Spinning Salmonella: Peanut Corporation of America

"PCA is second to nobody in its desire to know all the facts, and our team is working day and night to recall affected products and to complete its investigation." — Peanut Corporation of America

With the FBI issuing search warrants to assist the FDA in its ongoing investigation of the Peanut Corporation of America's (PCA) plant in Blakely, Ga., and corporate headquarters in Lynchburg, Va., it seems everyone wants to know the facts well ahead of "nobody."

Recently, the Associated Press reported that federal officials say the PCA knowingly shipped salmonella-laced products from its Georgia plant even after tests confirmed the contamination. Since federal law forbids producing or shipping foods that could be harmful to the public health, it also seems there will be charges.

Specifically, the FDA believes that the plant sold peanuts that tested positive for salmonella before receiving the second test and even after confirming salmonella was present. This is no longer a crisis communication case study as much as it seems to be a criminal investigation. Period.

How botched crisis communication is often indicative of cover up.

Some public relations specialists might be tempted to spin, but there is only one right answer when public safety is concerned. Tell the client or employer to come clean, immediately, with full disclosure and complete transparency. If they refuse, inform them that you are obligated to go forward without them.

We saw a similar case study unfold in the Endoscopy Center of Southern Nevada last year. The communication failed because there was only one thing to communicate — the bad practices were done, knowingly unsafe, in order to cut costs. In fact, the same might be said to Dr. Dipak Desai's attorneys. They claim Desai cannot testify after suffering two strokes. His inability to testify is still in question. Get it over with already.

While it is too early to say that the PCA operated with an equal and complete disregard for public health, the FDA is clearly moving in that direction. Even more interesting to us, the communication breakdown of both the Endoscopy Center of Southern Nevada and PCA are surprisingly similar.

Ten similarities between the crisis communication breakdown at the Peanut Corporation of America and Endoscopy Center of Southern Nevada.

• At the onset, both owners aggressively defended their operations, claiming that every safety precaution was taken.
• Neither expressed remorse, regret, or empathy despite unsafe practices (until someone told them to express empathy).
• Both regretted having to take action, but did not express any regret for their responsibility in harming others.
• After new evidence surfaced that demonstrated it was an ongoing practice, virtually all communication was cut off.
• There was virtually no communication with employees as they were laid off; former employees then came forward.
• Neither offered any compensation for those affected by their negligence, which, in this case, included deaths.
• Neither expressed any desire to compensate anyone for pain, suffering, and anguish at being put in harm’s way.
• Neither would pledge that they and their management team would never work in the profession again.
• Both continually reinforced not everyone was affected, even when it meant neglecting those who were.
• Both attempted to draw out the investigations as long as possible; and both resisted while claiming cooperation.

While it is too soon to call this case over as criminal charges have yet to be filed (although it seems likely there will be charges), Stewart Parnell, PCA president, could likely join those who put pennies before public safety. And even if he does not, his peanut days are done. The PCA and its various direct-to-consumer brands have crashed.

It happened fast, but not over night. Like all brand failures, they usually erode one shaky step at a time.

Recognizing Reader Picks: Top Posts Of 2008

With the new year upon us tomorrow, we would like to say goodbye to 2008 with a recap of this blog's five most popular communication-related posts, based on the frequency and the immediacy of reader views after they were posted.

The 3-Deep Leak of Jericho, Season 2

What began as the early coverage of a consumer protest over the cancellation of the television series Jericho last year became the longest running living crisis communication and consumer-driven social media case study ever covered here. While the fans succeeded in reviving the show for a truncated second season after sending 20 tons of nuts to CBS, two of several factors kept the show from achieving a third season: The network never grasped that yesterday's passive viewers had become active participants. Some fans misplaced trust in the network to do the right thing (and they continue to stumble), which resulted in a fractured fan base.

Of those posts, most written earlier this year, speculation of the 3-deep leak of the show online and potential consequences led the pack. Three days later, CBS followed up with a clarification that the leak was unintentional. (The fact that Jericho leads this list is a testament to the fans' vigilance as well as the potential for groups to use social media to organize.)

