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Las Vegas Doctor Facing Criminal Charges As Story Unfolds

Posted by Jane Akre
Monday, March 10, 2008 11:01 AM EST
Category: Major Medical, Protecting Your Family
Tags: FDA and Prescription Drugs, Medical Devices, Medical Malpractice, Wrongful Death, Colon Cancer, Hepatitis

Dr. Desai may be facing criminal charges for billing and unsafe practices at the Endoscopy Center of Southern Nevada.

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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.  #

 


29 Comments

Anonymous User
Posted by RP
Monday, March 10, 2008 11:47 AM EST

What sort of sources do you have that the use of nurse anesthetists are unsafe? The use of nurse anesthetists are common, accpeted by the community, and are well defended with peer reviewed literature. Any claims otherwise by the author are irresponsible.

Anonymous User
Posted by Bill Tann
Monday, March 10, 2008 12:00 PM EST

I think the author's point was that the clinic owner was using nurse anesthetists and charging the health insurance or government at M.D. anesthetist rates. I saw nothing to suggest that the competence of nurse anesthetists was questioned.

Anonymous User
Posted by Bill Tann
Monday, March 10, 2008 12:01 PM EST

I think the author's point was that the clinic owner was using nurse anesthetists and charging the health insurance or government at M.D. anesthetist rates. I saw nothing to suggest that the competence of nurse anesthetists was questioned.

Anonymous User
Posted by ann roberts
Monday, March 10, 2008 12:07 PM EST

They need to not only sue these doctors, nurses and owner of the hospital, but they need to infect the man that gave the heads up on cutting down on costs and just infecting people with no problem. Do what he did to them. These people have to live the rest of their live knowing that they may be infected or become infected over time; that is not right and not fair to them and their families. Do unto others as they do unto you.

Anonymous User
Posted by The hammer
Monday, March 10, 2008 12:13 PM EST

"Two" words for this dispicable piece of s**t.

DEATH PENALTY!!!!!!!!!!

Anonymous User
Posted by Tall Paul
Monday, March 10, 2008 12:36 PM EST

Got to agree with the Hammer on this one!!!!!

Anonymous User
Posted by leo
Monday, March 10, 2008 12:39 PM EST

we are agree with ann roberts

Anonymous User
Posted by nudelman
Monday, March 10, 2008 1:44 PM EST

Things like this should never happen- even in India where most of these so-called doctors are originally from. The doctors should be prosecuted to the fullest extent of the law and the their assets given to the victims. This should be considered attempted murder.

Anonymous User
Posted by Kumar
Monday, March 10, 2008 1:47 PM EST

Hang these as* holes.

Anonymous User
Posted by outraged
Monday, March 10, 2008 1:58 PM EST

The nurse anesthetists are as just as responsible as the doctor. Who do you think injected the drugs and reused the syringes and vials? The job of the anesthesiologist or nurse anesthetist is to monitor the patient and administer drugs. That a nurse anesthetist would ignore safe practices even under the order of a doctor is indefensible.

Anonymous User
Posted by Jane Akre
Monday, March 10, 2008 2:24 PM EST

IB News editor writes:
Nurses overseeing anesthesia may be perfectly safe. The article says 5 have surrendered their licenses to the medical board AND the doctor was billing at a much higher rate for MDs while pocketing the rest.

What is most disturbing is that nurses, doctors, no one spoke up! I'd say at the very least they were all ethically challenged - wouldn't you??

Would you speak up if faced with something similar?

How many people have the courage to do so?

And how many of you have labelled whistleblowers as just troublemakers?

Just asking-
Jane a.

Anonymous User
Posted by src24960
Monday, March 10, 2008 2:31 PM EST

Safety is everyone's responsibility. The nurses, nurse anesthetists, and the doctors all hold individual licenses and are individually responsible. The most responsible is the doctor, but someone should have spoken up long ago. I hope that if I am ever practicing unsafe medicine, one of my nurses or colleagues will have the integrity to let me know and protect my patients.

Anonymous User
Posted by Edward
Monday, March 10, 2008 3:14 PM EST

You have to expect problems like this given the system that we have. Here we have a doctor abandoning his native India where there is an overwhelming need for medical services to go where he can make the most money, the US. Not exactly an ideal situation.
Then we have this type procedure done with minimal oversight by quality control staff, simply to save money and maximize profit, the very reason this person left his native country.
I doubt using nurse anesthetists are related to the problem except that this further demonstrates the drive to save money. Most nurse anesthetists that I know are quite safe.

