Nevada lawmakers say the state will take a leadership role in ensuring the cleanliness of independent centers both locally and nationwide, a process that has just begun.
The response escalated after reports surfaced earlier this month about unhygienic practices at a Las Vegas endoscopy clinic that put as many as 40,000 people at risk for hepatitis C and HIV.
Senate Majority Leader Harry Reid, D-Nev., said Wednesday it is premature to start talking about legislative action to ensure clean practices in clinics both here and nationwide.
"What my reasonability is is to be a clearing house," he said, noting the curious public seems to want answers. "We learned the hotline we set up in Las Vegas has received 25,000 inquiries."
A Carson City-based ambulatory surgical center, Sierra Center for Foot Surgery, was one of four centers listed on the state health division's infection-control deficiency list but has been cleared by Carson City Health and Human Services of having gaps in its infection-control standards.
A spokesman Tuesday told the Appeal the practice under question was conducted by a sub-contracted local anesthesiology group and involved swapping a used needle for a clean one on a used syringe.
"To my knowledge one person said this might have happened years ago," said local attorney Jim Wilson, who represents the center. "We have no reason to believe that safe practices haven't been (employed) by this group of medical professionals for (years)."
Centers for Disease Control Director Dr. Julie Louise Gerberding, during a conference call Wednesday, said two factors contributed to the recent health scare - improperly trained medical workers and a tremendous incentive for employees to take shortcuts.
Because large single-use vials are cheaper than small ones, the temptation to use a vial on more than one patient could exist. Also, because physicians bill per hour, the time it takes to change syringes is also a factor, she said.
"Lack of knowledge with the desire to save time and money can be a deadly situation," she said.
"We're very concerned," she said. "These errors are more common than anyone suspected. We're learning in Nevada (and) we will be able to define the universe of what may have occurred ... nationally and what happened in the other 49 states."
Dr. Gerberding said hospitals are less likely to have problems.
"(In hospitals) they acknowledge when there is a problem, they all have a piece of it," she said. "It would be difficult to make an error and have people notice - it's much easier for someone to have a bad practice (in an ambulatory clinic)."
Jon Tyler, a spokesman for Carson Tahoe Regional Healthcare, which was also inspected recently by state and federal health officials, said his hospital's system is "set up" for sanitary practice.
"We work hard to ensure a patients' safety first," he said. "We have an (infection-control) program."
Dr. Gerberding said hospitals are prone to have multiple staff oversight as well as mandatory infection control programs in order to be accredited - which is not required in an ambulatory center's setting.
"We're responding immediately," said Richard Whitley, the administrator for the Nevada State Health Division. "Our staff will actually stay and abate the immediate problem to assure patient safety. At the completion of going to all 50 states, we will convene a group of infection control experts to make recommendations to improve our role."
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