Related Labels: Jericho, Consumer Marketing

The Nine Rules of Advertising, Inspired By Fred Manley

After referencing my instructional "nine rules" of advertising on more than one occasion, it seemed suitable to share a two-part post. The first post includes highlights from Fred Manley's classic “Nine Ways To Improve An Ad," which forced so-called advertising rules on the 1960 classic “Think Small” Volkswagen ad. The companion post revives advertising as a conversation as seen by Shirley Polykoff, who was the first woman copywriter for Foote Cone & Belding, before presenting Copywrite, Ink.'s The Real Nine Rules Of Advertising. The first rule? There are no rules.

Both posts can be easily applied to social media. And, if three posts make a better set, then consider Valeria Maltoni's bridge post on the topic, using Reader's Digest as the example.

Related Label: Advertising

Why News Releases Might Die From PR Confusion

With public relations seemingly confused with media relations and media relations seemingly confused with spamming journalists, it only made sense to write a somewhat satirical piece on today's most misunderstood profession. After sampling several random releases, we presented the seven deadly sins of the modern public relations professional as told to me by public relations professionals.

As well read as the post was, even being included on a tip sheet by Bad Pitch Blog, not many have learned anything. HWH PR was outed once again. Dennis Howlett banned pitches (except via Twitter). And I was reminded why being a journalist can sometimes suck.

Related Label: Public Relations

Endoscopy Center Demonstrates Crisis Communication Gone Wrong

Following the local crisis that surrounded the Endoscopy Center of Southern Nevada, which was responsible for the largest hepatitis C scare in the history of the country, became an exercise in evaluating futility. After the initial story — and then the denial, lack of empathy in a newspaper ad apology, refusal to comment on evidence, and alleged plans of the primary owner to flee the country — the center's credibility eroded until there was nothing left to believe. Eventually, the center was closed permanently.

From the series, the most popular post broke down the ill-advised newspaper apology, which opened: "Recent events at the Endoscopy Center of Nevada of Southern Nevada are causing great concern to our patients and the community at large.” Ho hum. Enough said.

Related Label: Endoscopy Center of Southern Nevada, Crisis Communication

Applying Twitter And How It Works For Business

In November, after following up as a live speaker to Aaron Uhrmacher's webinar, we had an opportunity to evaluate Twitter as a tactic for business communication (depending on the company and whether or not the people it wants to reach exist there). While there are other ways to use it, including real time reporting, we categorized six prevailing external communication approaches. They are outlined here.

The popularity of the post might reveal the need for social media participants to communicate in a language business people can understand or, perhaps, just the enthusiasm of Twitter participants to read something about, well, Twitter. There is nothing wrong with that.

Related Label: Twitter, Social Media

Five additional topics that came close in 2008

• How Veronica Mars fans continue to demonstrate unity and sustainability.
• How social media almost derailed our Bloggers Unite segment on CNN.
• Why applications like SeenThis? add value and expose trends.
• Our continuing coverage of broadcast-broadband convergence.
• TheLadders and RiseSmart battle for niche placement.

Since starting this blog in 2005, I always hoped that best practice posts would eventually draw more readers than the biggest mishaps. Looking back, 2008 seems to have accomplished a healthy mix, making 2009 more promising than ever. A very special thanks to everyone who joined the conversation to help make these posts relevant. It made a difference and it's appreciated.

Happy New Year!

Eroding Brands: Credibility Gaps

Erosion can be caused by many factors, including manmade. Trampling, for example, can reduce vegetation until the topsoil is removed. Then, as the underlining rock bed is exposed, pathways turn into gullies until they become impassable.

Credibility behaves much the same way. Once admired brands can become unsightly, devalued, and destroyed over time.

A few months ago, we began tracking how the Endoscopy Center of Southern Nevada mishandled its crisis communication plan shortly after it became responsible for the largest hepatitis C scare in the history of the country.

There is no more Endoscopy Center of Southern Nevada.

Instead, a quick search on the Internet will redirect you to a special section of the Southern Nevada Health District’s site, which provides some details about the ongoing
hepatitis C investigation and recommends that former patients receive testing for hepatitis C as well as hepatitis B and HIV.

It didn't happen overnight. As bad as the initial crisis was, it was an ongoing communication lapse that widened the gap. And as the path between the initial story was tread upon over and over again — the initial denial, the lack of empathy in a newspaper ad, the refusal to comment on evidence, and the alleged plans of the primary owner to leave the country — the center's credibility eroded until there was nothing left to believe.

