Clark County Medical Society

County Line

Newsletter LXI February 2005

Contents

Lowering Professional Liability Insurance Premiums?

Malpractice Filings Against Health Care Providers, Jan 2001 – Dec 2004

President’s Message

Membership Applicants

Reinstated Members

CCHD Report: Influenza season provides opportunities and challenges

CCMS BOT Minutes Synopsis

Clarification

HealthInsight: Nevada Seniors Need a Pneumococcal Shot

Alliance Message

CME Calendar

Clark County Health District Disease Statistics – December 2004

Classified Ads

County Line Advertisers

LOWERING PROFESSIONAL LIABILITY INSURANCE PREMIUMS?

By Weldon (Don) Havins, MD, Esq.

On November 23, 2004, the provisions in Question 3 amended Nevada statutes and became the law in this state. Where do we now stand in the medical liability morass?

Nevada medical professionals currently are affected by an amalgam of three sets of medical tort liability laws. The first involves statutes in place before October 1, 2002. October 1, 2002 was the date of implementation of Assembly Bill 1 of the 2002 Special Session of the Legislature. If the physician's alleged negligent conduct which gave rise to a claim for medical malpractice occurred before October 1, 2002, that claim is unaffected by A.B. 1. Some provisions in Question 3 (the Keep Our Doctors in Nevada initiative) affect a cause of action (a lawsuit) accruing (conduct occurring) before October 1, 2002, even if that lawsuit is filed today. Other medical liability statutes apply only if the cause of action accrued after October 1, 2002. Question 3 amended some of those statutes, but not all of them. Below, we will attempt to address what applies when.

Three provisions in Question 3 specifically apply only if the cause of action accrued after the date of implementation of the initiative (November 24, 2004):

1. A single $350,000 cap on noneconomic damages applies per injury or death when the alleged negligent conduct causing the injury occurred (accrued) on or after November 24, 2004. If the alleged negligent conduct occurred before November 24, 2004, but on or after October 1, 2002, the $350,000 cap on noneconomic damages applies from each defendant physician or dentist to each plaintiff, with two exceptions to the cap: gross negligence; or "unusual circumstances" as determined by the judge after the jury verdict is rendered. For this cap to apply, the physician or dentist must have maintained a minimal 1 million/3 million professional liability insurance policy. If the cause of action accrued prior to October 1, 2002, no cap applies.

2. The statute of limitations for a cause of action accruing prior to October 1, 2002, two years from the date of discovery of the negligent injury to a maximum of four years (certain exceptions apply - see NRS 41A.097), permits a lawsuit alleging health care professional negligence to be filed, with no cap on noneconomic damages, until September 30, 2006. Should the cause of action have accrued on or after October 1, 2002, but before November 24, 2004, the noneconomic damage limitations in A.B. 1 would apply, but only apply to physicians and dentists. That statute of limitations is two years from the date of discovery of the negligently caused injury to a maximum of three years from the date of the injury. A cause of action accruing during this period could be filed in District Court until November 23, 2005. Only a cause of action accruing on or after November 24, 2004 would subject health care providers to total noneconomic damages of $350,000 per injury or death. The statute of limitations for a cause of action accruing on or after November 24, 2004 is one year from the date of discovery to a maximum of three years (the exceptions apply).

3. "Deep pocket" Joint Liability is eliminated only for a cause of action accruing on or after November 23, 2004. On or after this date, fault-based liability (Several Liability only) will apply to all damages awarded for health care provider negligence.

For a cause of action accruing before this date, but on or after October 1, 2002, Several Liability applies only to noneconomic damages, and then only if the physician or dentist maintains a 1 million/3 million dollar professional liability insurance policy. Note that for health care providers other than physicians and dentists, no limitations on noneconomic damages apply for a cause of action accruing on or before November 24, 2004.

For a cause of action accruing before October 1, 2002, there are no limitations on damages, economic or noneconomic, for any health care providers.

The Keep Our Doctors In Nevada initiative does not specify the date of applicability of the other provisions voted into law by the people in the last general election, November 2, 2004.

