Doctors warn Nevada bill will push physicians out, attorneys argue patient protection

LAS VEGAS (KSNV) — A controversial bill (AB404) in the Nevada Legislature is scheduled to have its first hearing at 8 a.m. on Tuesday morning in the Assembly Judiciary Committee.

The medical community said it will increase the costs to operate in Nevada so much that many will be forced to close business or move to another state.

Trial attorneys said it will finally make the costs for medical malpractice lawsuits worthwhile enough to actually take on those cases.

AB404 is sponsored by the Assembly Judiciary Committee; and as such, was exempt from previous legislative deadlines. Tuesday will be its first hearing.

The bill will increase the caps for medical malpractice lawsuits from $350,000 to $2.5 million on noneconomic damages a plaintiff may recover. These are damages that don’t include lost wages or medical costs.

It will also increase the statute of limitations from 1-3 years to 2-4 years. AB404 is a sort of compromise bill from an earlier, more extreme version in AB209, which would have eliminated the caps altogether. AB209 died after not receiving a work session.

“With that bill [AB209], it would have fully repealed all of the medical malpractice that was on the ballot initiative back in 2004,” said Assemblywoman Brittney Miller, chair of the Judiciary Committee. “So, of course, there were concerns about such a significant change to the current structure. And so this bill, in speaking with N.J.A. (Nevada Justice Association), this was kind of the compromise position.”

A 2004 referendum put a series of protections in place to where the cap is now. Doctors at the time, who wrote into the committee against the bill, describe the period before that referendum as a time when many physicians couldn’t afford to practice in Nevada.

That’s a reality that doctors are arguing could come again should AB404 pass.

“Honestly, I would probably have to retire because that is not going to be something that I can sustain,” said Dr. Ati Hakimi, a family medicine physician who’s practiced in Las Vegas for nearly a decade. “We need to do better. We can’t say from one side of our mouths that we have terrible health care. And then for this legislation to even be considered—is really mind-boggling to me.”

Dr. Hakimi said her medical malpractice insurer informed her that her policy would triple under the new bill from $10,000 a year to $30,000.

Hakimi said it would adversely affect small practices and specialists the most since they would have a tougher time covering those extra costs.

It’s a sentiment shared by Diego A Trujillo, the CEO of Las Vegas Heals, which is a what he calls a “chamber for health care organizations” across the state.

“It’s also very hard for us to recruit physicians and bring them here,” said Trujillo. “Our concern is to make sure that Las Vegas is a very friendly and welcoming community to physicians so that we can attract physicians. The problem is this just increases the hostility. We’re reimbursing them less, and we’re putting them more at liability.”

Nevada ranked 47th in the nation for doctors per 100,000 population, 48th for access to primary care physicians, and 50th for surgeons, according to Your Nevada Doctors, a group that has been lobbying against AB404.

But attorneys who work in the medical malpractice field said this is long overdue so that they can better serve suffering patients.

Joseph Lee Benson II, a partner at Benson & Bingham in Las Vegas, estimated about 70% of the calls into his firm are for medical malpractice cases.

Because the current caps exist and these cases become so complex, Benson said most attorneys decline these cases because they essentially lose money on them.

“With this new bill, it’s going to enable at least some attorneys to want to do this type of law again. Because it’s been very restrictive, from a business standpoint, on whether we can take these cases,” said Benson. “So being able to raise that [cap] to $2.5 million, now that’s a step in the right direction. I wish there was no cap at all. I mean, you can kill someone, you can cut the wrong leg off, and we’re still stuck with $200,000 to 350,000 for noneconomic damages. It’s really unjust.”

Due to Nevada’s current affidavit requirement for a like-kind physician to review medical records, Benson said some of them charge “by the inch” of medical records to review.

“You could be in a case for $10,000 just to find out whether you have a case or not,” he said. “And that’s just not viable. Some of these cases require three experts. So you might be $30,000 into a case before you even know you have a case.”

