NOTE: This story originally reported that the indictment against Dipak Desai and Ronald Lakeman contained 28 counts. It was a 27-count indictment. The mistake has been corrected.

Las Vegas CBS KXNT – For more than seven weeks, they were instructed several times a day not to read, watch or listen to news about the trial. Not to use the internet for independent research. Not to discuss the case with each other, or anyone else.

On Friday, the jurors on the Dipak Desai criminal trial were finally free to discuss what they’ve seen and heard — if only among themselves.

They have access to thousands of pages of exhibits, including records seized by police from the Endoscopy Center of Southern Nevada, charts prepared by Metro Police personnel, and reports in which state and federal health agencies identified the most likely cause of a 2007 hepatitis outbreak that was traced to Desai’s clinic.

They’re tasked with considering each element of every criminal count on the 27-count indictment, and whether each element was proven beyond a reasonable doubt for both defendants. Desai and a former employee, nurse anesthetist Ronald Lakeman, are facing multiple counts of criminal negligence, patient neglect, insurance fraud, and a single count of second-degree murder, for their alleged roles in the spread of the hepatitis C virus to seven patients.

It took District Court Judge Valerie Adair half an hour to read the jury instructions on Thursday morning. Closing arguments followed, lasting all day.

Prosecutor Pamela Weckerly closed by arguing that Desai and nurse anesthetists in his clinic knew the risk to their patients when they used bottles of propofol on more than one patient, after double-dipping into bottles with syringes possibly contaminated by the first patient.

Weckerly told the jury safe injection practices are “nursing school 101,” and said the jurors understand the risks after hearing less than a day of testimony from health officials. It’s not reasonable to believe that Dr. Desai and his trained personnel didn’t understand, she said.

The defense team focused first on the large number of prosecution witnesses who testified in return for immunity. Desai Attorney Richard Wright suggested the state was so heavy-handed in its quest to flip Desai’s former employees and partners, that some of the testimony was coerced and unreliable.

Defense also argued that the state had not proven that reusing propofol bottles actually caused the hepatitis outbreak. Lawyers for both defendants suggested other possible sources, including biopsy implements and colonoscopy scopes.

They also denied that the defendants knowingly put the clinic’s patients in danger,

Wright has claimed since his opening statement that the injection practices used at the clinic were not widely understood to be risky at the time the transmissions occurred. He reviewed confusing and contradictory guidelines from the CDC, the FDA and Medicaid regarding what constitutes a “single-dose” propofol vial.

Attorney Rick Santacroce showed a chart listing patient procedure times for the days when the seven patients were infected, to raise doubt about how the virus was transmitted, and by which staff member. The chart demonstrates that the “source patient” — from whom the infections originated on one of the two days in question — was undergoing a procedure simultaneously with one of the victims who was in a different room.

Santacroce asked the jury to use logic when considering how the hepatitis could jump from one room to another.

The jury will not be required to deliberate over the weekend.


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