A court could find that the limitation on attorney contingency fees applies to any award or settlement occurring after November 23, 2004. However, it is likely courts will refuse to interfere with a prior contract between the plaintiff attorney and his or her client in place before this date. Courts may well hold that contingency fee contracts between plaintiff attorneys and their clients signed on or after November 24, 2004 are subject to the contingency fee limitations. A few legal pundits believe Nevada courts will not apply the contingency fee limitations unless the cause of action accrued on or after November 24, 2004. Other legal commentators argue that if the initiative had intended this interpretation, the initiative would have so specified. We await a successful medical malpractice plaintiff's lawsuit against his or her own attorney, and the eventual Nevada Supreme Court's ruling, to determine the issue.

Similarly, the collateral source rule elimination in professional negligence actions against health care providers awaits a definite date of application by the Nevada Supreme Court. The Court could determine that evidence of collateral payments to the plaintiff may be introduced into evidence only if the cause of action accrued on or after November 24, 2004, the date of implementation of the initiative. Alternatively, the Court could determine evidence of collateral source payments to the plaintiff could be introduced into evidence in any trial beginning on or after November 24, 2004.

The wording of the collateral source rule provision mimics exactly the same provision in California's MICRA (Medical Injury Compensation Reform Act). A part of the law provides that "a source of collateral benefits … may not recover any amount against a plaintiff or be subrogated…." California courts have upheld this provision which prevents medical insurance insurers from being reimbursed for payments made in favor of the patient when the injury was found to be caused by negligence. Some members of the Nevada Trial Lawyers Association argued that this provision in the initiative is "unconstitutional" because it prevents state Medicaid from obtaining reimbursement for medical care payments provided. Nevada statute, NRS 422, address Medicaid reimbursement in cases of awards for medical negligence (see endnote for reference information). The Nevada Supreme Court will need to determine whether this provision applies only to non-governmental programs, applies to all collateral payments, or does not apply at all.

While Nevada law has long provided that the successful plaintiff could request periodic payments of future economic damages, no one seems to recall a single case where that occurred. A provision in the KODIN initiative provides that any party may request periodic payment of future damages be ordered by the judge, who is then obligated to do so. The Nevada Supreme Court may rule that because the damages are related to the wrongful conduct causing the injury, this provision should apply only if the cause of action accrued on or after November 24, 2004. Or the Court could determine that this provision is procedural in nature and applies to any trial beginning on or after November 24, 2004, regardless of the date the cause of action accrued.

The Effect of Medical Liability Reform on Medical Professional Liability Insurance (PLI) Premiums

For several years before the implementation of medical liability reform adopted in the 2002 Special Session of the Legislature insurance premiums increased at an unprecedented rate. After the implementation of A.B. 1, most insurers raised premiums at annual double digit rates. No new PLI insurers entered the state and three additional PLI insurers ceased writing business in Nevada.

At least part of the problem was A.B. 1's elimination, effective October 1, 2002, of the requirement that potential medical and dental malpractice cases be screened by the Medical Dental Screening Panel. On and after October 1, 2002, cases alleging professional medical or dental negligence were required to be filed directly in District Court. Elimination of the MDSP was associated with a large increase in frequency of cases filed in District Courts. In 2003, an article published in the Clark County Bar Association's Communique periodical, authored by the Chief Judge of the Clark County District Courts, noted a tripling of medical malpractice cases filed. A letter from the Chief Judge of the Washoe County District Courts, Judge (now Nevada Supreme Court Justice) James Hardesty to Senator Randolph Townsend detailed a doubling of medical malpractice cases in Washoe County. All these cases involved causes of action which had accrued before October 1, 2002. Therefore, none of the cases were subject to the medical liability reform provisions contained in A.B. 1 since the provisions of A.B. 1 only applied to a cause of action accrued after that date. It is not surprising that most PLI insurers, faced with large increases in frequency of cases and no applicable liability reform, left the state or demanded large increases in premiums. In the experience of Nevada health care providers subject to these "skyrocketing" premiums, A.B. 1 "did not work."

Harkening back to PLI insurers' testimony "under oath" given to the Insurance Commissioner at a crowded public hearing in March 2002, the Keep Our Doctors In Nevada initiative was written in September 2002. PLI insurers at the March 2002 meeting testified that California-style MICRA medical liability reform would lower premiums in Nevada. Mr. Richard Busilla of the AIG (American International Group) testified that "it's the relative predictability of underwriting result and the perception of likely underwriting profit that would motivate [PLI insurance companies] to enter a market or stay in a market." Nevada's PLI insurance market in 2002 was not predictable. Kimber Lantree, director of the TIG Insurance Company, testified that all-encompassing tort reform modeled after the successful legislation in California need not only to be enacted but to be upheld by the Nevada Supreme Court. This testing in a state's Supreme Court usually takes five or six years. Without that, insurers do not know if the law is "good law" upon which insurers can base predictability.