The latest damage? One of the patients was proven to be a known carrier of hepatitis C. That means both the health care provider and the patient knew the virus was in the patient's bloodstream and yet, the flawed and unsafe procedures at the Endoscopy Center of Southern Nevada were allowed to continue, which is why the infection was spread to others.

The gap — an "isolated incident" as originally suggested by the practice and knowingly following unsafe procedures even while treating a carrier of hepatitis C — is now impassable.

There is little chance Francis Allen will be re-elected.

While unrelated, there is another story in southern Nevada that continues to leave some people treading the same ground. A few weeks ago, Nevada State Assemblywoman Francis Allen was arrested and charged with felony domestic violence after her husband had filed a police report stating that she stabbed him with a steak knife.

He quickly recanted the report after learning Allen would be charged with a felony. While the case was dismissed, prosecutors are reportedly seeking a grand jury indictment.

A few of my neighbors asked why the alleged, now recanted, story had convinced so many insiders that Allen cannot be re-elected. Easy.

The stabbing isn't the first phase of erosion. It's one of the last phases. The odd stabbing story might have garnered sympathy on its own, but not when paired with a questionable voting record, numerous ethics complaints filed against her since 2002, and campaign messages that don't match her actions while in office. Even her Photoshopped campaign photo bears little resemble to her likeness or mug shot for that matter.

So the problem isn't the stabbing story as much as it is that voters are tired of treading the same ground over and over again. It's virtually impassible anymore, except to new residents who might believe the myth contained in her campaign literature.

Only the first few stages of erosion seem convenient.

It’s something to keep in mind when it comes to crisis communication, even in social media. There is seldom a single catastrophe or issue or disagreement that will create a credibility gap (even though some people act like it). It's all those future issues that tend to pile up.

Ask President Bill Clinton. Hot button topics like Whitewater and Monica Lewinsky seem easy to escape. Some people even said it made him more human. The constant critiques about him during his wife's campaign proved much more problematic.

One CNN poll suggested his approval rating among Democrats had dropped 9 percent from 60 percent in the short course of one year. It's the price he paid for being too political while on the campaign trail, some say. It's the widening of a credibility gap, I might say.

Rolling Dice: Crisis Communication Meltdown

Following the crisis that surrounds the Endoscopy Center of Southern Nevada over the last several months has been an exercise in evaluating futility. It can best be likened to crisis communication and common sense gone horribly wrong, with dozens involved in making decisions that resemble games of chance.

For example, the majority of physicians who helped Dr. Dipak Desai create a multi-million dollar gastroenterology business, which was closed after causing the largest hepatitis C scare in the country, are reportedly working together to reestablish practices in southern Nevada. Their decision has left the community perplexed.

The few who would comment might have refused to speak about the past and ongoing investigation, but were happy to offer that they wanted to “
get back to the community and give good quality medical care. Our patients deserve the best.” According to the story, at least three clinics may be opened by former Desai physicians.

For example, while no one had reported questionable procedures at the clinics, the investigation has revealed several nurses had complained and at least one quit on the same day she started. In addition to original reports of unsafe injection practices, the investigation has revealed that devices put in patients’ mouths for some procedures as well as single-use biopsy forceps that snip tissue were being reused.

These findings came after a poorly thought out full-page advertisement taken out in the Las Vegas Review-Journal last March. Since, most decisions seem to have followed public outcry.

For example, legislators seem to have prompted the state Board of Medical Examiners to take action after almost two months. The state’s attorney general just recently filed complaints against Desai and Dr. Eladio Carrera, another of the one of four co-owners, on behalf of the board. Both doctors were directly linked to patients who were infected. Desai had voluntarily stopped practicing medicine during the investigation weeks ago.

However, the once prominent physician continues to make decisions that further erode his credibility. The latest speculation, according to the Las Vegas Sun is that Desai may attempt to flee the country while multiple agencies continue their investigation.

The speculation arose after sources said Desai took ownership of two leased Mercedes-Benzes so they may shipped to the country of Dubai. While authorities have not charged Desai with any crime, authorities have flagged his passport, asking that they be notified if he tries to leave the country.

