And, Why Your Doctor Won’t Get a Penny of That Money
Maybe some of you recall my posting a picture taken from the 3rd floor of the Clark County Courthouse. Perhaps you wondered why I was there. I had been called to jury duty. Now that the trial that I was in the jury pool for is over — except for appeals, of course — I think I can safely comment on the case.
There were 150 of us asked to fill out a 30+ page juror questionnaire, and when I saw it I immediately thought “Oh no, they do not want me on that jury!” When I got out and called my partner to let him know I was on the way home, he asked me about what had happened. I said “I can’t comment on the case, but I think I can safely say there’s a doctor who’s a witness, it involves propofol, and it doesn’t involve Michael Jackson.” He replied “Oh no, they do not want you on that jury!”
Sure enough I was called by the court and asked not to return.
Here are the facts of the story. Dipak Desai was a doctor who came to Vegas and built an “empire” on quickie colonoscopies. It all came tumbling down a couple of years ago when a cluster of Hepatitis cases was traced to his clinic. While hepatitis is a known possible complication of colonoscopy, this was an unusual number of cases. Six cases rapidly expanded to 114 cases (and counting), with tens of thousands of people needlessly exposed to disease while getting a screening exam in the name of staying healthy. Desai himself eventually declared bankruptcy, but not before a stroke, trying to flee the country (thwarted by the local Mercedes dealership!), and much handwringing over Nevada’s malpractice insurance “reform” and the fact that he only carried the $1,000,000 per incident and $3,000,000 per year coverage required by law. A small number of cases have been settled, but there are many more cases and not enough money to go around.
Now make no mistake: there are a lot of people who are very sick because of the actions of Dr. Desai, his colleagues, and his staff. But sometimes it is just not possible to make things right. So since you can’t get blood form a turnip, some very sick people and their lawyers started looking for the deepest available pockets.
The media has made much of the fact that the clinics used “single use vials” of medication more than once and may have re-used some syringes. If that’s how the Hepatitis was transmitted, then USA Today and the CDC are right that it’s the tip of the iceberg. Except that’s not how it happened; if it were, there would be clusters of blood-borne disease around every surgical center, vaccine clinic, and med-spa in the nation.
Enter the sad but true case of Henry Chanin, who at the time he was infected worked for the Mayor’s wife at the posh Meadows School. It’s the kind of place with multi-million dollar facilities, a waiting list as long as your arm, and a near 100% college admissions rate. His lawyers alleged that it was the fault of the drug companies that made the medication in the single use vials that was to blame for his hepatitis. And, since the drug companies were specifically not allowed to blame the doctors for “misusing” the product, the jury I narrowly missed being on found in Mr. Chanin’s favor and awarded him and his wife over $5,000,000.
Here’s the problem; it wasn’t the meds. My partner put it very well back in 2008 when this was a new story:
Consider that if a clinic’s management is so cheap and careless as to cut corners over a $.05 syringe which is essentially the accusation leveled at this clinic, how much risk are they willing to put patients at? Endoscopes require cleaning and disinfection. That takes time. In a busy center, there have to be enough scopes to do the procedures and still have the downtime for the devices to allow them to be properly cleaned and disinfected.
The scopes cost thousands of dollars which is a very likely place to cut corners if it’s all about the bottom line and patient care never really enters the equation. Couple that with a high volume clinic and violations of the cleaning guidelines for the endoscopes are certain to happen.
It was very likely the endoscope, not contaminated propofol.
Using “single use vials” multiple times is almost standard for many medications, and research has been done to clear a number of drugs for use in this manner. You could clog journals with thousands of studies like this and that. Re-using the syringe is not a good idea, but the drug companies didn’t tell clinic staff to do that. I think the one biggest thing in my questionnaire that got me off that jury was the fact that Allergan send representatives to my office to teach me how to sell Botox from vials that should theoretically have been single use. Well guess what, for what those vials cost, nobody is only using them only once. And strangely enough, not a single case of hepatitis or AIDS has ever been traced to a Botox party. Disclaimer: my partner used to work for the guy who filed this suit, who also happens to be quoted extensively in the link on Dipak Desai above. Yeah, sometimes it feels like the medical community in Vegas traces back to a very small number of people who all know each other.
While nobody can give Mr. Chanin his health back, blaming a drug company for a clinic that didn’t follow the instructions and according to many sources didn’t even properly clean the apparatus they put up people’s butts will only drive up everybody’s costs: drugmaker’s costs, malpractice insurance costs, liability insurance costs, doctor’s costs for drugs and insurance both. Your insurance company? They will raise your premiums. And your doctor? His costs will go up but he won’t make an extra dime.
In Closing: Natazia?; the tax revenue case for marijuana legalization; no more French Foreign Legion for American Boys if Senator LIEberman gets his blatantly unconstitutional citizenship forfeiture bill passed but you’re still clear to join Israel’s army; corporate America passing the expensive part of health insurance reform on to you (and I said something similar when??); educators can’t count; letting states protect citizens from banks must be part of financial reform along with “too big to fail = too big to exist“; on Social Security; deregulation disaster; all just a little bit of history repeating; 30 photos that that changed the world; employment is increasing, just not nearly enough; on terrorist attacks; Yoko Ono; and Happy I Suck Less Than Yesterday Day.