Nevada has just adopted MICRA-like tort reform. None of the medical malpractice cases currently filed in Nevada District Courts are governed by the amendments and limitations of the new laws. It likely will be several years before cases tried under the new laws will be tested in the Nevada Supreme Court.

The California experience after the passage of MICRA was that insurance premiums increased in the year after enactment of MICRA. The following year, and for every subsequent year until provisions of MICRA began constitutional testing in the California Supreme Court, premiums decreased. During the three year period the MICRA provisions were being decided in the Supreme Court, PLI premiums increased slightly. Upon the Court finding all the tested provisions constitutional, premiums resumed their decline to a level approximately one-half of current premiums in southern Nevada.

The graph below demonstrates that California has maintained about 15% of the nation's physicians. While loss payments decreased the first year at the passage of MICRA, premiums increased. Decreasing loss payments paralleled decreasing premiums until 1982-1985 where losses leveled and then increased while premiums increased steadily from 1982-1985 while the MICRA provisions were before the California Supreme Court. After 1985, all the provisions being found constitutional, premiums and loss payments steadily declined. Since 1988, California PLI premiums have been substantially below that national average.

What does this imply for Nevada PLI insurance premiums? Don't expect any sudden, precipitous drop in PLI insurance premiums. Nevada physicians might well expect a slowing or cessation the end of double digit PLI insurance premium increases that have characterized the last few years. For the trepid, this is a time in which new PLI insurers might choose to enter the market in Nevada. Particularly if the new insurer did not offer prior acts coverage, new claims would likely fall under the tort reform provisions effective in November 2004. With optimism that the Nevada Supreme Court will find the new laws constitutional, there is substantial profit to be made. The wrinkle would be to convince reinsurance companies that the optimism is realistic.

Of interest, on November 5, 2004, the Utah Supreme Court in the case of Judd v. Dregza, 2004 Utah 91 confirmed the constitutionality of Utah's $250,000 cap on noneconomic damages in medical professional liability cases. Nevada now sits between two states that have confirmed the constitutionality of a $250,000 cap on noneconomic damages in medical negligence awards.

One day, the Nevada Supreme Court will rule on the constitutionality of our $350,000 noneconomic damages limitation.

Endnote

NRS 422.29302 Recovery of benefits paid for Medicaid: Powers and duties of Department; claim against estate of recipient; regulations; distribution of money recovered; payment in cash.

1. Except as otherwise provided in this section and to the extent it is not prohibited by federal law and when circumstances allow, the Department shall recover benefits correctly paid for Medicaid from:

(a) The undivided estate of the person who received those benefits; and

(b) Any recipient of money or property from the undivided estate of the person who received those benefits.

2. The Department shall not recover benefits pursuant to subsection 1, except from a person who is neither a surviving spouse nor a child, until after the death of the surviving spouse, if any, and only at a time when the person who received the benefits has no surviving child who is under 21 years of age, blind or disabled.

3. Except as otherwise provided by federal law, if a transfer of real or personal property by a recipient of Medicaid is made for less than fair market value, the Department may pursue any remedy available pursuant to chapter 112 of NRS with respect to the transfer.

4. The amount of Medicaid paid to or on behalf of a person is a claim against the estate in any probate proceeding only at a time when there is no surviving spouse or surviving child who is under 21 years of age, blind or disabled.

5. The Director may elect not to file a claim against the estate of a recipient of Medicaid or his spouse if the Director determines that the filing of the claim will cause an undue hardship for the spouse or other survivors of the recipient. The Director shall adopt regulations defining the circumstances that constitute an undue hardship.

6. Any recovery of money obtained pursuant to this section must be applied first to the cost of recovering the money. Any remaining money must be divided among the Federal Government, the Department and the county in the proportion that the amount of assistance each contributed to the recipient bears to the total amount of the assistance contributed.

7. Any recovery by the Department from the undivided estate of a recipient pursuant to this section must be paid in cash to the extent of:

(a) The amount of Medicaid paid to or on behalf of the recipient after October 1, 1993; or

(b) The value of the remaining assets in the undivided estate,

whichever is less.