Sometimes public relations practitioners liken crisis communication to proper spin and damage control, rolling the dice on the location of press conferences or playing the “advice of legal counsel” card too frequently, when questionable actions — like shipping your cars off to another country — are patently more damaging than full disclosure.

Besides, sooner or later, public relations practitioners need to remember that reporters learn quick fix tactics as fast as professional dream them up. If you think they don’t know that press conferences are sometimes held across town to avoid on-site coverage, the only person you are really fooling is yourself.

Playing In The Road: State Needs PR Help

Sometimes elected officials are only as good as their advisors. One wonders what Nevada Gov. Jim Gibbons’ advisors were thinking recently, allowing the governor to address the crisis surrounding the Endoscopy Center of Southern Nevada, almost a full month late, without the most basic facts, and without any sense of empathy for those affected.

Instead, he came out against the media, criticizing them for their “buffoonery” in covering the health crisis caused by the Endoscopy Center and downplaying the roll of majority owner Dr. Dipak Desai, despite mounting public testimony that Desai and other doctors directed nurses to employ unsafe practices.

John L. Smith, columnist for the Las Vegas Review-Journal, lists dozens of mistakes made by the governor today. Smith likens him to a clown, with a rubber nose and oversized bow tie. David McGrath Schwartz of the Las Vegas Sun called it a crisis response dance.

Papers across the state have published similar reviews, likening the stunt to playing in traffic. It hardly matters that the governor regretted his words the next day.

“My intention was to be sure that people were not fearful of seeking medical care because of the intense media coverage, it was a poor choice of words and I regret it,' Gibbons had said, referring to “buffoonery.”

He might regret them even more. After several members of the Nevada State Board of Medical Examiners revealed ties to the Endoscopy Center of Southern Nevada and recused themselves from any investigation, Gibbons called for their resignations as well as that of the board’s executive director. Some publicly stated today that they have no intention of stepping down. Maybe they sense the obvious.

But this post isn’t about the governor. It’s about communication.

If the intent of the communication was to instill confidence in a health care system under fire, the better message needed to be about 180 degrees different. What could it have been? Here is a five-minute solution, painfully better than the one delivered over the weekend.

• There is a health care crisis; empathy for those affected
• That any Nevadans (regardless how few) are affected is not acceptable or tolerable
• There are many excellent doctors doing their best to help statewide
• There is a cross-agency investigation being undertaken by the state
• A task force is making recommendations to ensure it does not happen again
• Board members with conflicts of interest might ask themselves if they can meet their obligations to the state
• But above all, if you or a loved one is affected, it is important for you and your family to be tested. It’s the right and responsible thing to do.

In addition, the state could have recognized several medical facilities that are offering educational seminars to help people who need to be tested. And, it could have urged Nevadans to give blood. Donations at United Blood Services’ five fixed sites have dropped 25 percent since the crisis began in early March.

That is the message the state needed. Instead, the wrong message had the opposite impact. It has further shaken the citizens’ confidence in the center, in the health care system, and in the state.

It didn’t have to be that way. Crisis communication 101 suggests that you never adopt someone else’s crisis as your own. Or, in other words, no brand is so invincible that it belongs playing in the road against oncoming traffic while cursing at delivery boys when they drive by. You know, they don't ride bicycles anymore. Someone might get hurt.

Playing The Numbers: Endoscopy Center Forgets People

Since the beginning, the Endoscopy Center of Southern Nevada, which is responsible for the largest hepatitis C scare in the history of the country, has communicated a message much like it ran its practice — by the numbers.

Its message is clear. The risk is minimal to 40,000 patients who must be tested for hepatitis C as well as hepatitis B and HIV. Only six patients have been proven to be diagnosed with acute hepatitis C. Except… Except…

We’re not really talking about numbers. We’re talking about people.

Numbers don’t tell stories; people do.

My longtime friend and colleague Keith Sheldon, for example, is not a number. He’s a person. He’s also one of the many who never learned he needed to be tested because of a letter. He learned, like thousands of other patients, through the media.

“I was sitting in bed with my wife reading the Saturday paper,” Sheldon said. “At first, I didn’t think the crisis applied to me.”