Anonymous User
Posted by Worried!
Monday, March 10, 2008 3:27 PM EST

I think it's a form of terrorism if you ask me.... 40,000 ppl and there could be more.??!! What disturbs me in addition to the vials, is the endoscopes were not being cleansed correctly! Not only did they put two I.V.'s in my arm (with anesthesia injected in both) but they didn't cleanse the scope thoroughly? Does that make it a triple threat for me? This is not about nurse anesthetists in general being unsafe to do the procedures (I would have no problem with that), it's about the practices of every person, not matter what position they held, in that place. You go into a doctors office/center, they are being paid for their services, and you expect to be safe.

Anonymous User
Posted by indnajns
Monday, March 10, 2008 3:46 PM EST

"That nurse and others are now talking to investigators who are telling a frightning story of unsafe medical practices ..."
Sorry, too little too late. How do you call yourself a nurse and then do something like this? What is the point of requiring schooling and licenses if they're going to act more stupidly than the general populace? As someone above stated, HOW did they sleep at night? Job or no job, I would have been alerting someone the first DAY this idiot Dr told me to do something so irresponsible and life threatening. This will have a ripple effect for decades to come.

Anonymous User
Posted by RN Reporter
Monday, March 10, 2008 8:05 PM EST

I am an RN who has worked in the Operating Room for almost 20 years. The public has no grasp re the dismal state of patient safety in the OR. These are not issues exclusive to Nevada. Nurses in all states and practice sites are continually pressured to rush through procedures/treatments/care and cut corners. If you are know as "resistant" to such "team player" attributes, you will be ostracized and belittled by the other more compliant members of the "team". In the OR this can include surgeons, anesthesiologists, surgical techs (who are non-licensed, but can wield an amazing amount of clout), and other nurses.

EXAMPLE; There has been a national mandate to label all medications on the surgical field. This activity takes approx. 20-30 seconds. What most laypeople do not understand is - when the drugs are drawn into the syringe from the surgical field, it is often drawn-up by an unlicensed tech. It is easy to see in a busy case how multiple, clear-colored fluids would need to be labeled to prevent patient injury. There is still tremendous resistance from many of the technicians who scrub procedures to be compliant with this simple procedure. Imagine what kind of compliance resistance exists with more complex patient care safety procedures. Many are time consuming. Time is money is health care these days, and it is the primary metric to which all others are measured.
But how would you know this?
You cannot see what is happening to your loved one or you once you are in the Operating Room, The OR is a restricted environment. Even when inspectors are present, they will not enter an operating room with a patient present.
If you have had any injury/infection related to a surgical procedure, do not accept the explanation that this is normal. No infection contracted during a sterile procedure is normal. But it is becoming commonplace.
Always seek an advocate you can trust.

Anonymous User
Posted by Jane Akre
Monday, March 10, 2008 10:42 PM EST

RN Reporter and others -

Some of us are due to schedule a colonoscopy. These stories are frightning. What can you tell us that would make us better consumers of our healthcare?
For example - I've read that you are supposed to ask the doctor to take his/her time when doing an colonoscopy. Correct? Sounds like Dr. Desai did exactly the opposite and was proud of it.

Should you insist on a single vial that is used only for you? Should you oversee the techs and insist that they use a clean syringe/needle for each procedure? How can you do that if you are in a twilight state?

Anything those of you experience in this can tell us to empower the consumer would be much appreciated!
Thanks so much.
Jane A.

Anonymous User
Posted by drew
Tuesday, March 11, 2008 2:46 AM EST

"UNSAFE MEDICAL PROCEEDURES" are advertised in corrupted media. What 'medical proceedure' requires "reuse" of disposable syringes?????? call it what it is.... A CRIMINAL MEDICAL PROCEEDURE X 40,000 +++ -- This is akin to a type of Holocaust unleashed upon U.S. citizens. I happened to come across this story 3-weeks after it was reported! this should be national headline news everywhere. This story has been repressed by government and media. I went to the federal Center for Disease Control (CDC) [for the prevention and protection of the public health] and guess what... not one mention of this PUBLIC HEALTH THREAT whatsoever on their website and/or news articles... some thing very very disturbingly diabolical is occurring

Anonymous User
Posted by Dee
Tuesday, March 11, 2008 8:20 AM EST

This is Horrific. We can no longer trust our doctors nurses or even dentists? I am petrified now to think that a dental office is using this method of abuse.
But after reading from the OR lady. OMG i think i will just die rather then go to a hospital that might kill me anyway a slow agonizing way.
What about having our blood drawn? What about dental vials and syringes? We cant stop these UNETHICal things from happening that is why the govt is now hiding this and repressing it!
We need some Newspapers to step and expose this on a NATIONAL level.
I guess America is now considered a 3rd world country never know if your gona be infected if you go to a hospital now. What a sad time we must live in, a very sad time.

Posted by janice hoffman
Tuesday, March 11, 2008 8:55 AM EST

the public does not have to worry anymore about Desai and his cohorts anymore. what dr. would refer them? who would go to them? they are known know all over the world.my advise is to pack your bags, that is if you don't go to jail the rest of your life, and continue to practice your third world country medicine in India..Get ready to trade in your 300,000 dollar car for a camel..

