Freedom isn't free
Information on medical malpractice by VA, or Veterans Administration hospitals, physicians, and clinics run by the Department of Veterans Affairs. While many veterans receive satisfactory medical care from the VA, others do not. This site is designed to provide information to those veterans, who have received negligent medical care, from a Veterans Administration hospital, doctor, physician's assistant, surgeon or other VA medical provider and to encourage discussion about this problem. The VA paid out more than $2,000,000 a week during 2004 for medical malpractice claims. It would be better for our veterans, and for the taxpayers, if the VA chose to provide better medical care instead.
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June
15, 2006 Patient Safety Issues at the VA- Congressional Hearings
Audio Testimony
Doesn't it just make good sense to clean all of the fecal matter from an instrument that has been used to examine someone's prostate?
April 3,2006-Apparently, the VA didn't think so, and didn't bother to do it, because the manufacture didn't tell them that they had to. In what may turn out to be one of the "yuckiest" messes ever, thousands of veterans may have had their prostates examined, without having the instrument that was inserted, you know where, properly cleaned between patients. Thousands of veterans may have been exposed to potential infections including HIV. If you've had a prostate exam at the VA you will want to read the whole report.
BK Transducer Patient Safety Alert
Judge awards $7,400,000 to mothers whose children died as a result of malpractice by the VA. VA improperly releases Coatesville, Pennsylvania mental patient who shoots and kills four.
Read the complete
Judge to rule in medical malpractice case involving Wilkes Barre VA VA improperly releases patient in Wilkes Barre, Pennsylvania. Patient dies within minutes of discharge after a three day hospitalization, from heart condition that VA knew about when it discharged the veteran. Veterans Administration does not contest that it committed malpractice. Instead the VA contended that the veterans life was not worth that much.
VA Pays 448 Malpractice Claims in 2005 According to information obtained from the Department of the Treasury, 448 claims for medical malpractice were paid for medical malpractice claims by the Veterans Administration during 2005.
VA Estimates That It Has $528,000,000 in Claims Pending Against It- Paid Out $108,000,000 in 2004
Auditors Find $12,000,000 Discrepancy in VA Medical Malpractice Payments
1995 GAO Report on Malpractice Claims at the VA
One of the many investigations by the government about medical malpractice at the Veterans Administration, that shows that everyone knows about the medical malpractice problem at the Veterans Administration, yet little has been done about it in the last 10 years.
System Wide Reports & National Issues
VA Estimates That It Leaves a Retained Surgical "Item" in One Out of Every 6,000 Veterans That It Operates On....
Department of Veterans Affairs VHA DIRECTIVE 2006-018 Veterans Health Administration Washington, DC 20420 April 3, 2006
PREVENTION OF RETAINED SURGICAL ITEMS
- PURPOSE: This Veteran Health Administration (VHA) Directive provides policy to ensure that surgical items are not retained in a patient following surgery.
- BACKGROUND
- a. Surgical items are foreign bodies defined as instruments, sharps, sponges, or any materials used by the surgical team to perform a surgical procedure. Sharps are surgical needles, aspirating needles, blunt needles, scalpel blades or any items with a sharp or pointed edge that pose a risk for skin puncture by members of the surgical team. Sponges include 4" x 4" sponges, 2" x 2" sponges, laparotomy pads, surgical towels or any absorbent materials designed to absorb blood or bodily fluids that are not intended to remain in the patient’s body after the surgical procedure is completed.