It wasn’t until his wife started crying that his initial reaction, things like this happen to other people, didn’t apply. Sheldon was not only at risk, but had unknowingly put his wife at risk. And learning the center was notifying patients by letter and setting up a foundation was little consolation.

“As soon as I learned my health was at risk, I immediately made an appointment with my doctor,” he said. “He saw me the same morning … when it comes to your health, you don’t wait for red tape.”

It didn’t matter to Sheldon that he had to pay out of pocket for the test, despite promises that the center had already made arrangements with various health insurance providers. He needed answers … answers that still haven’t arrived. Because of the number of people being tested, most results will not be made readily available for seven to 10 days, which is next Monday or Tuesday at best.

“I hold the clinic’s management responsible for this disaster,” Sheldon said. “Specifically those individuals who had the day-to-day responsibility and oversight for how business was conducted.”

Recently, one doctor, who was employed at the center and asked the Las Vegas Review-Journal for anonymity because he fears "retaliation" from Dr. Desai (majority owner of the Endoscopy Center of Southern Nevada), said he left the clinic in 2000 — which places the start of the unsafe practices back to more than a decade — because he "was so depressed." He was reprimanded several times, the article says, because he was allegedly pressured to perform unnecessary biopsies, coupled with fabricated lengthy patient examinations, that could add more than $300 to a bill.

"It was so unethical," he said. "I couldn't live with myself."

As more stories surface, it seems to be that the entire practice was built on the concept of placing profits before people. By the account, it was always about playing the numbers: Reusing a single dose vial or the same syringe here and an extra biopsy there, well, it could help the clinic pay the bills.

Sheldon, who also teaches public relations and assists companies in crisis communication situations, is also mortified by the lack of empathy or apology by the center. From a business, ethical, and public relations perspective, the clinic is doing a dismal job of handling this crisis, he said.

“Rather than waste thousands of dollars on a poorly written, ill-conceived and
disingenuous full-page ad in the Review-Journal, the Endoscopy Center should have offered to pay for people to have their blood tested immediately,” he said. “ You just cannot put profit over people.”

When asked how the clinic might have responded, Sheldon offered…

“We demonstrated dismal judgment. We lost track of our mission of taking care of our patients to the best of our ability. We put profits over patients. For these transgressions, we are sorry. We pledge to make full restitution to the degree determined by the courts.”

I wholeheartedly agree. Anytime a company has surrendered all measure of professional efforts, there is nothing left to be done other than offer full disclosure, pledge full restitution, and permanently resign from the medical profession. These are not numbers; they are people — 40,000 people who are slowly learning through the media that they and their families — wives, husbands, sons, daughters — are at risk, one person at a time.

And, worse, it seems more and more clear every day that the numbers like six people infected and 40,000 at minimal risk, are designed to diminish the impact of real people, are growing every day. Dr. Desai ran six number-crunching clinics in southern Nevada. And, it has already become clear that the first clinic only offered a truncated list with 40,000 patients. Many more patients need testing.

For all of them, restitution seems obvious.

• Direct and full compensation for all testing without any fees being passed on to insurance companies.
• Free counseling for patients who are having challenges coping with the situation.
• Compensation for the pain, suffering, and anguish caused to the thousands of people put in harm’s way.
• The maximum amount paid out in medical malpractice to anyone who has to endure a shortened lifespan and risk of infecting loved ones as well as compensation to their families.
• The pledge that none of the management team will ever work in the medical profession again.

These are the only numbers we’re interested in reading about. As for the rest, it’s all about people. People you know and people who may never know if they are infected.

When handling a crisis, always put people first.

Sheldon offers up some hard but true advice for companies that abuse public or employee trust: “Would you have treated members of your family like this?”

The answer, more than likely, would be no. But we can only assume that. Other than the one-page advertisement that claimed patients should still have trust in the clinic, Dr. Desai isn’t talking.

Repeating Milgram: Endoscopy Staff Behavior

In 1963, Stanley Milgram gave the world a glimpse into obedience by publishing the results of his experiment in the Journal of Abnormal and Social Psychology. I learned about the study in college.

The experiment, conducted at Yale University, tested how much pain one participant would inflict on another, provided the participant inflicting the pain would relinquish responsibility to the person they perceived as an authority.