Anonymous User
Posted by Jane Akre
Tuesday, March 11, 2008 3:31 PM EST

Hello All-

I've been watching comments here and racist slurs are not appropriate. Outward distain and even hateful remarks about the color of ones skin, his motives in coming to the U.S., trading in a car for a camel- how is that any more ethical than shoddy medical practices? They all show a callous disregard for other humans, on a different level admittedly, but still hate toward others must stop here. Criticism welcome, just leave out the racial slurs.

Now as to a media conspiracy Drew- I'm the first one to claim mainstream media often glosses over the truth, or doesn't act like tough watchdogs, but you admit you didn't see this for three weeks after it was reported. It HAS been covered extensively by all media, including us here at Injurybord. No conspiracy, sorry. BTW- the CDC doesnt cover news so I wouldn't look to find any updates there. Check us out or the NYT, Las Vegas Sun and Reviewjournal.com have done an excellent job of coverage. The latter had a great pic of Dr. Desai and his lawyers walking to court to try and stop the closure of clinics.

Thirdly- I'd still like people to be empowered and take charge of their own healthcare. Instead of saying they won't go to a doctor Dee, health professionals please feel free to add comments here about what we should look for a clinic setting. It would be very helpful to hear from you POV.

Thanks all-
Jane Akre
Editor IB News

Anonymous User
Posted by RN Reporter
Tuesday, March 11, 2008 4:59 PM EST

I wish I had a short, succinct answer for the question of how to maximize safety/outcome when preparing for a treatment/procedure.

I'll answer this in two comment sections to prevent eyes glazing over.

#1. simple/basic procedures (ex: colonoscopy)

#2. surgical procedures


#1 -
If your health care provider suggests a basic procedure:
a. Avoid free-standing, physician-owned clinics.
Insist on the procedure being performed in a
hospital with Joint Commission Accreditation.
Although this inspection process is less than
perfect, it is thorough. Hospitals must have
accreditation to receive Federal reimbursement
(Medicare) and the inspections are performed
every two years. Look up their results.
b. Be your own best advocate. If possible, enlist
the assistance of a trusted professional health
care provider (RN, Physician). RESEARCH your
procedure on the internet, dig deep. Know the
"standard of care" for all aspects of your
procedure. This may take hours if you are not
experienced in internet research. It is worth
every minute.
c Ask questions. Write them down. It is every RN
and Physician's legal and moral obligation to
answer each one of them. Please remember, you
are there to be examined and/or treated, not
to make friends. I always tell my patients that
they are the boss. You are. If your questions
elicit impatience or condescension, I would not
feel confident re the care you are about to
receive. Most mistakes are not reported, or are
only reported in-house (remember - reports take
time - time is money, etc.). So, does this
staff/physician inspire trust? It is their
character as well as there skill that protects
you.
d. Understand your rights. You may refuse treat-
ment/cancel at any time. Even if you are
wearing the funny patient gown and hat. Even if
they are wheeling you into the treatment room.

YOU are the boss.

Anonymous User
Posted by shailaket
Tuesday, March 11, 2008 6:05 PM EST

I have read all the comments...just because you see a doctor was from India does not mean that Indian docs pratice "third world medicine"...this could be a practice of any physician who has no remorse for such unforgivable acts... where did the hippocrates oath go "first do no harm "...I hope that all my physician colleagues whether they are from India or the USA or any third world country remember the oath everytime they are with a patient. It is quite painful to read about this physician and I hope that this brings out more stringent audits on doctors so that they do not get away with such lowly activities.

Anonymous User
Posted by laura
Tuesday, March 11, 2008 7:41 PM EST

honestly, I had a colonoscopy there, during those years, my tests have come back negitive, but honestly I have to go back in 6 months for another HIV test bc it sometimes doesn't show itself... per my NEW doc's request. I actually like my new doc and here's a really bizarre one. I am 32 and I still see a Pedatric Cardoloist, why you ask, well, bc I was born with a heart condition, most adult cardiologists don't deal with my condition. I am lucky to still see someone who cares about her "kids" as she calls them. Everyone one of them she takes the time to talk to them, their parents, or anyone they bring with them. She has even asked me to bring someone with me, who I trust, since two sets of ears is better than one and it's nice for her to know I have someone looking out for me here in Vegas bc I live alone (well not for much longer, the boyfriend will be moving in with me soon) and she'd like to know I am safe. That's a true doctor. They are still out there. I am so lucky to have had some of the best doctors in the U.S. take care of me that, yes this has shook my faith in doctors, they have set such a foundation that I know I will keep seeing doctors.

