Doctors endangered thousands, still licensed

Nevadans tend to assume they’re protected by a state regulatory and licensing regime that checks to make sure doctors, nurses and other medical professionals are — at the very least — avoiding dangerous practices that could endanger thousands of lives.

But is that really true?

No one expects a regulator to be leaning over the shoulder of every nurse to make sure that syringe and vial aren’t reused. Regulators depend on routine reporting — the kind that showed the Endoscopy Center of Southern Nevada was the nexus of a recent cluster of hepatitis C infections — infections caused, we now know, by syringes and medical vials being reused there over a period of nearly four years.

But up till now, have spot checks and unannounced inspections played no role? Even in the cases of doctors previously caught doing things wrong, who were let go with a wrist slap?

People who pierce ears, paint nails, apply tattoos and cut hair in Southern Nevada can be put out of business if they’re caught operating “without a license.” They — along with restaurant owners — can lose their livelihoods over health violations that pose a lot milder threats.

Nearly 40,000 patients who received treatment at the endoscopy center from March 2004 to mid-January have received letters telling them they’re at risk for exposure and urging them to be tested for hepatitis B and C and HIV — the biggest public health notification operation in U.S. history. And there may be more to come.

This was not a one-time aberration by a single lazy or ill-trained employee. It was policy. It was done to save money — half a buck here, half a buck there can really add up when you’re hustling patients through like cars on an assembly line.

Finally, Tuesday, the State Board of Nursing decided such a pattern of life-threatening abuse called for a bit more than a stern lecture and a fine. The board asked five nurse anesthetists associated with the parent company of the endoscopy center — professionals who are expected to know what’s going on, and who were ethically bound to blow the whistle — to voluntarily relinquish their licenses. They did.

It’s a good start. Though it hardly boosts public confidence when the board won’t even say where these nurses practiced, let alone who they are.

This isn’t about being vindicative or abandoning due process. These professionals deserve a chance to make their cases in the proper forum. But this is a matter of life and death that called for decisive action — one whose long-term costs are impossible to measure.

Scores of lives are saved every year in Nevada because colon cancer and pre-cancerous conditions are detected early by colonoscopies. It doesn’t take much to imagine large numbers of patients deciding to skip the routine screening for the next few years — at an indirect cost of many lives.

Now, finally, the state Department of Health and Human Services says its “surveyors” are making unannounced visits to other ambulatory surgery centers to observe procedures.

And file reports suitable for shelving in triplicate?

The question is — now that the nursing board has done the right thing — why are the doctors who actually gave the orders and oversaw day-to-day operations at these clinics still licensed to walk into a procedure room and do the very same thing again, tomorrow?