Briefly: the cost of medical care posted a small 0.1 percent increase in February as doctors' fees actually fell.

However, medical care, the fastest-rising price category outside of energy, is still up by 4.5 percent over the past year.

The Reno Gazette reports that the State Health Division has fallen behind in inspecting surgical centers for more than 10 years and has failed to inspect half of all centers over the past six years as is called for by Federal guidelines.

More specifically, State inspectors failed to inspect 22 of Nevada's 50 surgical centers over the last six years and at least one center has gone without inspection for 15 years.

The Director of the Centers for Disease Control and Prevention has indicated that it is assessing whether unsanitary practices are occurring at surgical centers nationwide. Interestingly, she noted "tremendous cost incentive" for clinics to skirt proper procedures.

I've been traveling for depositions the last few days while the story of deficiencies among ambulatory surgery centers has been brewing.

What's clear from the recent publicity regarding surgery centers other than the infamous Endoscopy Center of Southern Nevada is that not so much is clear.

Apparently when the State determined that as many as 40,000 people who visited the Southern Nevada house of surgical ill-repute might be infected with some awful thing or another, the State decided that it might widen its probe. Not completely surprisingly, the State found bad practices elsewhere, including in Reno.

While bad practices are bad practices, it's not clear as of this writing just what the State may have found at locales north, and residents may wish to wait before rushing to judgment. My information is that allegations regarding Digestive Health Center in Reno are misleading and that local press may print clarifications in the coming days. So stay tuned and we'll see what happens.

Here are a few things we know:

First, people who have visited centers that have been cited for deficiencies or have questions about the investigation can talk to an expert by calling the health department's hotline at (702) 759-4636. The hotline can also be used by Northern Nevada residents; there is currently no hotline set up for local calls.

The foregoing was reported by the Reno Gazette Journal, which also indicated that "[f]or now, the state is advising the public to be patient."

Why, though, should the State think that people should or will be patient when the State itself has publicized vague information and directives?

Importantly, there has been no report that I know of that anyone in the Reno or surrounding areas has tested positive for some disease associated with bad practices at any northern Nevada facility. There is no known correlation between the spread of disease and northern Nevada deficiencies. And this distinguishes the northern Nevada inspections from the southern Nevada inspections.

Here are some other things we know:

State police, the FBI and Nevada's attorney general's investigators served warrants today at six southern Nevada medical clinics associated with a facility accused of infecting patients with hepatitis by reusing syringes and vials of medicine. According to the Reno Gazette Journal, police say the raids are part of a criminal investigation of officials at the Gastroenterology Center of Nevada;

Governor Gibbons said today in a news conference that better funding for more inspections of Nevada's out-patient surgical centers likely would not have prevented the unsafe practices that infected six patients with hepatitis C at a Las Vegas clinic. Frankly, this sounds somewhat absurd. Of course more inspections would have been useful. As things now stand, these clinics are inspected sporadically, and inspections occur once every seven or so years. Why wouldn't more inspections serve the public good?

The Nevada Health Department's site isn't especially enlightening, but there is a press release issued as of Friday and I reprint that below. Keep tuning in: I will be watching this story closely and will bring you unadulterated and balanced reports based upon media and independent research. For now, I agree that northern Nevadans should not jump to conclusions.

Here's the State's official press release, which can also be found at State Press Release on Surgery Center Inspections March 7, 2008

SEVERAL ADDITIONAL OUTPATIENT SURGICAL CENTERS
FOUND TO HAVE DEFICIENT PRACTICES

No Further Infectious Disease Reports Identified

Carson City--Nevada Department of Health and Human Services (DHHS) Director
Mike Willden announced today that the Nevada State Health Division, Bureau of Licensure and Certification (BLC) has found several outpatient surgical centers that have had deficiencies noted during Focus Surveys currently being conducted. The Surveys are being completed as part of the State's effort to inspect all fifty Ambulatory Surgical Centers (ASCs) in the state that perform outpatient surgical procedures.

In Northern Nevada, Focus Survey inspections have been done at ten of 19 ASCs. Three
facilities in Reno were found to be deficient due to a lack of using proper antiseptic practices or for not using proper infectious disease prevention procedures. Five other facilities were found to have problems that did not pose an infectious disease risk. In all eight cases, immediate corrective action was undertaken before BLC staff exited the facility. At two facilities, Sierra Vista Surgery Center and South Meadows Endoscopy Center, no deficiencies were noted. In Clark County, the Gastrointestinal Diagnostic Center will receive a formal Statement of Deficiencies on Monday, March 10, from BLC. The deficiencies noted at the facility are similar to those discovered at the Endoscopy Center of Southern Nevada. The facility will have ten days to submit its Plan of Correction to BLC (March 21, 2008). Upon further inspection, if the facility is found to be negligent in adhering to the Plan of Correction, the facility is subject to summary suspension of its license.

"It is important to note there has been absolutely no known infectious disease reports
associated with any of the facilities that were notified of deficient practices," Willden said.
"Further, the Bureau of Licensure and Certification does not leave a facility whose practices pose a threat to public health until corrective action is taken."

Willden said the State Health Division continues to work closely with the Washoe
County Health Division and the Southern Nevada Health Division to monitor any reports of infectious disease any of the three agencies discovers.