I am not saying this guy is not evil and wrong, but there are still GREAT docs out there. He was horrible and I will always regrete seeing him, but I am lucky and some of us seem to be, yes he did violate every code of eithics I can think of, but at least my health is still in okay standing after the butcher got ahold of me.

Anonymous User
Posted by Martial
Wednesday, March 12, 2008 9:50 AM EST

Las Vegas physicians gambling with the health of patients? How quaint.

Needed is socialized medicine to prevent this stuff. The high rate of malpractice lawsuits did nothing to prevent this horror, systematic and repulsive. With malpractice lawsuits hugely common, a government of lawyers treats leniently the worst practitioners, who beome expert witnesses against competent doctors.

Anonymous User
Posted by RNstudent
Thursday, March 13, 2008 3:08 AM EST

RN Reporter is SOO right. ASK QUESTIONS! I am a nursing student and Health care workers often forget what its like to be a PATIENT. these procedures become so routine they often forget that patients may not understand them. regardless of your fear or anxiety of asking, the patient needs to ASK QUESTIONS!!! Doctors are not God's their normal people just like the rest of us, but people are so intimidated by them. Patients need to get over that anxiety and realize that it is a patients right to know what is going on. Unfortunately in this situation questions may not have been a preventitive measure, I mean we trust these people, now everytime we go to a procedure do we need to ask "is everything sterile?" and epescially in this case, the health care providers may lie. anyways, ASK QUESTIONS! dont be afraid!!!!!

And seriously, those racist comments are unnecessary. Jane Akre is so right when she said "how is that any more ethical than shaddy medical practices"

And remember ASK QUESTIONS!!!!!!!!!!!!!!!!

Anonymous User
Posted by jen
Sunday, March 16, 2008 1:23 AM EST

Trust doctors????? NEVER!!!!! Always be your own advocate, watch & ASK QUESTIONS!

Anonymous User
Posted by Mark Sumpter
Wednesday, March 19, 2008 4:50 AM EST

What this doctor did and what the nurses decided to do was to clearly violate the trust of the public. My mother was a victim of their "cost cutting" efforts to make a few people rich.

In January of 2007, my father passed away suddenly, which prompted my mother to seek a complete physical. One of her tests recorded that she go to this clinic for a procedure.

My 71 year old mother received a clean bill of health which excited the entire family for California to the midwest.

Suddenly her world was turned upside down when the story broke of the dispicable acts of this clinic and the doctors who ran them.

My mother was one who tested postive for Hepatitis C. In her opinion, she has been handed a death sentence. I have struggle to convince otherwise. For the first time in her life, she does not believe me.

As a man who does everything to protect his mother, I feel a complete sense of angry and my first thought would be an act of violence however, two things greater will prevail.

First, the system will hammer their asses and hopefully take their freedom and secondly, they will have to face their maker and answer why they chose to ruin the lives of so many.

To the doctors, you will rot in hell. And the nurses, may you never see the lifestyle doing the good of people would bring you. May you always struggle wondering what life will hand you, just like my mother and so many others have to wonder for the rest of their lives.

Mark Sumpter
Kansas City, MO

Posted by Elda Remington
Wednesday, March 19, 2008 10:47 AM EST

Many parts of the medical industry/system broke down and caused this Nevada debacle.

Licensed/certified "professionl" Medical employees refused to meet their obligation to speak truth to power.

An M.D. sold his medical ethics for a few extra dollars.

A medical Board behaved as if they were a political puppet instead of the keeper of patients trust.

A compromised Medical Board is not exclusive to Nevada. I have been following the behavior of the Kansas State Board of Healing Arts for two years. I have found that the Board moves slowly to ID problems and correct "bad" doctors. The corrections are usually very light when you exmine the offense. The Board dosn't like to give access to many public records. If I had had easier access to public records I would hve chosen another primary care doc. I would have chosen a doctor who had not been sighted for a dirty office. KSBHA waited, then reinspected 18 months later. Some of the unsanitary conditions remined in the doctors office! All the KSBHA did: fined him $500 payable over two months and never, never told him offically to clean up his office!

A Nevada governor proved that politics should never come before morals and ethics.

The CDC leadership is in question. A situation has happened at least four times before when the public has been infected w/hep. on a large scale.

If the CDC had chosen they could have done national public eduction before the fact and possibly stopped the dangerious behavior before it got out of hand.

Curious Factoids:

The system of Medical Training in India is not exactly like the American System and is difficult to compare and track.

Search the newspapers in India & you will find that the Foreign Medical Students are as disturbed as we are in the US about this Medical Doctor who happens to come from India.

While searching I have found that he graduted from a medical college in a town aprox. 100 miles from the Pakistan Boarder.

On several India websights it is advertised how easy it is to buy medical credentials and Visas and other necessary paper proofs. Understably many want to come to the United States and other western countries.

Comments for this article are closed.

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