Benson said most of the medical malpractice lawsuits he does handle are because he “wants justice” for the victim.

Joel Selik is another professional malpractice trial attorney who has practiced in both Nevada and California for the past 37 years. He agreed with Benson’s insight that most Nevada attorneys can’t make it worthwhile to take on medical malpractice cases.

He doesn’t agree that AB404 would push out physicians, adding that negligent doctors should be held accountable.

“Dealing with the statute of limitations, when there is malpractice, a patient and his family may be so wrapped up with that person’s care for the first year that they have no time, and they’re not thinking about hiring an attorney,” said Selik. “So many cases get excluded because people simply don’t know that they have a one-year deadline—or they’re so wrapped up in their medical care. One year is just an incredibly short amount of time.”


Hygiene concerns arise as Chaparral High School students forced to use ‘porta-potties’

Earlier this week, an email was sent to Chaparral High School parents informing them that all student restrooms were closed “for student safety and repairs.”

In their place, 19 portable toilets—or porta-potties—were installed Tuesday in front of Chaparral High School along Annie Oakley Dr in southeast Las Vegas.

This move caught students and staff by surprise and has triggered many unforeseen consequences and health concerns.

“It’s a sanitary issue, and I feel it’s cruel and unusual punishment,” said one concerned staff member. They asked to remain anonymous due to fear of reprisal.

According to the staff member, no work has been done on the closed bathrooms, as far as they can tell.

Both the employee and a student, who also asked to remain anonymous for the same reasons, said with the porta-potties, most students aren’t washing their hands.

The staff member also said students were choosing not to use the portable toilets at all. They are instead holding it in for the duration of the school day.

The student and staffer added the entire situation is depriving the school of basic safety needs. The employee referred to it as a “draconian display of collective punishment.”

The situation allegedly came from a Monday incident where someone lit at least one fire in a school bathroom. The fire alarms went off multiple times as a result.

“The principal announced that he was closing all bathrooms because of a non-student burning the trash cans or something like that,” said the Chaparral student. “And then he just said that he would be closing it.”

It wasn’t clear what was meant by a non-student as both the employee and student were under the impression someone unaffiliated with the school may have lit the fire.

Once the porta-potties were installed, News 3 received multiple emails complaining about the situation.

Chaparral’s website lists the school as having over 2500 students. With 19 porta-potties seen outside the school on Thursday, that means there’s about one portable toilet for every 132 students.

“The inability to wash your hands, they don’t do that in jails,” said the employee.

The portable toilets outside of Chaparral do have hand sanitizer but lack any type of water and soap to wash their hands properly.

Some may think that’s sufficient, but Dr. Ati Hakimi, a family medicine physician with Vegas Direct Primary Care, said it’s not good enough.

“Hand sanitizers are able to kill some types of germs, but not all the types of germs,” Dr. Hakimi said. “So we really prefer the soap and water situation in terms of full cleanliness.”

Hakimi added if she were a parent of a Chaparral student, she would be concerned about the situation.

“Students need to be able to use the restroom when they need to use the restroom in terms of preventing various things such as urinary tract infections,” she said. “Holding your urine and or bowel movements is not really sanitary, either. So having that accessibility is extremely important.”

A student at the school said they’re prone to urinary tract infections, so their mom asked the school to let her kid use the staff restroom, which is still open.

The school refused, according to the student.

Another cause for concern, the student said, is the fact the porta-potties are positioned outside the school gates, meaning anyone from the street can walk in and use them.

“It’s just all really scary for a lot of people right now,” the student said. “Not only is the mask mandate off, which I know a lot of my friends and I are concerned about. There’s also now, we can’t wash your hands with soap.”

News 3 reached out to Clark County School District on Thursday, asking specific questions addressing these concerns. No response was received as of Thursday night.

Covid-19 Vaccines – A Conversation with Medical Professionals

Henderson physician Dr. Ati Hakimi and CSN Biology Department Chair Dr. Matthew Mahrt answer your questions about the COVID-19 vaccine and why it’s important to get vaccinated during this pandemic.

