CARSON CITY, Nev. (CN) – Although a health clinic manager is responsible for six former patients contracting hepatitis C, the death of one patient did not warrant a second-degree murder conviction, the Nevada Supreme Court ruled Thursday.
The court reversed the murder conviction of Dipak Kantilal Desai, who founded and managed the Endoscopy Center of Southern Nevada in Las Vegas.
An opinion written by Justice James Hardesty said six patients of the center in 2007 contracted hepatitis C after the health clinic's nurses knowingly put needles into used vials of propofol after using the vials on patients with hepatitis C.
Hardesty said the disease eventually killed patient Rodolfo Meana, who had several procedures done at the clinic.
The U.S. Centers for Disease Control determined the six patients became infected by two other patients who told the clinic they had hepatitis C before undergoing medical procedures, Hardesty wrote.
The CDC said unsafe injection practices occur when a nurse uses a needle and syringe to administer a dose of propofol, and then places that same syringe back into a vial of propofol.
Doing so creates a risk that any blood in the syringe from the first patient will transfer to the Propofol and then to other patents, according to the CDC.
When the state investigated the matter, it found nurses – acting under Desai's orders – knew there was a risk of contaminating others. Desai told them to do it "to save money," Hardesty wrote.
One nurse said he would be fired if he didn't use all the propofol in a vial, Hardesty said.
But other factors, including not following through on his medical treatment, contributed to the death of patient Rodolfo Meana, Hardesty wrote, adding, “Because there were intervening causes between Desai's actions and the victim's death, we conclude that the state presented insufficient evidence to convict Desai of second-degree murder."
A Clark County jury found Desai guilty of second-degree murder, seven counts of performance of an act in reckless disregard of persons or property resulting in substantial bodily harm, and seven counts of criminal neglect.
The jury also found Desai guilty of theft, nine counts of insurance fraud and two counts of obtaining money under false pretenses.
Hardesty and the Supreme Court panel reversed the murder conviction, but upheld Desai's other convictions.
In the unanimous decision, Hardesty said Desai's appeal asks the court to determine if it is possible for someone to aid and abet a reckless or negligent crime.
So long as sufficient proof is provided that the "aider and abettor possessed the necessary intent to aid in the act that caused the harm," the court ruled it is possible.
"Because the state presented sufficient proof that Desai acted with awareness of the reckless or negligent conduct and with the intent to promote or further that conduct in the endangerment crimes for which he was convicted, we affirm his convictions of those crimes," Hardesty wrote.
Desai also challenged his convictions on the grounds that his right to confrontation was violated when Meana died before Desai could cross-examine him. Desai also said the court improperly allowed Meana's death certificate to be admitted, and a surrogate testified about Meana's autopsy report.
Desai argued the court committed prosecutorial misconduct, and it should have ordered a competency hearing after Desai suffered a series of strokes.
He also argued his convictions for reckless disregard of persons and criminal neglect of patients are lesser-included offenses of second-degree felony murder, and the court must overturn them.
Hardesty wrote those arguments have no merit and do not warrant consideration.
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