Three facilities in the Reno area who were identified as being deficient due to a lack of
using proper antiseptic practices or for not using proper infectious disease prevention procedures are:

St. Mary's Outpatient Clinic at Galena
18653 Wedge Parkway, Reno

Improper sterilization procedures

Digestive Health Center
5250 Kietzke Lane, Reno

Improper sterilization procedures

Sierra Center for Foot Surgery
1801 N. Carson Street, Carson City

Staff admitted reusing syringes

Willden said the State Health Division will post on its website (http://health.nv.gov)
information about all ASC inspections by BLC. Members of the public may call (775) 684-5900
24 hours a day to receive information about any questions related to the inspections or infectious
disease prevention.

According to an article from PBS: Newshour Extra dated March 7, 2008, a number of parents are blaming vaccinations for the emergence of autism in their children.

Parents are filing their cases in a "federal vaccine court," which was set up to protect vaccine makers from bankruptcy. If the vaccination companies are found at fault, the award plaintiffs will come from a government fund and not from the industry itself.

The parents claim that thimerosal, a preservative in vaccines that contains mercury, caused their children to have autism. This is a preservative that is common in many of the vaccinations given to young children.

A study conducted by the Centers for Disease Control in 2003 disputes this contention and maintains that there is no scientific evidence to show that the preservative causes autism in children.

Some parents argue that autism levels are rising in the U.S. Only one infant in every 10,000 births in the 1880's was diagnosed with autism while that number rose to one in every 166 births in 2003.

Some scientists argue that the increase in autistic children is actually do to the fact that autism is being used more liberally as a label for any child who is mentally retarded or learning disabled. Using autism as the classification of the illness qualifies the child for financial aid and other education assistance.

Nine test cases in this matter are set to be resolved in June and will set the precedent for thousands of other cases to follow.

Here's a great link to the Las Vegas Review Journal's Clearinghouse page of links. Highly recommended!

Review Journal Links on Hepatitis Scare: http://www.lvrj.com/hottopics/hepatitis_investigation.html

I used to live in Taiwan and I've travelled back and forth to Mainland China many times.

The Chinese do things in subtle ways sometimes.

For years now, China has felt the pressure of U.S. criticism of Chinese safety standards.

This is why it comes as little surprise that China is now running stories in the Chinese press about LOW AMERICAN SAFETY STANDARDS. We shoot at them; they seek out hypocrisy and shoot back.

More specifically, the Chinese Xinhua news agency has run regular stories on this event and reports as of today.

In one story, Xinhua notes that:

An outbreak of hepatitis C at a Nevada clinic in the United States may be "the tip of an iceberg" of safety problems at clinics around the country, said the head of the Centers for Disease Control and Prevention.

In another:

Roger Von Bergendorff, who remains in a coma at Spring Valley Hospital, also has had financial problems, filing for bankruptcy in 2000.

She said Von Bergendorff wasn't social with neighbors and often didn't return a friendly wave. But while Von Bergendorff could be awkward around people, he loved animals, she said. She said he returned to Utah several times after he moved to Las Vegas to search for a lost cat.

See: xinhuanet.com

Other stories Xinhua is currently running deal with China's efforts to improve rural medical care and U.S. statistics which suggest that use of cosmetic surgery in the U.S. soared in 2007.

This comes to me once again from Susan Gallagher, Associate Professor at the University of Massachusetts:

Dipak K. Desai, M.D., was re-elected to the position of Secretary-Treasurer of the board. Dr. Desai practices in Las Vegas and has served on the board since September 1, 1993, having just been re-appointed by Governor Miller for his second four-year term. In his capacity as Secretary-Treasurer, Dr. Desai will continue to serve as Chair of the board's Investigative Committee.
It appears that Dr. Desai may have left the Board in 2003...

See also: Medical Board Newsletter

Thanks to Professor Gallagher for her valuable research.

A number of weeks back I was flying into Vegas, and as we were nearly on the ground I looked out my airplane window and noticed an unusual sight, even for Vegas: the top floor of the Monte Carlo was on fire and there were flames jumping off the top of the hotel. And then, suddenly, the pilot aborted the landing and we were back up in the air. No explanation given.

That's the way authorities now seem to want to handle the Ricin find: they want us up in the air without explanations.

That's fair enough, but if they're going to handle things that way then why reassure us that there's no link to terrorism? Every statement from authorities as of yesterday emphasized that: no reason to suspect terrorism.

Or is it that what they're really saying is that there's no reason to suspect "foreign" terrorism? And since they allegedly know so little, why urge even that conclusion?

Associated Press reports that:

As police tried to piece together how a rare, deadly poison ended up in a motel for transients, the 57-year-old man who could hold the key lay unconscious in a hospital.

Adding to the mystery, police said firearms and an "anarchist type textbook" were found in the same room where the ricin was discovered two days later.

I'm not much of a criminologist, and less of a conspiracy theorist, but when one finds a bunch of Ricin in a transient hotel and along with it they find an "anarchist type textbook," perhaps eliminating terrorism, domestic or foreign, from the list of what's conceivable might be a tad premature.

And if authorities, who according to their own admission don't really know much, then why eliminate the possibility that a man with Ricin and a chemical weapons cookbook might just want to do some harm?