The COVID-19 vaccines provide protection against every variant so far. Even with more breakthrough cases reported with the Delta variant, the vaccines are effective at preventing serious illness and hospitalization.

FDA approves Pfizer vaccine, health officials hope authorization boosts vaccination rates

The Pfizer BioNTech Covid-19 vaccine is the first to receive full approval from the FDA. The vaccine will now be marketed as Comirnaty and is approved for those ages 16 and older.


The vaccine is still available under emergency-use authorization for kids ages 12 to 15. As well as a third dose in certain immunocompromised individuals.

Southern Nevada health officials said Monday’s approval puts the Pfizer vaccine on the same level as regular immunizations for children and adults across the country.

“For all the naysayers that have had concerns about it not being approved by the FDA that they should feel confident and they should feel comfortable that it is now approved,” said Dr. Ati Hakimi MD, family physician with Vegas Direct Primary Care.

As the nation battles the most contagious variant yet, delta. The FDA gives approval to Pfizer as the first Covid-19 vaccine.

Dr. Fermin Leguen with the Southern Nevada Health District said the approval only confirms what health officials have been saying for months: the vaccine is safe and effective.

“Some organizations are waiting for the full approval of the vaccine so they could request or mandate the vaccine for their operation. Now they can incorporate that as well,” Dr. Leguen said.

County officials say right now they can’t predict if the approval will boost traffic at vaccination sites. But they hope it does.

The Stan Fulton drive-thru vaccination and testing site at UNLV will continue to offer 300 doses daily of Pfizer, Moderna and Johnson & Johnson vaccines. They’ll adjust as needed.

A spokeswoman with CVS Pharmacy tells News 3 only one type of Covid-19 vaccine is offered at pharmacies giving the shot. When registering, people can see which store offers which vaccine.

In a statement, CVS said “we’re fully prepared to meet any increase in demand resulting from full FDA approval of the Pfizer-BioNTech vaccine and expected regulatory approval of booster shots beginning in the fall. We’ve administered more than 30 million COVID-19 vaccines across the country, and immediately began offering third doses to immunocompromised individuals when authorized to do so.”

As for other SNHD partners, Dr. Leguen said there shouldn’t be an issue with people asking for a specific vaccine.

“We have more than one vaccine available at any of our sites, whether its Pfizer, Moderna or Johnson and Johnson,” Dr. Leguen said.

Dr. Hakimi added that full FDA approval is a rigorous process that goes beyond approving medication but manufacturing as well.

“We hope that we’ll be a source of comfort for them to know that there is all of this extensive data and research and manufacturing approval that has gone into this,” Dr. Hakimi said.

Nevada partners with pharmacies to increase provider access to COVID-19 vaccines

Nevada’s State Immunization Program has announced a new initiative to boost Covid-19 vaccinations across the state by pairing pharmacies with local doctors to get more shots in the arm.

To read the full article and video, please click here:

The pharmacy depot program will allow pharmacies like CVS, Walgreens and Smiths to distribute vaccines in small amounts to enrolled providers.

Right now, less than half of Nevadans are fully vaccinated, that’s according to the CDC.

“Increasing points of access is the overall goal in boosting those rates,” said Kristy Zigenis, Covid-19 program manager with the Nevada State Immunization Program.

So, the Nevada State Immunization Program is partnering with the Nevada Board of Pharmacy to pilot the Pharmacy Depot Program. To get Covid-19 vaccines into the hands people trust most.

“We have discovered that some providers didn’t think they could vaccinate their patients due to the minimum required order sizes,” Zigenis said.

Through federal guidelines, providers can order a required minimum of the Covid-19 vaccine. Zigenis said that’s somewhere between 100 to more than 1,000 doses.

RELATED | Clark County passes 5,000 COVID-19 deaths

But through the new program, doctors will be able to request *small* amounts of vaccine from more than 140 pharmacies across the valley, without wasting unnecessary stock.

