With every step, clinic's boss fails to demonstrate professionalism

Some guys just don't get it. Faced with the staggering news that his medical clinic might be responsible for infecting as many as 40,000 patients with deadly diseases, Dr. Dipak Desai didn't rush to voluntarily close the Endoscopy Center of Southern Nevada.

City officials had to do that for him. Now Clark County and Henderson officials have followed suit.

Desai did, however, hire R&R Partners to craft his publicity message and criminal defense attorney Richard Wright to shepherd his legal affairs. There's sure to be plenty of spinning and lawyering on Desai's behalf in the coming months now that District Attorney David Roger and Metro police have confirmed their intention to conduct a criminal investigation of the events surrounding the center's practices.

The DA and cops will probably bump into FBI agents and Nevada attorney general's office investigators while they're out in the field conducting interviews.

And, of course, they'll all surely notice the presence of private investigators associated with the personal injury lawyers combing the community for clients for the inevitable crush of lawsuits. Newspaper and television advertisements from personal injury lawyers seeking clients from the center are signs that the courthouse sharks indeed smell blood in the water.

With the equivalent of the population of Elko potentially harmed by the center's actions, there's plenty of room for criminal and civil scrutiny.

And that raises reasonable questions about the center's practices: not just its medical practices, which are slowly coming into frightening focus, but its billing practices as well.

While its nurses were busy using vials of anesthesia for more than one patient, thus running the risk of infecting patients by using more than one syringe per bottle, how was the billing processed?

It's hard to imagine patients were billed for half a vial each. Were two or more bottles billed, but just one bottle used?

Such behavior not only would violate standard medical practices, but potentially also violate accepted business practices as well.

I'm not sure whether local police or the FBI will want to seek the answer to that question, but if the center has been double or triple billing for its anesthesia, then you have the potential for numerous counts of insurance or Medicaid fraud.

Meanwhile, the public and press are left attempting to weigh the rhetoric used in Desai's full-page "Open Letter to Our Patients and the People of Southern Nevada" in Sunday's Review-Journal. If these are the doctor's actual words, then we're dealing with a man whose arrogance has far exceeded his professionalism.

If he were trying to allay the community's concerns, he fell short of his goal. He did, however, take time out to scold the media for its "erroneous news reports."

Sticklers for detail will notice there isn't the word "apology" anywhere in the text.

Although he states that he wants "to express my deepest sympathy to all our patients and their families for the fear and uncertainty that naturally arises from this situation," he fails to cough up a simple "I'm sorry."

"In cooperation with the Southern Nevada Health District and other health agencies and officials, we have carefully reviewed our procedures and implemented the changes they recommended," he wrote.

Yes, it's all about cooperation and a recommendation - after putting 40,000 patients at risk. He managed to make a screw-up that made national news sound like a public service announcement.

Although Desai thanks the health district "for bringing this issue to our attention," he apparently doesn't have the time or space to explain how the center's sloppy behavior over a four-year span was allowed to become the "issue."

And although the physician goes out of his way to tell us that "evidence does not support that syringes or needles were ever re-used from patient to patient at the center," he doesn't admit that potentially tainted vials were used from one patient to the next. This is deception on its face.

Then Desai played handicapper for the community when he assured the public "that the chances of contracting an infection at our center from 2004 through June 2007 were extremely low."

Yes, so far just six cases of exposure have been established.

Six persons with a potential death sentence: Hey, that's not many.

Thanks for giving us the odds, doc.

But you'll understand if we don't take your word for it.

• John L. Smith's column, reprinted from the Las Vegas Review-Journal, appears on Thursdays on the Appeal's Opinion page. E-mail him at smith@reviewjournal.com or call (702) 383-0295.