(Added to NRS by 1993, 917; A 1995, 2566; 1997, 1240, 2237, 2626; 1999, 581, 877, 2242; 2001, 158; 2003, 874)-(Substituted in revision for NRS 422.2935)

Top

Clark County District Court Medical Malpractice Filings Against Health Care Providers, Jan 2001 – Dec 2004

2001 2002 2003 2004

Jan 39 33 108 61

Feb 20 14 98 72

Mar 35 30 169 123

Apr 37 34 111 81

May 37 35 126 65

Jun 27 24 103 90

Jul 19 100 114 45

Aug 54 51 76 67

Sep 20 65 105 79

Oct 37 83 110 59

Nov 38 184 59 78

Dec 9 170 67 47

Sum 372 823 1246 867

Top

President’s Message

By Michael P. Colletti, M.D., 2004-2005 CCMS President

As many of you know, as a consequence of the Special Session held in July 2002, the Medical/Dental Screening Panel (MDSP) was abolished. In retrospect, this was a major mistake. There was a feeling of several physicians, including myself, that the Panel was ineffectual. It was viewed as a delay tactic because of the shortage of manpower (doctors and attorneys) to review cases in a timely manner. The panel was also flawed in that there was "no probable malpractice" found in 52% of the cases but 50% of those cases proceeded to district court. It appeared that the panel had little effect. As you know, AB1 was passed by the legislature providing some improvement in the medical malpractice law suit arena and the Medical/Dental Screening Panel was "bargained away" in the process. This prompted the peoples' initiative KODIN- Keep Our Doctors In Nevada which passed with a mandate during last election, thus superceding the changes effected by AB1.

After the Medical/Dental Screening Panel was eliminated, there was a flood of medical malpractice law suits. In the year 2001, there were 372 suits filed against health care providers. By the end of 2002, after the Medical/Dental Screening Panel was eliminated, the number jumped to 823. In 2003, the number climbed even higher to 1246 and through December of 2004, 867 suits were filed.

It was a major mistake to eliminate the screening panel. The panel should have been kept in place with modifications to make it more efficient and meaningful. The Legislators can correct this situation during the next legislative session that starts this February. We have supported many legislators, but there are still many pro-attorney legislators in key positions.

The Clark County Medical Society will strongly support re-institution of the Medical/Dental Screening Panel. We propose the panels be overseen by administrative law judges knowledgeable in medical malpractice. We also recommend the doctors and lawyers serving on these panels do so during the day, rather than at night, and there also be monetary compensation for their time. A pool of physicians and lawyers, perhaps some who are working part time or are retired, would be excellent candidates to serve on these panels.

It is time for us to identify which legislators are going to be against re-instituting the Medical/Dental Screening Panel. Re-instituting the panel will be a positive force in attracting high quality physicians to Clark County and Nevada. Health care continues to decline in Southern Nevada, including access to care, affordability and in many cases, quality of care. To improve the quality and access, we need to create a favorable environment to attract excellent physicians to come to this state. Those few legislators that would block re-instituting the panel are doing a disservice to the public health and we intend to make this known to our patients/ voters.

Top

Applicants To Go Before Credentialing Committee

If you have any pertinent information about the following membership candidates, please contact:

Clark County Medical Society, 2590 E. Russell Rd., Las Vegas, NV 89120

· Shahrokh Assemi, MD, Diagnostic Radiology

· Genghis N Portillo, MD, Anesthesiology

For information on becoming a member of the Clark County Medical Society, call Marlaina Burns at 739-9989

Top

Reinstated Members

· Candice Tung, MD, Internal Medicine

· James Hogan, MD, Family Practice

Top

Influenza season provides opportunities and challenges

By Donald S. Kwalick, MD, MPH

Public health and health care workers once again faced another challenging flu season when the Department of Health and Human Services announced nearly half of the expected supply of influenza vaccine would not be distributed due to manufacturing problems at one of the two providers of vaccine for the United States.

Fortunately, flu activity at the local and national levels was low during October through early November. Clark County Health District syndromic and sentinel site surveillance programs identified increases of influenza-like illness (ILI) in the community in late December. Additionally, this season's influenza vaccine strains have been well matched antigenically to the influenza viruses isolated this season. Clark County Health District (CCHD) received vaccine in late November and nursing staff administered more than 22,000 flu vaccinations to adults and almost 1,200 to children by early January.

