Nevada has overhauled the state medical board’s discipline procedures in an effort to make them more responsive to dangerous practices and more open to public scrutiny. The action follows a scandal last year when some 50,000 patients were possibly exposed to hepatitis C at two endoscopy clinics that reused vials and syringes. As of April, nine confirmed diagnoses were linked to the clinics, and 105 other hepatitis C cases were considered suspect.

The new law permits the board to immediately suspend the license of a physician whose actions may pose an imminent danger to patients. Had that power been available at the time, the endoscopy clinic doctors would have been suspended immediately instead of weeks after the initial complaint, Executive Director Louis Ling, JD, told a state Senate committee.

In an effort to promote timeliness, the board now faces a 90-day deadline after a complaint is filed for the board to decide whether to dismiss it or investigate. Ling said the board reviews about 700 cases each year. For the first time, complaining patients will be allowed to appear at disciplinary hearings and to address the board before sanctions are imposed. Also, for the first time, summaries of cases will be made public. Meanwhile, efforts to modify or eliminate caps on “pain and suffering” damages in malpractice awards failed in both Nevada and Colorado.

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Colorado has limited noneconomic damages to $300,000 since 2003. A bill to raise the cap to $460,000, with automatic annual adjustments for inflation, also required insurance companies to get state approval before they raised malpractice premiums by more than 5%.

After a committee removed the cap from consideration, the full House rejected the insurance provision as unnecessary. The defeat was the second in two years for proponents trying to raise the damage cap.

Nevada has limited noneconomic damages to $350,000 since 2004. In another reaction to the hepatitis scandal, legislators proposed eliminating it altogether in cases of “gross negligence,” which was defined as a “disregard for and indifference to the safety and welfare of the patient. The cap would have remained in force for cases of “professional negligence.”

This bill was approved by the state Assembly, but it died when a Senate committee failed to act before a legislative deadline.