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HEPATITIS C OUTBREAK: No promises on medical safety

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  • scarletpaolicchi
    May. 31, 2009 Copyright © Las Vegas Review-Journal http://www.lvrj.com/news/46567377.html HEPATITIS C OUTBREAK: No promises on medical safety But state health
    Message 1 of 1 , May 31, 2009
      May. 31, 2009
      Copyright © Las Vegas Review-Journal

      HEPATITIS C OUTBREAK: No promises on medical safety

      But state health official praises new legislation


      Michael Willden wishes it were possible.

      But the director of the state Department of Health & Human Services says there
      is no way he can promise Nevadans that newly passed public health legislation
      can prevent a situation similar to the recent hepatitis C outbreak.

      "I think the laws that have been passed to protect the public are absolutely a
      huge improvement," Willden said last week. "It is far less likely. But I can't
      say we'll never have an infection-control event like that again."

      The reason for Willden's caution, despite new laws on the books dealing with
      everything from stepped up clinic inspections to easier suspension of medical
      licenses, isn't difficult to understand: No one, he noted, can legislate human

      Authorities investigating a cluster of hepatitis C cases had observed nurses at
      the Endoscopy Center of Southern Nevada reusing syringes in a manner that
      contaminated vials of medication and, they believe, infected patients.

      City officials in a report said the clinic's owner, Dr. Dipak Desai, ordered
      that practice, and that city investigators were told this was to save money.

      But Willden and a number of legislators and medical officials contacted by the
      Review- Journal believe the new laws will so heighten attention on proper
      protocols that it is far less likely that Southern Nevada Health District
      officials will again have to do what they did in 2008: ask 50,000 patients to be
      tested for HIV and hepatitis.

      Assemblyman Joe Hardy, R-Boulder City, who is a physicain, said passage of
      Assembly Bill 123 is a big step forward for public health. It requires
      ambulatory surgical clinics to be the subject of yearly, unannounced inspections
      rather than inspections every three to six years.

      "It is much easier to keep things in line," said Hardy, who believes another
      aspect of the bill, requiring accreditation by a national regulator in order to
      do business, is also critically important. "It shows we won't tolerate bad

      Larry Matheis, head of the Nevada State Medical Association, said the fact that
      the state health division will now assign a nurse to accompany all inspection
      teams specifically to observe infection control should also give Nevadans more
      confidence in the state's health care system.

      "This can assist in immediate corrections," he said. "This may become a new
      national model."

      Hardy said Assembly Bill 10, signed Friday by Gov. Jim Gibbons, puts more teeth
      in legislative protections for medical whistle-blowers.

      "This will help both nurses and doctors and other medical personnel who want to
      do the right thing," Hardy said.

      Debra Scott, executive director of the Nevada State Board of Nursing, said
      Thursday that some nurses were afraid to step forward in the outbreak case for
      fear they would lose their jobs.

      Passage of two other Assembly bills, 112 and 206, look to bridge potential gaps
      in communication during a public health crisis.

      The governor is now required to determine if a public or health emergency needs
      a coordinated response by a team of state officials.

      "We now will have everyone on the same page in an emergency," said Assemblywoman
      Debbie Smith, D-Sparks, who chairs the Assembly Health and Human Services
      Committee. "We had problems with coordinating what different offices were

      Assemblywoman Sheila Leslie, D-Reno, whose interim health care committee held
      hearings on the outbreak last year, said it is now clear through legislation
      that the state health division has the power to have a facility shut down in a

      "That was a problem we didn't need to have, " she said.

      Leslie said last year that she believed existing law gave the state the right to
      shut down Desai's clinic, an action that the city's business license division
      took when health authorities did not act to close the clinic.

      Another bill that Leslie said "clarified existing law" was state Senate Bill
      362, which states that a health care professional's license can be suspended if
      the facility they own is investigated or disciplined for misconduct.

      Last year, Leslie repeatedly said she believed that the Board of Medical
      Examiners had the right to suspend Desai's license.

      The board's then-executive director, Tony Clark, had long said the board didn't
      have the power to issue a summary suspension.

      Clark later said the board did have that power, but that there wasn't enough
      evidence to summarily suspend Desai's license.

      Michael Washington, one of nine people whose hepatitis C case was linked to Las
      Vegas clinics where Desai was the majority owner, has been closely watching the
      work of the Legislature.

      Washington was supposed to testify on behalf of Assembly Bill 495, which would
      remove a $350,000 cap on pain and suffering damages, a key element of the 2004
      medical reform initiative. But the Assembly-approved bill died in the state
      Senate in apparent retaliation for an Assembly committee chairman's decision to
      sit on two Senate-passed construction defect bills.

      "I want to believe that the legislators care about what's happened with this
      hepatitis C tragedy," Washington said.

      "But I don't understand what construction bills had to do with a bill that would
      allow people to be justly compensated when doctors are doing something wrong."

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


      Assembly Bill 10: Provides additional protection against retaliation or
      discrimination for registered nurses and other medical personnel who report
      concerns about patient safety. Also prohibits physician licensing boards from
      taking adverse action against doctors who cooperate in investigations of
      possible wrongdoing by other physicians.
      outcome: Bill signed into law.

      Assembly Bill 112: Requires the governor to determine if a public health
      emergency needs a response by an emergency team. If a coordinated response is
      required, the governor must issue an executive order creating the team. It would
      be chaired by the state health officer and comprised of representatives of state
      agencies and licensing boards.outcome: Bill signed into law.

      Assembly Bill 123: Requires ambulatory surgery centers to maintain accreditation
      by a national organization. Physician offices providing anesthesia must obtain a
      permit from the state health division. Requires health division to conduct
      annual and unannounced inspections of both entities.
      outcome: Bill signed into law.

      Assembly Bill 206: Gives the Nevada State Health Division power to immediately
      issue a cease-and-desist order at a facility where patient safety is in question
      until after an investigation.
      outcome: Bill signed into law.

      State Senate Bill 362: Affirms law already on the books that summary
      professional license suspensions can be carried out by the Board of Medical
      Examiners and other medical boards. Also allows the suspension or revocation of
      a license of a health care professional who owns or operates a medical facility
      that is investigated or disciplined for misconduct.outcome: Bill signed into

      Assembly Bill 495: Would have removed a $350,000 cap on pain and suffering
      damages. Also would have given possible victims of malpractice a year longer to
      file claims and allow attorneys five years, rather than two, to bring a case to
      outcome: Bill died in committee.

      Best wishes,
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