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Desai Defense Will Raise Intent, Reasonable Doubt

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(Photo: CBS) Dr. Dipak Desai

(Photo: CBS) Dr. Dipak Desai

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Las Vegas CBS KXNT – Attorneys for former endoscopy clinic operator Dr. Dipak Desai and a nurse anesthetist who worked for him tried to cast doubt during opening statements on the likelihood that the charges against their clients can be proven. The two men are on trial for crimes including medical billing fruad, criminal medical negligence, and second-degree murder for their roles in a hepatitis C outbreak that was traced to the Endoscopy Center of Southern Nevada.

Desai’s lawyer, Richard Wright, told jurors they’ll hear from employees of the Center for Disease Control, who liken medical practices at the endoscopy center to wrong-way driving on the freeway. Wright said the analogy is overly simple for the purpose of proving criminal negligence. He distinguished drivers who turn down a one-way street because they aren’t familiar with the neighborhood from a wrong-way driver who knows it’s likely to result in harm, and does it anyway.

Testimony will focus on vials of the drug propofol, Wright said, which are intended for single use, and were used on multiple patients by nurse anesthetists at the clinic. Some of the witnesses will be former employees describing how the drug was administered using a clean needle and syringe for each patient, but sometimes going back into the bottle for second dose if a patient started to awaken during a medical procedure. The second doses were drawn from the vials with syringes that had traces of the patient’s blood.

The CDC concluded during its investigation of the outbreak that some of the vials were contaminated while drawing the second dose, and then were used on subsequent patients because the propofol inside was not used up. The propofol vials were pegged as the source of a hepatitis C outbreak which has been called the largest in U.S. history.

Wright said the clinic employees believed they were using best practices, and had no training prior to the outbreak indicating contamination could occur from reusing drug vials.

The lawyer for nurse anesthetist Ronald Lakeman ripped into the state’s case, telling the jury Lakeman had no contact with some of the infected patients, including the patient whose death prommpted the murder charge against him, Rudolfo Meana. Attorney Rick Santacroce said records show it was another nurse anesthetist, not Lakeman, who treated Meana.

Santacroce also cast doubt on the CDC’s conclusion that propofol vials were the source, telling the jury there was public hysteria when the outbreak was announced. He suggested the CDC reached a hasty conclusion because of public pressure for an explanation. He also showed charts that indicate not all patients who received the drug from the same vials contracted the disease.

The trial is expected to last six weeks.

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