient neglect in a 28-count indictment returned against Desai and the two nurse anesthetists in June 2010.

All three defendants, who are to stand trial before Adair on Oct. 22, are also facing felony charges of racketeering, insurance fraud and obtaining money under false pretenses.

The racketeering count alleged the three defendants carried out a criminal enterprise between June 2005 and May 2008 that falsified anesthesia records during routine procedures at Desai's clinics and submitted false anesthesia records to various insurance companies.

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

The criminal investigation, which began in 2008, was one of the largest undertaken by Las Vegas police. Officials notified 40,000 former clinic patients at the Endoscopy Center of Southern Nevada about possible exposure to blood-borne diseases because of unsafe injection practices. More notifications followed for patients of a sister clinic, Desert Shadow Endoscopy Center.

The outbreak was blamed on nurse anesthetists reusing propofol vials between patients after they had become contaminated by syringes that were reused on patients with hepatitis C.

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