“For a provider that has a smaller practice, it was just too much to manage. And so, they just wouldn’t sign up to provide the vaccine,” Zigenis said.

Dr. Ati Hakimi MD with Vegas Direct Primary Care is one of those small practices with 150 patients.

“I would love to be able to give vaccines,” Dr. Hakimi said.

Dr. Hakimi said getting the vaccine is vital in keeping the virus from mutating. And doctors can provide an environment patients are comfortable in.

“Because we do have a relationship with our patients right so we want to be there for them and take that opportunity when they do have the questions to ask and answer them but if they want that vaccine right then and there, we can give it to them,” Dr. Hakimi said.

Zigenis said if providers have a refrigerator that can maintain the appropriate temperatures to store the vaccine, there shouldn’t be any barriers.

But according to Dr. Hakimi, storing and refrigerating vaccines such as Pfizer takes time and money.

“We have been trying to work with entities such as Immunize Nevada and the health department to enable us to do that but with this new program I think it will be invaluable for us smaller practices to actually get that going,” Dr. Hakimi said.

For more information and to enroll in the Pharmacy Depot Program, click here.

Questions answered: Who, what, when and where of booster shots

Today, President Biden announced plans to recommend all fully vaccinated Americans get a COVID booster shot for better protection.

We break down what this means for you and Nevada:

To Read The Full Article And View Video Click Here


Per the Biden administration, this would be all fully vaccinated Americans 18 and up who had the Moderna or Pfizer vaccine.

Federal officials say more data needs to be collected with Johnson & Johnson before an official decision.

This follows an earlier decision from the CDC to OK booster shots for those with weak immune systems.


A third, so-called “booster shot”.

This isn’t a “new” formula–but rather the same vaccine. The only reaction that’s different is the one from your body.

“People think the booster shots are a new formulated shot against the variants. It’s not. It’s the same shot we got earlier in the year,” Family Physician Dr. Daliah Wachs said. “Getting that extra boost reminds your antibodies: ‘Hey guys, remember, you need to be on the lookout for this.'”

Doctors say you should stick with whatever dose you previously had. That means if you got a Moderna shot 8 months ago–your booster should be Moderna too.


With FDA approval, the rollout would begin on September 20th.

It would first be available to those who had the second dose at least 8 months prior. (Those who got their second shot at or before January 20th would be eligible on September 20th, those who got it in February would be eligible in October and so forth) Officials with the Southern Nevada Health District say this is a normal timeline for boosters.

Of course, all of this depends on approval from the FDA to ensure third doses are safe. That’s expected within a few weeks.


Currently, COVID vaccines are available throughout multiple locations in the valley, including dozens of pharmacies.

SNHD tells News 3 it has the capacity to provide additional vaccines to the public. A spokesperson says SNHD will continue to monitor the demand and is prepared to open additional or larger clinic sites if needed.


In his address, President Biden said the possibility of booster shots has been discussed for several months.

Family Physician Dr. Ati Hakimi says this is due to two variables: most vaccines wane in efficacy over time, and most viruses also mutate.

“We have discovered with the research, about 6 to 8 months is when it starts to wane,” she said. “This virus is so smart and it’s mutating.”

A recent study of 10 million New Yorkers shows vaccine effectiveness decreased from 92 percent in May to 80 percent in July.

So far, the vaccines have done their jobs fending off serious disease and death. While breakthrough cases are documented, the vast majority of those hospitalized with COVID-19 remain unvaccinated locally and nationally.

However, doctors fear another variant—stronger or deadlier than Delta–could emerge.

That could be concerning, says Dr. Hakimi, with vaccine protection fading as the months go on.

“So that 90 percent will start to become maybe 70, 80, possibly 60 percent,” she said. “So if you get that booster you will get yourself back up there to get the antibodies that will fight for you.”

Health professionals argue the idea is to keep immunity high and be proactive against future variants.

“It’s actually the best time to be proactive with these boosters instead of being reactive,” Dr. Hakimi said.