Although the experiment was staged (the person enduring the pain was a actor) and no one was injured, Milgram found that 65 percent of participants would administer an electric shock of what they believed to be 450 volts. Even more surprising, not one participant refused to administer shocks before the 300-volt level, despite several switches clearly marked “danger: severe shock” and the actor complaining of chest pain, banging on the wall, or dropping silent.

With light to moderate prodding, an authority figure in the experiment was able to convince the participant to deliver electric shocks. Some would protest, but continue to “shock” the actor nevertheless.

Understanding Obedient Staff Behavior.

Understanding Milgram’s experiment was followed by strip search prank call several years ago. It was not an experiment. It involved a caller claiming to be the police and instructing fast food managers to strip search employees. In more than 70 reported cases, managers surrendered personal responsibility to an authority figure, becoming like a puppet, and demanded employees remove their clothes.

By comparison, the notion that staff at the Endoscopy Center of Southern Nevada would blindly follow the instruction of administrators to reuse vials of single-dose medicine would likely take less surrendering of responsibility to a higher authority, especially one who had served on the board of the Nevada Board of Medical Examiners.

Why? Proximity to the authority figure. Perceived level of authority. Assurances of a minimal risk. Other nurses already practicing the procedure. And on. And on.

It the only answer for people still wonder why they didn’t stop the practice at the Endoscopy Center of Southern Nevada. Objectivity was sacrificed in favor of perceived acceptance. As one CDC officer reported it: the center’s practices to be so obviously dangerous that it was like “driving the wrong way down the freeway.”

I feel the same way about the center's crisis communication plan. It's like watching a horror show of a horror show, where you watch the next victim stumble up stairs with a flashlight.

The latest update: The Las Vegas Metropolitan Police Department and county prosecutors opened a preliminary criminal investigation. These investigations join inquiries by the FBI and the Nevada attorney general’s office.

Add to all this news an endless stream of sources being tapped by the media, including a very telling and almost incoherent interview with the center’s recently hired third-party crisis expert. Somebody forgot to tell her she wasn't a spokesperson.

Employees Need To Learn To Say No.

Comedian George Carlin includes it in his bit. He says people are too fat and happy to question authority. He's right. It happens all the time.

Even on social networks, it's obvious people blindly follow perceived authority figures, sometimes even participating in a “pile ons” just to be accepted. There is no concern for facts. Most online diatribe can be traced back to obedience and acceptance. It happens everywhere in places all over the world, places just like the Endoscopy Center.

There is only one lesson, and more employees could learn it:

• Th nurses could have complained to the administration that the practices were unsafe, refused to perform them, and demanded correction.
• Upon administrative insistence, the nurses could have told the center to correct its practices or report the incident to county health officials.
• Upon insistence or further inaction, the nurses could have resigned and immediately reported the infractions to county health officials.

Three simple steps could have protected thousands of people from being at risk of hepatitis B, hepatitis C, and HIV. Unfortunately, no one was up to the task. In all the world, only a mere 10-25 percent of people would have been willing to step up to the plate, depending on the country where they were raised.

Skirting Apologies: Endoscopy Center Not So Sorry

On Friday, the Las Vegas Review-Journal reported that the city of Las Vegas shut down the Endoscopy Center of Southern Nevada. After waiting until six patients had completed treatment, all employees were asked to leave the building and the doors were locked.

As mentioned last week, the Endoscopy Center of Southern Nevada was using single dose vials of medication, some of which had become infected with hepatitis C, a potentially fatal blood-borne virus, more than once. Hepatitis C is not the only potential infection that could have been spread; some fear hepatitis B and HIV could have also infected patients, some as far back as 2004 or earlier.

In what appears to be an effort to "control communication," the Endoscopy Center of Southern Nevada, which has declined to comment to any media outlet, did not seem short on words this Sunday. They ran a full-page advertisement in the Las Vegas Review-Journal.

The advertisement, designed to mimic an "open letter to the public" with the headline “Open Letter to Our Patients and the People of Southern Nevada,” smacks as a near-exact carbon copy of an ill-advised communication disaster attempted by Jack in the Box several years ago. Somebody must have missed that case study. It did not work then. It will not work today.