The initial shortage of influenza vaccine caused the health district to cancel a mass vaccination drill planned for mid-October. When vaccine supplies arrived, staff seized this real-life opportunity to drill on mass vaccination capabilities the first day of the flu clinics, Tuesday, November 30, 2004.

The overarching objectives of the drill were to demonstrate the ability to design a mass immunization/prophylaxis clinic, utilize volunteers and the Medical Reserve Corps, and effectively inform the public of the clinic and vaccine availability.

The results of the exercise demonstrated the clinic design provided optimal patient flow and will be duplicated during future drills or real-life events. In the course of the nine hour exercise, 3,376 people were immunized. Client flow averaged more than 350 per hour, while allowing for an adequate degree of surge capacity (443 clients were vaccinated between the hours of 11 a.m. and noon).

Based on the success of the exercise the clinic model was maintained in the days following the exercise as staff continued to immunize more than a thousand people each day. During the first four days of flu clinics our nursing staff administered shots to more than 11,000 high-risk individuals, sustaining an average of more than 300 clients per hour.

If an extreme situation were to occur, a clinic staffed with approximately 100 medical and non-medical personnel would be able to provide prophylaxis to 24,000 people in 48 hours. It would require more than 50 clinics, fully staffed and based on two 12-hour work shifts, to vaccinate the entire population of Clark County in that same timeframe. These facts illustrate the need to have an active and prepared cache of medical volunteers as members of the Clark County Medical Reserve Corps.

The shortage of flu vaccine also served to place emphasis on the need to modernize flu vaccine manufacturing procedures and to create incentives and limit liability for the development and production of vaccines for emerging and resurging infections. It is imperative this challenge be met if we are to be prepared for a possible influenza pandemic. In the meantime, the health district will continue with planning and preparedness activities in order to ensure an effective response to any future public health crises we may face.

Top

BOT Minutes Synopsis

CLARK COUNTY MEDICAL SOCIETY BOARD OF TRUSTEES MEETING

Tuesday, November 16, 2004; 6:00 P.M.

Minutes Synopsis

Dr. Colletti congratulated every one on the success of passing Initiative #3 (KODIN) and defeating questions 4 and 5. Dr. Colletti directed staff to remove Goal #5 from the BOT Agenda due to the accomplishment.

The minutes from the October BOT meeting were approved unanimously.

Financial Report

Dr. Steinberg reported a large dues check was received in October. The revenue was more year-to-date compared to last year. Expenses are up compared to last year at this time.

MedPac

Dr. Steinberg reported out of the 25 races MedPac supported, 18 candidates prevailed.

Credentials Committee

The following 16 physicians were unanimously approved for active membership: Richard A. Byrd, MD, Anesthesiology; Garland A. Cowan, MD, Anesthesiology; Neel V. Dhudshia, MD, General Surgery; J. Marlow Fenn, MD, Anesthesiology; James S. Forage, MD, Neurosurgery; John T. Goodsell, DO, Anesthesiology; Mark B. Heinonen, MD, Anesthesiology, Stuart S. Kaplan, MD, Neurosurgery; Aloysius N. Lwin, MD, Anesthesiology; Gregory R. McGovern, MD, Anesthesiology; David A. McRae, MD, Anesthesiology; Michael Messina, MD, Anesthesiology; Rosendo (Don) F. Mortero, MD, Anesthesiology; Mostafa I.I. Sheta, MD, Family Practice; Donald P. Wingard, MD, Family Practice; and Michael G. Wood, MD, Cardiovascular Surgery.

Membership Report

Dr. Kline reported there were more dues paid members this month compared to last year at this time. Dr. Kline updated the Board on his contacts with the hospitals regarding waiving re-credentialing fees for CCMS members.

Community Health/Community Relations Committee

Dr. Jameson reported the special session interfered with attendance of interns for the mini-internship program (nine interns participated). Dr. Jameson reported her committee is working on development of a Speaker's Bureau and continues to develop ideas to improve the image of physicians in the community.

President's Report

Dr. Colletti presented Annette Mohs, Alliance Legislative Chairperson, with the President's Award in recognition of her outstanding effort in achieving landmark legislation for the people of Nevada.

CME Committee

Dr. Evins reported his Committee met to develop a 2005-06 Needs Assessment Survey. The programs will be scheduled after assessing which programs engendered the most interest from the survey.

Presentation by David Slattery, MD and Paul Bailey from FEMA

Dr. Slattery presented an overview on the national response team using slides from the World Trade Center.

