The last week has seen one of the most horrific breaches of trust by a physician group and clinic that I can remember. It happened right here in Las Vegas. Since the original announcement of violations of universal precautions that may have exposed unknown hundreds of people to viral diseases like Hepatitis C and HIV, every single one of this group’s clinics have been systematically closed by the local governments. Rightly so, disregarding the risk of infection to 40000 people is an enormous public health risk.

I have read through multiple descriptions of this clinic’s alleged wrongdoing. Currently an outbreak of hep. C is being blamed on the clinic’s syringe and medicine handling. While there is some risk in these procedures that seems remote and ignores something even potentially riskier.

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.

Hepatitis C transmission is a known risk with endoscopy and has historically been considered very rare. Maybe we shouldn’t consider it so rare anymore. If the current cases in Las Vegas are any evidence, endoscopy may not the be the safe procedure we in the medical community have considered it to be for so long. Certainly in the hands of profiteers willing to cut corners it isn’t.