Personal Injury Law

Las Vegas Doctor Facing Criminal Charges As Story Unfolds

By Jane Akre

Dr. Dipak Desai, owner of the now closed Endoscopy Center of Southern Nevada may soon be able to tell his side of the story to criminal investigators.

The Nevada Attorney General's office is investigating whether he defrauded the government by overbilling Medicaid or insurance companies while practicing medicine at several of his now closed clinics, the most notorious, the Endoscopy Center of Southern Nevada. 

Meanwhile former co-workers are telling investigators plenty.

The Las Vegas Sun is reporting that the center had a practice of doing assembly-line colonoscopies as a way to save money. Investigators have found that appointments were often double booked and patient waits of two hours were not uncommon.

Patients were hurried through the procedure in minutes, whereas a careful examination of the colon should take at least 15 minutes. Nurses would have patients out the door to a recovery area then send them home.

A nurse says of Dr. Desai, the owner of the clinic, "Time is money. The faster we would go the happier he was."

"He'd say, 'I'm the fastest endoscopist, the best endoscopist, in town,'" recalled a doctor, who like others asked for anonymity for fear of reprisals. "That was his pride and joy."

Unfortunately that speed also caused two patients to have their colons perforated investigators have found.

78-year old Duke Breuer underwent a colonoscopy at the center. A nurse left a bandage on his arm. She told him to take the tape off when he got home. That's exactly what he did but when he pulled the tape he found the IV needle had been left in his arm. He had accidentally pulled it out and it started gushing blood.

"The darkest blood" he'd ever seen went all over his pants and Chinese silk rug.  

Amazingly when he returned for a second procedure he told the nurse about the rug and suggested he should sue them for its value.

Her response astounded him.

"You ought to sue us for a lot of other things that go on here," Breuer says the nurse replied. "You don't know what goes on here. I hate my boss."

That nurse and others are now talking to investigators who are telling a frightning story of unsafe medical practices and the employees of Dr. Desai who kept their mouths shut.

According to investigators the co-owner of the clinic Dr. Desai ordered the unsafe practices that now have the state scrambling to find 40,000 former patients to have them tested for hepatitis C and HIV.  Investigators have found that when a patient undergoing a colonoscopy needed more sedative, the nurses, ordered to save money would dip the same syringe back into a vial.

At least one time that was done on a patient who had hepatitis C and the vial became contaminated. Even though they were intended for single use, they would be reused on other patients spreading hepatitis C to at least six others.

The entire cost savings by reusing syringes?  About $5 to $10 per patient. Unrelated to the hepatitis outbreak, the state has found that technicians were told to skimp on detergent used to remove blood and body fluids from endoscopes after a colonoscopy. The cleaning solutions were not being discarded after each use but rather being used to clean the next endoscope.

Clinicians were also reportedly told to cut costs by cutting in half disposable underwear that protects the bed-saving about 21 cents each. 

Cost cutting even applied to anesthetists. Dr. Desai used certified nurse anesthetists rather than medical doctor anesthesiologists. By using the nurse anesthetist, Dr. Desai could put them on a salary and bill more like what a MD would charge.

Five nurse anesthetists have voluntarily surrendered the licenses to the state Board of Nursing. A nurse says he also billed for 30 minutes when he never went over 15.  

The newspaper reports that Dr. Desai proudly boasted that he ran the most cost-efficient clinic in the entire country.

He attended medical school in India and completed his residency and internship in New York. Dr. Desai has been a professor at the University of Nevada School of Medicine. He and his wife, also a doctor own a $3.4 million, 8,700 square-foot home in Summerlin.

He has not consented to an interview but took out an ad in a local paper to say he did nothing wrong.

Meanwhile a state lawmaker from Las Vegas says that the shoddy practices at the Endoscopy Center of Southern Nevada wouldn't even be practiced in Iraq.

Nevada State Sen.. Joe Heck has written to Nevada's Republican Gov. Jim Gibbons. Heck is an emergency room doctor and a member of the U.S. Army Reserves currently serving in Iraq.  

Heck says he is appalled to learn the lack of safety practices that would spread hepatitis C and says "blatent disregard of patient safety" would not even occur in a war zone or the Third World conditions he is currently practicing in.  #

Full post as published by InjuryBoard on March 10, 2008 (boomark / email).