Alliance Report

Marian Haas encouraged Board members to participate in the CCMSA's Annual Holiday Greeting card project.

Health District Report

Dr. Don Kwalick sent a report on various issues involving the Clark County Health District.

Scholarship Report

Dr. Colletti expressed his desire to give out more scholarships to nursing and medical students and asked Dot Freel to set up a meeting of the Scholarship Fund Directors.

NSMA Report

Dr. Evins reported the Executive Committee will meet every week during the legislature to discuss pending legislation and to make decisions on most effective use of lobbying assets.

AMA Report

Dr. Evins stated both Dr. Horne and Dr. Nelson will be attending the AMA meeting in December.

NBME Report

Dr. Havins reported he spoke to Tony Clark, Executive Secretary of the NBME, regarding CCMS' request that the NBME hire a transcriptionist for their meetings. Mr. Clark indicated the NBME Board members are not interested in obtaining transcription themselves but that he will work to correct the adverse manner some NBME members treat the transcriptionists.

New Business

Dr. Colletti announced the passing of member Dr. John Andrewjeski.

There being no further business, the meeting was adjourned at 7:30 pm.

Top

Clarification

New CCMS Member Dr. Neel Dhudsha’s specialty is Cardiovascular Surgery.

Top

HealthInsight: Nevada Seniors Need a Pneumococcal Shot

By Kristen T. Boucher, BSN, RN, CMC, HealthInsight

In response to current efforts to redistribute the influenza vaccine, HealthInsight, Medicare's Quality Improvement Organization (QIO) in Nevada, recommends that adults should check with their healthcare providers to see if they need a pneumococcal vaccination.

"Pneumococcal disease is a common bacterial infection that can be a complication of influenza, especially in older adults" said Robert Shreck, M.D., Senior Medical Director at HealthInsight. "Medicare claims data suggest 70.3 percent of Nevada residents 65 and older need the pneumococcal vaccine."

Pneumococcal pneumonia kills more people every year than all other vaccine preventable diseases combined, according to the Centers for Disease Control and Prevention. Almost 353 Nevada residents died from the disease in 2001. The CDC estimates that as many as 40,000 Americans die from pneumonia each year.

"Plenty of pneumococcal vaccine is available," Dr. Shreck said. "Nevada residents should call their healthcare providers and ask if they need a pneumococcal shot."

Unlike the influenza vaccination, Dr. Shreck said that most seniors 65 and older need only one pneumococcal vaccination in their lifetime; a booster shot may be required for those who received their shot before the age of 65.

"With the influenza vaccine redistribution under way, it is even more critical that Nevada residents receive the pneumococcal vaccine," said Dr. Shreck. "If you do develop influenza, a pneumococcal vaccination may give you protection against one of its most frequent complications."

In light of the influenza vaccine redistribution, HealthInsight reminds healthcare providers to offer influenza vaccination only to those deemed high-risk by the Advisory Committee on Immunization Practices (ACIP).

The following priority groups for vaccination with inactivated influenza vaccine this season are considered to be of equal importance and include:

· All children aged 6-23 months;

· Adults aged 65 years and older;

· Persons aged 2-64 years with underlying chronic medical conditions;

· All women who will be pregnant during the influenza season;

· Residents of nursing homes and long-term care facilities;

· Children aged 6 months-18 years on chronic aspirin therapy;

· Healthcare workers involved in direct patient care; and

· Out-of-home caregivers and household contacts of children aged less than 6 months.

For more information on the pneumococcal shot, see: http://www.cdc.gov/nip/publications/VIS/vis-ppv.pdf.

Top

Alliance Message

By Marian Haas and Kathie Slaughter, 2004-2005 CCMS Alliance Co-Presidents

This new year got off to a wonderful start with our Brunch at Nordstrom. We had a wonderful brunch buffet served inside the store with presentations on fashion accessorizing and make up and then had the remainder of the morning to shop. We saw many members who have difficulty in attending luncheons welcome a morning activity.

For February we are continuing the idea of doing different events by having a dinner event at Café Bleu. This is a new cooking school, Le Cordon Bleu College of Culinary Arts, in Summerlin. The event is planned for February 15 with cocktails at 6:00 and dinner at 7:00. This promises to be a lovely social event for members in which to bring spouses and friends. It is hoped that by providing events at new times we will meet the needs of those who find a luncheon difficult to attend.

