Desai case’s aftershocks continue to linger

Six years ago, as a result of a hepatitis outbreak at his clinics that caused more than 50,000 people to get tested for hepatitis and HIV, Dr. Dipak Desai was forced to give up his medical license.

In October, after a jury earlier found him guilty of all 27 criminal counts related to the outbreak, including second-degree murder in the death of infected patient Rodolfo Meana, Clark County District Judge Valerie Adair sentenced Desai to life in prison.

Desai’s clinics were tied to nine hepatitis C cases and “possibly linked” by investigators to 106 more. Most patients went to him for colon cancer screening colonoscopies.

During his closing argument before Adair that called for a tough sentence for Desai, chief deputy district attorney Mike Staudaher said, “This community essentially was put at risk for years,” which suggested a public health crisis had ended.

Today, however, with National Colorectal Cancer Awareness Month underway, recent data on colon cancer screening — coupled with what gastroenterologists say patients still tell them — suggest that what happened at Desai clinics, the use of unsafe injection practices to save a few pennies per patient, continues to put the community at risk.

Fear of it recurring still lingers, translating into too few people getting colonoscopies that save lives.

Whether that fear will be erased anytime soon is debatable, particularly since every gastroenterologist other than Desai who once practiced at endoscopy clinics associated with the hepatitis C outbreak is still able to practice in Southern Nevada: Eladio Carrera, Clifford Carrol, Vishvinder Sharma, Dipesh Banker, Snehal Desai, Frank Faris, Carmelo Herrero, Albert Mason, Ranadev Mukherjee, Sanjay Nayyar, Shahid Wahid, Nicolae Weisz and David Manuel, who has moved to Illinois. (The head of the Nevada State Medical Board admits not all the doctors were investigated or even interviewed.)

Consider: While John Packham of the University of Nevada School of Medicine says colon cancer screening rates have jumped from 52 percent to 65 percent during the past six years in Northern Nevada’s Washoe County — on par with rates nationally — Southern Nevada’s screening rate has barely budged to 55 percent during the same time frame.

Why the huge disparity when all Nevadans get the same public health information, the kind of material colon cancer survivors Roddy Belford and Mary Alford will deliver Saturday at the Green Valley Library in Henderson from 3 to 6 p.m.?

Belford and Alford know that though we lose about 50,000 Americans, including nearly 500 Nevadans, every year to colon cancer, we do so largely because cancers were not found early. More than 90 percent of those diagnosed when the cancer is confined to the rectum or colon survive more than five years.

If that’s not a good argument for starting screening at the recommended age of 50, nothing is.

Both gastroenterologist Frank Nemec and Dr. Joseph Thornton, a colon and rectal surgeon, say patients have told them they don’t want a colonoscopy because they fear hepatitis C, although both say those now expressing such fears are fewer.

“I tell people that just as Las Vegas became the safest place to stay in a hotel because of new laws after the MGM fire, Las Vegas is safest for colonoscopies for the same reason,” Thornton says.

(A November 1980 fire in the then-MGM Grand, the hotel now called Bally’s, resulted in the deaths of 87 people. Eighty-four died in the fire; three died later of injuries.)

But Thornton, who still holds classes twice monthly to convince people colonoscopies are safe, notes there is little increase, if any, in Las Vegans getting screened.

Fear of hepatitis, according to Reno’s Dr. Clark Harrison, has not been a concern of someone there in deciding whether to have a colonoscopy. However, he acknowledges a public relations firm was hired to ensure that the mess “that came from drive-thru colonoscopies down south” did not spread up north.

Dread of the bowel-cleansing prep for the procedure remains the major concern, he says.

Because they said the Nevada Medical Board never clarified how doctors who worked for Desai “managed to work differently than their boss,” an elderly Las Vegas couple recently traveled to Utah for colonoscopies.

“I don’t want to make trouble,” said the husband, a retired electrician. “We just want to be safe. I couldn’t remember the names of all his doctors. I’ve never worked where the boss didn’t have final word.”

Nemec, a director in the statewide Nevada Colon Cancer Partnership that works to get more people screened, says many patients have told him they won’t use any doctor who worked for Desai.

The medical board filed formal complaints against three clinic doctors — Desai, co-owner Carrera and clinic manager Carrol.

Carrera’s complaint involved three patients contracting hepatitis from a procedure he performed. But the board backed off serious charges after he testified before a grand jury when a prosecutor agreed not to charge him. The board dropped its hepatitis complaint against Carrol because evidence was tied up in Desai’s trial.

Douglas Cooper, the medical board’s executive director, says it “wasn’t necessary” to investigate all doctors employed by Desai to find out who was culpable, and adds people have no reason to think most of Desai’s doctors acted like him.

Maybe Cooper’s right. But the retired electrician makes a good point. What made a boss, particularly one who micromanaged to the last penny of anesthesia the way Desai did, decide to let employees do things their own way?

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.