Virus has Las Vegas police detective preaching precaution

Las Vegas police detective Kenny Nogle talked about how he got his affairs in order before he took a bullet.

No, he wasn't referring to filing a living will or advance directive that would let doctors know when to pull the plug.

What he was referencing were the conversations he's had with fellow officers, warning them to wear gloves should he be bleeding from a gunshot wound.

"When an officer gets shot, another officer will just jump in there to stop the bleeding," Nogle said as he sat outside a Steak 'n Shake on the southwest side of Las Vegas. "I wanted them to treat me just like they do when they pick up a vagrant on the street. Use universal precautions."

In 2008 Nogle learned he had hepatitis C, a potentially deadly virus that attacks the liver. The virus is primarily passed from person to person through direct blood-to-blood contact, including mucous membranes or broken skin.

The dangerous nature of police work means there is the real potential for exposure to the virus.

"It was awkward at first talking about this to other officers, but they appreciated what I was doing," he said.

Nogle, 27, didn't contract the virus on the job.

He ended up in Dr. Dipak Desai's clinic in November 2006 following a trip to the emergency room for blood in his stool. When the ER doc couldn't make a definitive diagnosis, Nogle decided to get a colonoscopy.

Desai performed the procedure. The results showed Nogle suffered from a minor problem: hemorrhoids.

His real problems were just beginning.

In early 2007, Nogle, a regular blood donor, made a donation. A letter he later received from the blood service said he could no longer do so because tests showed he had antibodies for hepatitis C. After seeing some primary care doctors, they recommended he see a gastroenterologist.

He went back to Desai's clinic for a retest, which doctors there said came back negative.

"I now believe they were lying," he said. "I went a year thinking I didn't have it."

On February 27, 2008 public health officials urged more than 40,000 people who had procedures at Desai's clinic to get tested for hepatitis and HIV, the largest such notification in U.S. history. Authorities said nurses had been observed reusing syringes in a manner that contaminated vials of medication.

According to clinic staffers interviewed by city investigators, this practice was done at the direction of Desai and other administrators to save money.

Through testing, Nogle soon found he had the disease.

Nogle's lawsuit against Desai, according to his attorney, Billie Marie Morrison, is solid because his only risk factor was getting treated at Desai's clinic.

When I met with Nogle, experts had recently found Desai competent to stand trial in March on felony charges, including neglect of patients. "He could only act for so long," Nogle said.

Nogle looks healthier than when I saw him early last year. Then, he had just started to put back on the 35 pounds he lost from his muscular 5-foot 6-inch, 170-pound frame during treatment for the virus.

He recently received some good news. The virus is still undetectable in his blood since his treatment for hepatitis C ended nearly two years ago.

Doctors compare the side effects of that treatment, which involved Nogle injecting himself in the stomach with medication for a year, to those caused by powerful chemotherapy. Then a training officer, he worked through chills, fever, headache, fatigue and depression when he could have gone on sick leave.

Unwilling to let the disease slow his career, Nogle passed the test to become a detective a few months ago.

What has changed most in his life since he contracted hepatitis, he said, is how he views the medical profession.

"I was brought up to think they cared about people more than other people did," he said. "I know better now. They're no better or worse than anybody else."

He said he has made it his business to study the medical profession since he contracted the disease. He has noted how doctors are regularly caught for financial fraud, selling drugs, performing unnecessary procedures.

"Getting more money -- greed -- motivates too many of them," he said. "Their moral compass should never be thought of as superior to that of any other profession."

Paul Harasim is the medical reporter for the Las Vegas Review-Journal. His column appears Mondays. Harasim can be reached at pharasim@reviewjournal.com or 702-387-2908.