Dr. Dipak Desai offers sympathy but no apology.

“Recent events at the Endoscopy Center of Nevada of Southern Nevada are causing great concern to our patients and the community at large.”

This opening line says it all. It is so obviously written to mask where the responsibility might reside. This was not an accident. The responsibility lands squarely on the medical director and presumed "letter writer" of the advertisement.

In fact, according to the Las Vegas Review-Journal story referenced above, clinic staff has already told health investigators that they knew this technique fell well below accepted medical practices and was dangerous. However, they say they were ordered by administrators to engage in the practice anyway. So they did. The ad continues…

”First, I want to express my deepest sympathy to all our patients and their families for the fear and uncertainly that naturally arises from this situation. The trust we have spent for years building in this community has been challenged by the discovery that some of our patients may have been exposed to blood-borne diseases at our facility. In cooperation with the Southern Nevada Health District and other health agencies and officials, we have carefully reviewed our procedures and implemented the changes they recommended.”

Despite the near admission in the third sentence, there is no direct admission (despite mounting testimony) or any apology whatsoever. Clearly, the aim is an ill-advised attempt to position the crisis as an accident while once again attempting to leverage "trust" that patients placed in the clinic while they were "unknowingly" placed at risk by what seems to be a very "knowing" staff. The ad continues…

“We are also working with third party payers to be sure all our patients who need to be tested are, and that the costs are completely covered.

For those who are uninsured, a foundation is being set up to cover the cost associated with their tests. You will learn more about this in the days to come.”

It amazes me that any company or organization would attempt to promote the argument of denial, despite the fact that the clinic is already proven responsible for the infection of several patients. In addition, the attempt to portray itself as a good public citizen by setting up a foundation reminds me of post-crisis measures employed by Jack In The Box, which they only implemented after sustaining a loss of $20 to $30 million.

The ad continues with another paragraph, first thanking the health district for bringing the problem to the Endoscopy Center of Southern Nevada’s attention and continued clarification that the clinic did not spread the disease to patients one way as has been reported, but another erroneous way all together. As if that matters. The ad closes…

"At the same time and without making excuses, I think it’s important for the public to know that the chances of contracting an infection at our center from 2004 though June 2007 were extremely low. Of the six cases reported, it appears one exposure took place in July 2007 and five on Sept. 21, 2007. Regardless, if you were a patient at our facility, I encourage you to get tested.

Thank you for allowing me to share these thoughts with you.”

The six cases mentioned were those that prompted health officials to conduct an investigation, and not the results of 40,000 tested. Worse, this closure attempts to use the number of confirmed infections as a tool toward exoneration, as if six patients who have been confirmed infected are less significant when compared to the 40,000 that have yet to be tested.

What it also neglects to mention is that health officials are also concerned, however, that even more patients could have been infected prior to 2004 when the clinic operated under a different name. Not everyone is taken by these controlled statements. As expected, one local law firm, Craig P. Kenny & Associates, ran a full-page advertisement in the same section. Its advertisement encourages patients to contact the firm to discuss legal action.

While heroes are seldom found during a crisis, there is one clear hero in Las Vegas. Quest Diagnostics, which is completely unaffiliated with the Endoscopy Center, is the first business to offer to test patients for free. The offer from Quest Diagnostics to provide this community service came after the Endoscopy Center was slow to offer the same and after another health care provider, one that sent overflow patients to the Endoscopy Center, shrugged off any responsibility.

As shocking as it seems, the Endoscopy Center of Southern Nevada has not made any mention of how it intends to compensate those patients who have been infected nor has there been any comment that seems to demonstrate remorse or empathy. So far, it seems they are content to play the numbers and control an uncontrollable message.

Causing Crisis: Health Clinic Spreads Virus

Sometimes a crisis communication checklist is not enough. The Endoscopy Center of Southern Nevada is attempting to apply some practices, but the message is failing to resonate. I’m not surprised.

This is the largest hepatitis C scare in the history of the country.

The Endoscopy Center of Southern Nevada was reportedly using single dose vials of medication, which had become infected with hepatitis C, a potentially fatal blood-borne virus, through their initial use and were used again. Hepatitis C is not the only potential infection that could have been spread.