In a recent press conference with health officials, Dr. Anthony Facui, infectious disease expert at the National Institutes of Health, said studies show a ten-fold increase of antibodies after a third dose of the mRNA vaccines.

“You don’t want to find yourself behind playing catch up,” he said. “Better stay ahead than chasing after it.”

Not everyone agrees

However, not all doctors are on the same page on boosters. Just earlier this year, the World Health Organization asked wealthy countries to pump the break on boosters as thousands in the world still haven’t received a single dose.

“We need an urgent reversal from the majority of vaccines going to high-income countries, to the majority going to low-income countries,” WHO Director-General Tedros Adhanom Ghebreyesus said at a press briefing.

Other doctors suggest the data points to only giving some populations—including the immunocompromised and elderly—a third shot.

“These data support giving additional doses of vaccine to highly immunocompromised persons and nursing home residents, not to the general public,” Dr. Celine Gounder, an infectious disease specialist at Bellevue Hospital Center and a former adviser on the pandemic to the administration told the New York Times. “We’ll be better protected by vaccinating the unvaccinated here and around the world.”

“If you look at the whole, unvaccinated populations could be worse to public health, than those who have had two shots but might need some more immunity,” said Dr. Wachs earlier this month.

Ask your Doctor

In the next few weeks and months ahead, Dr. Hakimi says the best person to ask for advice for the booster shot is your personal doctor. And in the meantime, if you haven’t been vaccinated yet, she urges you to do so to help out our community.

“If we want Vegas to come back to how we had Vegas, then we all have to be on board,” she said.

Nevada doctors see rise in telehealth appointments

Tele-health, or virtually visiting your doctor via phone or video chat, has been around for years.

But as many people gravitated for more *at-home* options over the last year, this realm of medicine boomed during the pandemic — and health insurance providers — along with physicians — are taking note.

You can read the full article HERE

COVID-19 breakthrough infections: Local physician explains rare cases, encourages vaccine for protection

LAS VEGAS (KLAS) — Though someone contracting COVID-19 after being fully vaccinated is rare, it can happen, so 8 News Now spoke with a local doctor about the role immunization plays in community defense.

You can view the full video HERE

Concierge Medicine: Exploring Direct Primary Care

LAS VEGAS (KLAS) — Nevada ranks nearly dead last nationwide — 48 out of 50 — when it comes to the number of doctors per population. But while we have a serious doctor shortage, there are options for care.

They could change your healthcare journey and help you nix the long wait at a provider’s office.

“I’ve had years of that, and I was ready for a change,” said Trina Morella, a Direct Care patient.

The change for her was leaving traditional insurance-based healthcare and moving to Direct Primary Care (DPC).

“I can’t see patients in 10 minutes, that’s not quality care,” said Dr. Ati Hakimi, a Direct Care physician.

She was also frustrated by the system, so she opened her own practice and welcomed patients, like Morella.

Hakimi is a DPC doctor, which some call concierge or retainer-based medicine. It shifts most of the financial responsibility to the patient, in exchange for improving your healthcare experience.

It costs anywhere from $1,200 to $3,000 a year. Hakimi even offers house calls.

“It’s quality, it’s affordable, it’s completely transparent,” the doctor explained, “there’s no hidden fees. It’s just that flat fee once a month, and people have all access to me.”

Hakimi negotiates rates directly with drug manufacturers and providers, including imaging, which may be cheaper than using insurance.

“I can order an x-ray tomorrow for $25, a CT scan for about $150, an MRI, $200,” she shared.

This approach may require you to think about health insurance differently.

“So, you don’t use your car insurance to put gas in it to maintain it; you don’t use your homeowner’s insurance and paint your house to make it look nice,” Hakimi compared.

Morella noted, “You can still have your healthcare insurance, and it covers your big items that you need … It has to be the right fit for you, and this was the right fit for me.”

Concierge medicine has both its critics and supporters. While the patient-centered benefits of quicker care access and better relationships are attractive, some people say the model does not promote health equity.