/Health District Concludes Desert Shadow Endoscopy Center Investigation Announces Implementation of a Hepatitis C Exposure Registry

Health District concludes Desert Shadow Endoscopy Center investigation, announces implementation of a Hepatitis C Exposure Registry

June 5, 2008

LAS VEGAS – The Southern Nevada Health District has concluded its investigation into the acute case of hepatitis C associated with the Desert Shadow Endoscopy Center, formerly located at 4275 Burnham Avenue, Suite 101, based on the information and records that are currently available. While it has been determined this acute case is linked to the center there is not sufficient information at this time to determine the likely source of disease transmission.

Patients of this clinic are encouraged to discuss their risk for disease transmission with their physician and to pursue testing for hepatitis C, hepatitis B and HIV if they are concerned. The health district has obtained a list of patients from this clinic location and, while there is no way of determining the completeness of the list at this time, a letter outlining the investigation findings and current recommendations will be sent to the available list of patients.

“It is unfortunate we are not able at this time to conclusively determine the route of disease transmission that lead to this patient’s infection,” said Dr. Lawrence Sands, chief health officer for the health district.

“While we are unable to make a specific recommendation based on documented unsafe injection practices, such as those that occurred at the Endoscopy Center of Southern Nevada, we are stressing it is important for patients to know their infection status and work proactively with their physicians to manage their health,” said Sands. The Southern Nevada Health District estimates that more than 13,000 patients were treated at the Desert Shadow clinic since it opened approximately two years ago.

A clinic staff person was observed reusing single use vials of propofol at this facility during an inspection by the State Health Division Bureau of Licensure and Certification in January 2008, and propofol logs provided further documentation the bottles of anesthesia were reused on multiple patients. However, staff has not been able to document the reuse of syringes because this clinic location was closed prior to the identification of the associated acute case.

The acute case of hepatitis C that lead to further investigation of the Burnham clinic was self-reported to the health district by the patient in March 2008. Laboratory tests document this person tested negative for hepatitis C days prior to undergoing a procedure at the Desert Shadow Endoscopy Center and later developed an acute infection. Seven additional cases are associated with the Endoscopy Center of Southern Nevada. This clinic was the subject of the initial investigation and the identification of unsafe injection practices lead to the notification of more than 40,000 patients of their potential exposure to bloodborne illnesses.

Hepatitis C Exposure Registry
The health district is announcing the implementation of a Hepatitis C Exposure Registry in order to gather additional information related to patients of both the Endoscopy Center of Southern Nevada and the Desert Shadow Endoscopy Center. The registry was developed to assist in the identification of patients who had procedures at the clinics, including those who are infected with the hepatitis C virus, and will allow those patients who have tested positive the opportunity to learn their case classification. The registry will also include sections to allow patients to report on possible hepatitis B or HIV infections.

The health district will be mailing enrollment forms to patients of both these clinics and encouraging patients to enroll in the registry. Registry information and enrollment forms are available on the health district’s website, www.SouthernNevadaHealthDistrict.org. In addition, enrollment forms will be available at the health district’s public health centers or patients can contact the hepatitis C helpline at (702) 759-4636 to request a form.

“There are many patients we have not been able to locate during this outbreak because clinic records were not complete,” said Sands. “We are encouraging patients to enroll in the registry so we can continue to identify people who were exposed at the clinics. This information will aid in our continuing investigation and may allow us to make additional recommendations to patients of the clinics.”

Since the initial notification 77 additional cases of hepatitis C infection have been identified as potentially linked to the Endoscopy Center of Southern Nevada. Participation of clinic patients in the exposure registry will allow the health district to classify additional cases of infection that may be associated with these clinics.

The health district continues to update its website as resources and information become available. For additional information, patients can contact the helpline, (702) 759-4636 (INFO).

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The Southern Nevada Health District serves as the local public health authority for Clark County, Boulder City, Henderson, Las Vegas, Mesquite and North Las Vegas. The agency safeguards the public health of the community’s residents and visitors through innovative programs, regulations, and initiatives focused on protecting and promoting their health and well-being. More information about the Health District, its programs, services, and the regulatory oversight it provides is available at www.SNHD.info.