Nevada Governor Reacts to Hepatitis C Outbreak

CARSON CITY, Nev. (AP) - The head of a state licensing bureau was fired Monday on orders from Nevada Gov. Jim Gibbons, but some of his other housecleaning efforts following a hepatitis C outbreak in Las Vegas faced delays and obstacles - and raised more questions.

Saying he was "focused like a laser" on restoring public confidence in Nevada's health care system, Gibbons ordered the removal of Lisa Jones as head of the state Bureau of Licensure and Certification. The bureau oversees clinics including the endoscopy center linked to the hepatitis outbreak.

But three doctors on the state Board of Medical Examiners who Gibbons wants replaced didn't resign immediately. Drs. Javaid Anwar, S. Daniel McBride and Sohail Anjum already had recused themselves from any board meetings dealing with the endoscopy center.

Gibbons said that if the doctors don't step down from the board on their own, he will seek to have them removed for cause. The terms of Anjum and McBride run until mid-2009 while Anwar's four-year term doesn't expire until mid-2011.

McBride termed the governor's move "outrageous," adding that he won't step down and accusing Gibbons of "trying to inject politics into the board process." He said that if the Board of Medical Examiners seemed to move slowly on the hepatitis issue, it was because Gibbons' Board of Licensure and Certification delayed informing the examiners' panel until after stories of the problem broke.

Anwar and Anjum didn't immediately return calls seeking comment. McBride said he believed that both intended to stay on the board.

Tony Clark, the medical board's executive director who Gibbons also wants replaced, said Monday he wouldn't step down at Gibbons' request and instead would follow the direction of the board, which
by state law decides whether he stays or goes.

Clark added that Gibbons' move against him looks like political payback. Clark, formerly Nevada's adjutant general, ran the state Air and Army National Guard when Gibbons, a decorated military pilot, was ordered to retire as Air Guard vice commander in late 1994. Gibbons, a Delta Airlines pilot at the time, unsuccessfully fought the order.

Gibbons said it was "patently false and preposterous" to suggest he might have a payback motive, adding that Clark should go because he "should have taken swift action in the face of this crisis and he did not do his job."

As for the three doctors who Gibbons wants replaced on the nine-member Board of Medical Examiners, Gibbons said his office had been trying repeatedly without success to reach them to see whether they would step down voluntarily. But McBride said he hadn't received any calls from the governor's office.

Gibbons wants the three doctors replaced because of their associations or business dealings with Dr. Dipak Desai, owner of the Endoscopy Center of Southern Nevada. Officials last month said through unsafe syringe use, six patients at the center were infected with hepatitis C.

Another 40,000 people at risk for potentially fatal blood-borne diseases are being notified to get tested. Their final test results are pending.

"I want a Board of Medical Examiners that has members who can participate, who can share valuable viewpoints and can vote on these issues, and I want action ... to restore public confidence in the state's health care system," Gibbons said.

Desai served on Gibbons' health care transition team following the governor's November 2006 election. He also served on the Board of Medical Examiners from 1993 to 2001, including a stint as chairman of its investigative committee. Desai has refused to answer questions about the outbreak.

The case sparked a massive health alert by the Southern Nevada Health District, the Centers for Disease Control and Prevention and the state Bureau of Licensure and Certification.

The case also prompted a sweeping probe of Nevada's 50 surgical centers by state health inspectors, who have found similar unsafe procedures at six other clinics so far. No disease transmission has been linked to any other clinic.

Gibbons has defended the Endoscopy Center, saying more cases of
hepatitis C would have been discovered by now had its doctors and
nurses been grossly negligent.

Health officials found no evidence of doctors or nurses reusing needles at the endoscopy center. But they think nurses contaminated single-use medication vials with reused syringes and then used
those vials on multiple patients.

(Copyright 2008 by The Associated Press. All Rights Reserved.)