The Southern Nevada Health District is asking some 40,000 patients who had procedures requiring injected anesthesia at the clinic between March 2004 and January 11, 2008, to contact their primary care physicians or health care providers to get tested for hepatitis C as well as hepatitis B and HIV. Given the transient nature of Las Vegas, it is nearly impossible to tell how many of these patients have moved out of the area or have been living with an infection for years.

The reality and gravity of the situation is severe enough that the statement released to the media by the Endoscopy Center of Southern Nevada fails to exhibit even a basic understanding of crisis communication, considering the severity of the issue.

“On behalf of the Endoscopy Center of Southern Nevada, we want to express our deep concern about this incident to the many patients who have put their trust in us over the years. As always, our patients remain our primary responsibility and we have already corrected the situation.”

Obviously not. If patients were the primary responsibility, this would have never happened. How could anyone even think such a statement was appropriate to include as a patient care message during a press conference that addressed wrongdoing of the worst kind — reusing single dose vials is widely known to pass infection.

The statement goes on to say things like “In addition to our corrective actions, we are on a mission to maintain the trust our patients have had in us during our years of service to southern Nevada.” They must be joking. And, unbelievably, they attempted to play the legal counsel card — pending class action suits already being organized and a criminal investigation — to limit their comments and refuse to take reporters’ questions. Unbelievable.

If you break off communication with the media during a severe crisis, they will have no alternative but to seek other sources. Every media outlet covering the story is doing exactly that.

According to the Las Vegas Sun today, several doctors unaffiliated with the Endoscopy Center of Southern Nevada have surmised that the clinic appeared to put profits ahead of patient care, directing staff to cut corners in order to accommodate the high volume of patients. The procedures were performed by certified nurse-anesthetists, with apparently no one at the practice willing to step up and say what they were doing was wrong.

These practices continued until the Southern Nevada Health District identified six cases of hepatitis C, five of which stemmed from the Endoscopy Center of Nevada. While the center continues to stress that the actual risk of anyone being affected by this is extremely low, it seems to be little consolation for the individuals. Elected officials are already calling for the removal of the clinic’s license.

This crisis has already been mishandled to the point of no return.

In such extreme cases, one might ask if the clinic is worth saving. While this could be debated endlessly, I’d rather focus on what they did wrong from a communication standpoint, which made this unrecoverable.

They are attempting to apply a truncated crisis communication formula frequently employed by public relations professionals who have little real world experience. Worse, they are being selective in which ones they are using — the statement doesn’t even include an apology, possibly for fear of admitting criminal negligence.

Look, crisis communication is a process and not a formula. You can come forward, apologize, explain the incident, address corrective measures, seek outside consult, promise it will never happen again, and perhaps demonstrate some measure of empathy (I was told the owner appeared empathetic at the press conference) all you want. But it won’t change gross negligence.

What the crisis communication team needed to consider.

• The clinic needed to come forward sooner and explain precisely what occurred and why it occurred, regardless of potential civil and criminal cases. If the crisis was caused by placing profits before patients as some speculate, an admission is appropriate.

• The clinic needed to apologize, at minimum, to the five people likely infected with hepatitis C by its procedures and offer immediate restitution. It further needed to voluntarily pay for a proactive location and testing of all 40,000 patients as well as family members that may have been affected as a result.

• The clinic needed to maintain an open door policy to address all concerns and questions from the media and other stakeholders, regardless of personal jeopardy, as personal and public safety remain at risk.

• The clinic needs to verbalize empathy, sympathy, and embarrassment over its procedural practices without any trite statements revolving around preserving patient trust and promises that it will never happen again. It would seem more logical for the clinic to voluntarily dedicate 100 percent of its resources to the crisis.

• Dipak Desai, medical director and majority shareholder in the practice, needs to step forward as his own spokesperson and promise to step down immediately after overseeing restitution to the victims. Desai also needs to fully cooperate with all investigations and help determine which doctors and nurses were engaged in these procedures or knew about the procedures but neglected to speak up.

All this should have already happened. However, it did not. Given the severity of the crisis and the initial handing, it’s likely this will be unrecoverable. And frankly, despite placing it in the living case study slot, maybe that is for the best if it does not recover.