Nevada's ambulatory surgical centers inspected for unsafe practices

The statewide inspection followed the discovery of unsafe practices at a Las Vegas gastroenterology center that led to at least six cases of hepatitis C. Officials suspended Endoscopy Center of Southern Nevada's business license Feb 29 after learning the center had been reusing syringes and vials for anesthesia. The clinic's owner, Dipak Desai, MD, subsequently agreed to stop practicing medicine. Five nurse anesthetists surrendered their licenses voluntarily, as well.

More than 40,000 patients from Endoscopy Center of Southern Nevada alone could have been exposed. Six patients were diagnosed with the infection.

The outbreak was the largest since 2002, when both Nebraska and Oklahoma faced similar crises due to unsafe practices.

Investigators announced inspections on all of the state's ambulatory surgical centers were completed by March 20. Several other centers were found to have deficient practices as a result of the inspections. A Web site was set up to inform citizens of the situation and answer several frequently asked questions.

Julie Gerberding, head of the Centers for Disease Control and Prevention told The Associated Press the initial incident "could represent the tip of an iceberg" concerning unsafe practices nationwide.

Past outbreaks:

2002, Nebraska
Officials initially learned of a potential hepatitis C outbreak after learning of four infected patients who were undergoing treatment at the same cancer clinic. Later testing of 494 patients who had visited the clinic from March 2000 through December 2001 revealed that 99 were documented as becoming infected with hepatitis C within that time period. Researchers believe shared saline bags were contaminated through syringe reuse.

2002, Oklahoma
The Oklahoma State Department of Health investigated an outbreak in August 2002 after six patients were unexpectedly discovered HCV-positive after treatment at the same pain remediation clinic. Of 908 patients who were tested, 71 were infected with hepatitis C, and 31 with hepatitis B. The infections appear to have occurred at higher rates when uninfected patients visited the clinic on the same day as infected patients. Upon review of staff practices, nurse anesthetists were found to have been reusing the same syringe needle to sedate all patients throughout any given day.

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