Amid growing controversy over
procedures that exposed 10,000 veterans to the AIDS and
hepatitis viruses, the Department of Veterans Affairs is now
bracing against news that one of its facilities in Pennsylvania
gave botched radiation treatments to nearly 100 cancer patients.
Veterans groups and lawmakers
say VA hospitals have permitted these violations because federal
regulations allow doctors to work with little outside scrutiny.
They say the VA health system, with its under-funded hospitals
and overworked doctors, is showing signs of an "institutional
breakdown," in the words of one congressman.
An official with the American
Legion who visits and inspects VA health centers said
complacency, poor funding and little oversight led to the
violations that failed the cancer patients in Philadelphia and
possibly infected 53 veterans with hepatitis and HIV from
unsterilized equipment at three VA health centers in Florida,
Tennessee and Georgia.
"Lack of inspections, lack of
transparency" were likely to blame, said Joe Wilson, deputy
director of the Veterans Affairs and Rehabilitation Commission
for the American Legion, who testified before Congress this
month on transparency problems in a budgeting arm of the VA.
Wilson said the American
Legion is investigating the case of the VA Medical Center in
Philadelphia, where doctors gave 92 veterans incorrect radiation
doses for treatment of prostate cancer during a six-year span
when no peer review or proper oversight measures were in place,
the
New York Times reported.
Those doctors, whose
continuous errors were finally detected last year, were
immediately fired from their work at the VA center, but not
before putting the lives of the 92 veterans at risk. That news
came on the heels of months of investigations into
medical lapses that permitted endoscopic procedures like
colonoscopies to be performed improperly for years.
Wilson told FOXNews.com that
poor funding has aggravated problems, and that money is often
misspent on repairs for old facilities and equipment to help
manage a construction backlog that has put the VA years behind.
He said the aging facilities are incapable of handling or
properly operating new technology and equipment.
"The average age of VA
facilities is about 49 years," he said. "That's too old. In the
private sector the average age of facilities is about 12 years."
The VA Medical Center in
Philadelphia is 57 years old. Doctors there were performing a
procedure called brachytherapy, in which radioactive seeds the
size of rice grains are implanted into organs to kill cancer
cells.
But doctors there were
sometimes implanting the seeds into the wrong organs, and in
many cases gave significantly less radiation than was prescribed
-- including during an entire year when their monitoring
equipment was broken and they were essentially flying blind, the
New York Times reported.
And
when one physician, Dr. Gary Kao, was found to have botched a
brachytherapy in 2003, he simply changed his surgery plan to
make the error appear to be intentional, the Times reported.
Despite the violations that
cost Kao his job, some veterans' groups said the general care
provided by VA is among the best in the world, and they
applauded the department for taking steps to address its
problems.
"Our feeling is that the
quality of the care is excellent," said Jay Agg, a national
spokesman for AMVETS, the American Veterans organization.
"However, the fact that it occurred in the first place really
points to a lack of oversight, and corrective measures need to
be taken."
Both AMVETS and the American
Legion welcomed advanced funding that was granted to VA this
week, reversing a trend of late funding that has kept the
department on tenterhooks for nearly 20 years.
But investigations conducted
by the VA last month show that systemic problems remain. Under
half of VA centers given surprise inspections had proper
training and guidelines in place for common endoscopic
procedures.
VA Secretary Gen. Eric
Shinseki and senior leadership "are conducting a top to bottom
review of the Department," a VA representative told FOXNews.com.
"They are implementing aggressive actions to make sure the right
policies and procedures are in place to protect our veterans and
provide them with the quality health care they have earned."
The representative said that
all brachytherapy treatments have been ended at the Philadelphia
hospital, and the VA has hired a national director of radiation
oncology and developed standard procedures for calculating the
accuracy of seed placement.
But veterans advocates say
that won't be enough, and they say they haven't seen any
evidence of changes that could fix what they call a broken
healthcare system.
"How many patients can you see
in a day and still give proper care?" asked Jim Strickland, a
veterans' advocate and former health care technician who
contributes to
VAWatchdog.org. "There aren't enough physicians to handle
the crisis that the VA faces."
Richard Dodd, a litigator who
has represented veterans in lawsuits against the government,
said that poor funding has lowered the quality of care and
interest from some physicians.
"They're generally
under-funded ... and I think the interest of the doctors suffers
to some degree," he told FOXNews.com. "Generally speaking, the
physicians that work at the VA work there because they have no
interest in private health care, and in some situations are
unable to find jobs in private industry."
Strickland said care and
oversight would not improve until funding is increased and the
leadership makes sweeping changes.
In the meantime, he said, "we
are doing such a disservice to our veterans."
Lawmakers, who are bristling
at that "disservice," led congressional inquiries into the
endoscopy debacle during hearings last week.
"[T]here is no question that
shoddy standards -- systemic across the VA -- put veterans at
risk and dealt a blow to their trust in the VA," said Rep. Harry
Mitchell, the Arizona Democrat who chairs the House Veterans'
Affairs Subcommittee on Oversight and Investigations.
Sen. Arlen Specter, D-Pa., is
now gearing up for action over the Philadelphia facility. He
wrote to Shinseki Tuesday asking "what allowed such chronic
failures to occur" and demanding to know what steps the VA has
taken "to ensure that such problems do not occur at other VA
hospitals."
Specter called for a field
hearing of the Senate Veterans Affairs Committee on Monday, June
29, calling the alleged abuses at VA hospitals "very serious"
and promising that they would get a "full and prompt review."
A lawyer for Gary Kao said the doctor would appear at the
Philadelphia hearing and answer any questions from Specter
"fully and completely."