- b. Estimates of rates of retained surgical items have ranged from 1 in 19,000 to 1 in 1,500 operations (see subpar. 5b). Recent data based on the Agency for Healthcare Research and Quality’s Patient Safety Indicators suggest that the Department of Veterans Affairs (VA) rate in 2001 was approximately 1 in 6,000 inpatients
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According to the VA's 2006 Office of Inspector General Report, the "Environment of Care" needs to be improved at 17 out of the 23 medical facilities that it inspected during fiscal 2005
"Environment of Care" Chart by VA Facility Fiscal 2005
VA Confirms that the VA Director of Research Improperly Spent $1,700,000 on meals, travel, conferences and equipment
Veterans Affairs Memorandum
Date: March 22, 2004
From: Assistant Inspector General for Investigations (51)
Subj: Administrative Investigation – Use of Government Funds, Travel, Personnel,
Impartiality, and Management Issues, Research and Development Office, Veteran
Health Administration, Report No. 03-03053-115 (Case IQ-0179)
To: Under Secretary for Health (10)
1. Attached is our final report of an administrative investigation into
allegations against Dr. Nelda P. Wray, the Chief Research and Development
Officer in the Department of Veterans Affairs (VA) Veterans Health
Administration (VHA). Complainants alleged that Dr. Wray misused funds provided
to VA by pharmaceutical companies; misused Government travel funds; unfairly
hired, promoted, and managed staff; and did not act impartially or reasonably
when approving and disapproving Research and Development Office projects.
2. We substantiated that, between
January 2003 and October 2003, Dr. Wray and certain members of her staff were
responsible for improperly spending nearly $1.7 million provided to VA primarily
by pharmaceutical companies. The funds were maintained and administered by
Friends Research Institute, Inc. (FRI), a private nonprofit corporation. While
the pharmaceutical companies provided these funds for VA’s use in conducting
specific cooperative research studies,
the money was used for purposes unrelated to the projects specified, such as
costly research equipment for an unrelated study; consultant and other
management services; conference facilities and meals; local and out-of-town
restaurant expenses; and other business-related and personal items. In effect,
this spending constituted an illegal augmentation of the Department’s
appropriations, and a misuse of position. Dr. Wray’s predecessors acted
similarly in misspending over $537,000 of these funds during calendar year 2002
One Third of VA Hospitals Inspected During 2003 Did Not meet the VA's Standards for Infection Control
The VA's own studies show that nearly half of the hospitals that it inspected during 2003 did not meet the VA's standards for cleanliness and sanitation. More than a third of the hospitals that the DA inspected during 2003 did not meet the VA' standards for infection control.
VA uses unsupervised residents and other practices that would not be accepted elsewhere
VA Skirts the law to employ foreign doctors
Have you ever wondered why it is so hard to understand your the doctors at the VA?
No wonder the VA can't afford to pay for the best doctors and equipment,. Perhaps the dentists at the Philadelphia VA could afford enough surgical gowns so that they could comply with the VA's guidelines and change gowns between patients if it cut back on travel, maybe the VA could afford soap for the employee rest rooms, if it spent less on lavish "off site entertainment"
GAO Study Finds VA Health Care: Improved Screening of Practitioners Would Reduce Risk to Veterans Does it really surprise anyone that the VA would provide better medical care and have fewer medical malpractice cases, if the VA would screen potential doctors more closely? Are you surprised that the VA would hire doctors on the "no hire" list? Was your VA physician a terrorist? Surprisingly, some veterans can answer this question in the affirmative
Prime Time with Diane Sawyer-Hidden Camera Investigation into VA Hospitals April 2004
Secretary Principi was supposed to be interviewed for this, but when he found out about the "hidden camera" footage, he canceled the interview
Reports Organized by Veterans Administration Medical Facility
Click here to find out what is going on a Department of Veterans Affairs medical facility near you.
Current Veterans Administration Policy on Malpractice Disclosure to Patients
It is the policy of the Department of Veterans Affairs that medical malpractice should be disclosed to a patient who has received inadequate medical care. "The medical center will inform the patient and/or the family, as appropriate, of the event, assure them that medical measures have been implemented, and that additional steps are being taken to minimize disability, death, inconvenience, or financial loss to the patient or family." The manual also states that "District Counsel will advise the medical center Director about informing the patient and/or family of their right to file ... Application for Compensation and Pension ... or to file an administrative tort claim. ... " Patient Safety Improvement. Department of Veterans Affairs VHA Manual.
