After Desai, urologist reused single-use devices

The Southern Nevada medical community still needs makeup to cover the shiner left three years ago by Dr. Dipak Desai and the cheap, disgusting, disease-spreading practices of his local endoscopy centers.

Despite the good work of scores of outstanding physicians and organizations here, a perception resulted from the reuse of contaminated supplies at the centers: Las Vegas doctors are willing to compromise patient safety if they can make more money.

Now, with Desai still in the headlines because of the ongoing criminal and civil cases against him, the local health care industry has suffered another blow to its reputation. Dr. Michael Kaplan, a urologist, had his medical license suspended this month following a joint state and federal investigation that found he was reusing single-use medical devices.

Following the discovery that Dr. Kaplan was discarding $10 plastic needle guides only when they became “too bloody,” the Southern Nevada Health District sent letters to 101 of his patients, advising them to be tested for HIV and hepatitis. Additionally, Nevada’s chief health care officer, Dr. Tracy Green, sent a bulletin to every health care provider, directing them to not reuse items intended only for one use, an astonishingly obvious reminder akin to telling doctors and nurses they need to wash their hands after using the restroom.

To have another major breach of infection control in this valley is both outrageous and disheartening.

There are major differences between Desai and Dr. Kaplan, to be sure. Foremost, there are no known cases of disease related to Dr. Kaplan’s practices. And Dr. Kaplan did not run his practice like a cattle call, as Desai did.

Last week, Dr. Kaplan’s lawyer ran an advertisement defending the reuse of the needle guides because the physician was told by a vendor it was OK to reuse the devices “three to five times” if he disinfected them.

Food and Drug Administration standards allow some single-use medical devices to be reprocessed at an FDA-approved facility. But the needle guides Dr. Kaplan used are not on the list of products approved for FDA reprocessing, and Dr. Kaplan’s office is not authorized to reprocess single-use devices.

The proper protocol for Dr. Kaplan was clear enough: Use the single-use needle guides just once, then throw them away. He trusted the word of a vendor enough to abandon basic infection control? He’s the physician. He’s the party ultimately responsible for the care of his patients.

Cost is a consideration in many health care decisions. But taking a chance at spreading infection — no matter how small the increased risk — to save $10?

That’s horrific, especially when considering all the hidden costs of Desai’s wrongdoing and the investigation of Dr. Kaplan. Now Dr. Green, the state’s chief health care officer, has told all hospitals and health care providers to again “review their policies and educate their staff” on these protocols. We will all pay for this lost productivity, one way or another.