We are looking forward to the Fashion Show Fundraiser, which will be held on March 15th at Neiman Marcus in the Fashion Show Mall. This event will benefit the CASA Foundation, and Child Focus, two wonderful organizations that provide for the needs of foster children in Clark County. We are asking our members to solicit items for our raffle and silent auction.

We are continuing our support of Child Haven, the emergency shelter that provides temporary care for neglected, abused, or abandoned children, with donations of clothing, toys and gift certificates. So far we have collected over 166 items! We plan to continue collecting items that will be used for Birthday and special awards to the children of Child Haven.

Our April Luncheon will be in the home of April Stewart. This will be the time for our election of officers for our 2005-2006 board. Our nominating committee, chaired by our Past President Annette Mohs will be calling on members to volunteer for these positions. If you would be willing to consider a position on the board, please contact Annette @ 248-9624.

Top

CME CALENDAR

Clark County Medical Society 739-9989

MLAN 364-4962

4/2 - “Risk Management & Ethics Program,” 8 a.m., 3 CME hours (2 Ethics hours)

St. Rose Hospital 616-5832

Southwest Medical Associates 242-7735

2/10 - “Cardiology Update”

3/10 - “Men’s Health: Sexual Dysfunction in the Elderly”

4/14 - “GI Malignancies: Screening and Surveillance”

Summerlin Hospital 233-7572

2/5 - “Bioterrorism and Weapons of Mass Destruction Training,” 8 a.m., 5 CME hours

2/12 - “Medical Ethics of Pain Management,” 8 a.m., 2 CME hours

3/12 - “Bioterrorism and Weapons of Mass Destruction Training,” 8 a.m., 5 CME hours

3/26 - “Bioterrorism and Weapons of Mass Destruction Training,” 8 a.m., 5 CME hours

Sunrise Hospital 731-8210

2/1 - “Wilson’s Disease,” 6:30 p.m.

2/10 - “Multidisciplinary Breast Conference,” 7 a.m.

2/15 - “Care of the Caregiver,” 7:30 a.m.

UMC 383-2604

2/12 - “Weapons of Mass Destruction & Ethical Issues,” 7:30 a.m., 7 CME hours

3/19 - “Weapons of Mass Destruction & Ethical Issues,” 7:30 a.m., 7 CME hours

4/9 - “Weapons of Mass Destruction & Ethical Issues,” 7:30 a.m., 7 CME hours

Valley Hospital 388-4847

2/8 - “Current Points in Ophthalmology,” noon

2/22 - “Outcome of Questions 3, 4 and 5: What Will it Mean for the Future of Medicine in Nevada?” noon

3/8 - “Update on COPD,” noon

To have your CME courses listed on our calendar, contact Deborah Barton at 739-9989 prior to the 12th each month.

Top

Clark County Health District Disease Statistics* - December 2004

DISEASE CASES REPORTED YEAR TO DATE

Dec 2003 Dec 2004 2003 2004

VACCINE PREVENTABLE DISEASES

DIPTHERIA 0 0 0 0

HAEMOPHILUS INFLUENZA 0 0 8 7

(invasive)

HEPATITIS A 2 1 17 7

HEPATITIS B 3 6 62 53

INFLUENZA 159 5 207 58

MEASLES 0 0 0 0

MUMPS 0 0 2 0

PERTUSSIS 0 6 22 16

POLIOMYELITIS 0 0 0 0

RUBELLA 0 0 0 0

TETANUS 0 0 0 0

SEXUALLY TRANSMITTED DISEASES**

CHLAMYDIA 413 682 4718 5092

GONORRHEA 235 357 2084 2610

SYPHILIS (Early Latent) 1 3 20 14

SYPHILIS (Primary & Secondary)0 4 8 38

ENTERICS

AMEBIASIS 1 1 17 13

BOTULISM-INTESTINAL 0 0 1 0

(INFANT)

CAMPYLOBACTERIOSIS 10 17 103 101

CHOLERA 0 0 0 0

CRYPTOSPORIDIOSIS 0 0 5 2

E. COLI O157:H7 0 0 17 20

GIARDIA 5 9 94 74

ROTAVIRUS 50 78 442 663

SALMONELLOSIS 11 19 121 129

SHIGELLOSIS 4 13 53 64

TYPHOID FEVER 0 0 0 1

VIBRIO 0 0