VA Regional Counsel explains how disclosure helps to start the statute of limitations
....The point you made about disclosure verses discussion is really important. What we found in some cases is that there’s a tendency to prematurely discuss something that really hasn’t been ascertained. We do not exactly know the cause of what happened, but people are guessing at it because they want to give an answer to the patient/family.
I do not think that is a very good idea at all. We have to tell them exactly what happened and in as factual terms as possible. I get very nervous out here in California when staff say, “We made a terrible, terrible mistake,” which is what some people advocated doing. You can tell them that an error was made. In fact, there are very good legal reasons to tell them an error was made. The statute of limitations for tort claims is 2 years. However, there is case law that states the clock does not start to run until the patient knows or should have known about the facts.
So if we do not disclose we could have that 2 years statute almost forever, extending until they do find out. And then your chances are a lot greater of being sued. I think we have to be truly factual about what we tell the patients. And if we do not know what happened, tell them “We are not quite sure yet what happened.” That’s a perfectly good answer, and we let them know when we find out. I really advocate for adhering strictly to the facts of the case....
Dr. Berkowitz:
Well, thank you Dale for your comments. Two really important points, the one that may have been hidden in there a little bit is that by documenting disclosure you start the clock on the statue of limitations. . Which may, from a legal standpoint, actually work out in your favor.
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Regional Counsel, San Francisco Comments on Disclosure Policy:
How the Disclosure Policy Benefits the Veterans Administration
While notifying the veteran of his right to file a tort claim may seem like a noble thing to do, it is also a clever defensive strategy on the part of the government. Under the Federal Tort Claims Act, a veteran has two years to present a proper administrative claim for the medical malpractice, to the Department of Veterans Affairs, from the date of the malpractice. In certain situations it can be difficult to determine the statute of limitations for malpractice claims. When the director of the medical center visits you and gives you a 95 to complete, the statute of limitations clearly has begun to run. If you are handed a Standard Form 95 claim for injury, completing it properly will have a significant impact on your ability to obtain compensation. You should obtain copies of all of your VA medical records, an examination from a non VA physician to determine the extent of your injuries and consider retaining counsel immediately to protect your rights, because the Veterans Administration and its lawyers are doing everything that they can to control your medical malpractice case.
The government will sometimes use a patient's relationship with a government medical provider to try to encourage a claimant not to make a claim, or to resolve the claim on terms that are favorable to the government. The hand out from the 1999 U.S. Army Claims Service Claims Training Course "NEGOTIATING HIGH VALUE CLAIMS" specifically states:
When the claimant has a close relationship with a military health care provider, keeping the provider advised in a general way of the progress in negotiations could be beneficial.
The only thing that is "beneficial" to the government is resolving a claim on terms that are favorable to the government. If a Veterans Administration health care provider is "interested" in your malpractice case, you should ask yourself are they interested in me, or they more interested in helping the VA, and their friends who work for the VA?
Videos
VETERANS MEDICAL ALERT from wallysparks76 on Vimeo.
Jim Leherer's report on what the VA is doing to improve patient safety, reveals many of the lapses in patient safety that have occurred at the VA over the last decade, including lack of hand washing, wrong site surgery, as well as the fact that the VA performs surgery on the wrong veteran about once a month.
Where Do VA Officals Go When We Need Medical Care?
Odds are that it is not the Veterans Administration...
We sent Freedom of Information Act requests to the VA to see what type of health plans top VA officials have chosen. The VA refused to release the information. As Federal employees VA doctors and staff members get to pick their health care plan from "...one of the widest selections of health care plans in the country". If they are not happy with the plan that they have chosen, they can change it each year during open enrollment.
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VA pays approximately 75% of your
health benefit premiumDuring 2004 the US spent on average $447.70 per month per employee for employees of the VA to get medical care from private health care facilities....
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This page was last updated on 01/18/2009 12:19 PM
