Nevada Gov. Jim Gibbons, who fought a plan for additional medical surveyors in 2007, said Monday that more inspections by more state staffers may not have stopped clinic practices that led to a recent hepatitis outbreak in Las Vegas.
Gibbons also said the state is working closely with federal and local authorities to prevent future problems and determine exactly what happened at a Las Vegas endoscopy center where six patients were infected with hepatitis C.
If anyone at the Endoscopy Center of Southern Nevada knowingly endangered someone's life, "that does constitute a criminal act" and those responsible "must be held accountable," the governor said.
But he added all the facts aren't known yet in the case that may have endangered thousands of other people through unsafe injection procedures.
Fourteen surveyor jobs are vacant at the state Bureau of Licensure and Certification, and Gibbons said he favors filling those posts, paying an average of $60,000 a year, as soon as possible.
Gibbons said the bureau, which now has 50 surveyors, has access to a $5.2 million fund that could be tapped to cover and even raise salaries for such staffers in order to help fill the vacancies.
But he also said more staffing is akin to more Highway Patrol troopers to nab reckless drivers, adding, "You do not have enough patrolmen to stop everybody who makes a mistake. We could inspect (surgical centers) annually and then pretty soon, have we done overkill?"
As part of his anti-new tax or fee policy, Gibbons cut 10 new surveyor positions for the bureau during the 2007 legislative session. Lawmakers challenged him, and in the end approved six new positions. The surveyors' pay is covered by fees paid by clinics that get surveyed.
Gibbons and top aides insisted the 2007 fee increase controversy isn't a factor in the current staffing shortage. Instead, they said difficulty in recruiting and retaining qualified staffers is the primary reason.
While the Gibbons administration has been criticized for the level of its monitoring, the governor said the issue isn't a new one and the focus now should be "not on assessing blame or pointing fingers."
Gibbons, state Health and Human Services chief Mike Willden and others also said all 50 surgical centers, including some that haven't been surveyed for several years, are being checked now. The state is nearly halfway through that review, and will be aided later this week by staffers from the federal Centers for Disease Control.
Six cases of acute hepatitis, a potentially deadly virus that attacks the liver, have been traced to the Endoscopy Center. Another 40,000 patients have been notified that they are at risk and should be tested for hepatitis and HIV. The clinic has been temporarily closed and fined $3,000.
Health officials believe the virus was spread when clinic nurses used the same syringe twice to administer anesthesia, contaminating the vial. The staff also was found treating multiple patients with vials of medication intended for a single patient only.
Also Monday, police, the FBI and state attorney general's investigators served warrants at the Endoscopy Center and five other southern Nevada medical clinics associated with the Gastroenterology Center of Nevada, headed by Dr. Dipak Desai.
Assemblywoman Sheila Leslie, D-Reno, who heads a legislative health care committee, Sen. Randolph Townsend, R-Reno, and Sen. Joe Heck, R-Henderson, all said legislation to prevent such problems in the future will be considered during the 2009 legislative session.
Leslie also renewed her criticism of the governor's opposition last year to more state surveyors, saying, "Decisions have consequences. It was a bad decision. Now we're seeing what happens when basic government resources aren't adequate."
Heck, an emergency room physician, said he hasn't seen such a "blatant disregard for patient safety" even in Iraq, where he's now stationed as an Army reservist.