updated 3/6/2008 5:41:48 PM ET 2008-03-06T22:41:48

Health officials used an incomplete patient list to notify people exposed to hepatitis and HIV at a Las Vegas clinic, an epidemiologist testified Thursday.

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"We know of patients who had been there whose names were not on the list," Southern Nevada Health District epidemiologist Brian Labus told a state legislative committee on health care.

The public hearing was the first investigating the spread of hepatitis C from unsafe practices at the Endoscopy Center of Southern Nevada. An outbreak of six cases of acute hepatitis C was made public last week. The surgical center and five other affiliated clinics have been closed.

Nearly 40,000 patients who received treatment at the center from March 2004 to mid-January have received letters telling them they are at risk for exposure and urging to be tested for hepatitis B and C, and HIV.

Labus said the patient list was provided by the center and based on financial records. He did not explain why some patient names would not have appeared.

Health officials believe the clinic spread the virus by reusing syringes and vials of medication. Health District chief Lawrence Sands said it was a well-known violation of common safety standards.

The clinic's records show the practice of using single-patient vials of medication to treat more than one patient has been in use since March 2004, when the clinic underwent a renovation and expanded operation, Labus said. Inspectors could not be certain the practice wasn't in place before March 2004, he said.

The clinic's majority owner, Dipak Desai, and member of the governor's commission on health care, has refused to answer questions about the allegations. He took out a full-page ad in Sunday's Las Vegas Review-Journal insisting that needles had not been reused and that the chances of contracting an infection at the center in most of the last four years were "extremely low."

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