VA patients hope for real answers

Congress to address contamination at hospitals By Clay Carey THE TENNESSEAN • and Bill Theobald TENNESSEAN WASHINGTON BUREAU • June 15, 2009 Walter McRae wants to hear the U.S. Department of Veterans Affairs tell him it is sorry. He wants its highest-ranking officials to say they're doing something to make sure veterans who turn to the government for medical treatment aren't being exposed to dirty equipment, the way he may have been six years ago. And he wants to know that those problems aren't going to make him sick someday. McRae and other veterans may begin getting some answers Tuesday, when a congressional committee finds out what VA investigators have learned since the chilling discovery of problems with endoscopic exams at Murfreesboro's Alvin C. York Medical Center and other agency hospitals. In February, the VA advised thousands of patients to get blood tests after it discovered that valves on colonoscopy tubes used at the Murfreesboro hospital weren't working correctly, possibly exposing patients to other people's bodily fluids. Since then, at least 28 patients have tested positive for hepatitis or HIV. Officials with the VA would not comment on the upcoming hearing. Some in Congress and in veterans groups have been supportive of how the agency has handled the problem, while others have criticized the VA for not being open enough about its investigation. The VA has said the chances of catching diseases because of the colonoscopy problems are slim, and it has insisted that there's no way to know whether the patients contracted those illnesses at the hospital. Thirteen VA officials are scheduled to testify Tuesday — including Juan Morales, director of the Tennessee Valley Healthcare System, which operates the Murfreesboro and Nashville VA hospitals along with 11 clinics in Middle and East Tennessee and southern Kentucky. "I don't know if there is anything they could say that would make me happy, not after they did something like this," said McRae, a 64-year-old former Marine from Old Hickory. McRae's tests came back negative. Fellow Vietnam veteran Thomas Mayo wasn't so lucky. When Mayo got his test results back in February, he learned he had Hepatitis C, a blood-borne liver disease. He got a colonoscopy at Murfreesboro's VA hospital in late 2006. The Chattanooga resident insists there's no other way he could have caught the virus. "There's nothing they can say," said Mayo, 58. "They've given me something that may kill me. They didn't do it intentionally, but they should have done better than they have." Procedures criticized U.S. Rep. Phil Roe, a Knoxville obstetrician-gynecologist and the top Republican on the House Veterans Affairs subcommittee on oversight and investigations, believes health-care workers at VA facilities in Murfreesboro and in Georgia and Florida failed to follow rules for servicing and cleaning the devices, which are used to examine the colon, nose and throat. At big institutions, people do things a particular way and train the next person to do it the same way, Roe said. "That's why protocols are important," he said. "Those procedures have to be ironclad." The first group of VA witnesses scheduled to testify Tuesday are from the agency's inspector general's office. They are expected to reveal what they discovered during an investigation requested by Congress. Roe said he has not yet seen the IG's report. He hopes to learn not only how the scopes were handled improperly but who is responsible and what is being done to prevent problems in the future. A total of 6,805 veterans who had colonoscopies at the Murfreesboro hospital over the previous five years were notified. Of the 5,215 tested, seven were found to have Hepatitis B, 20 had Hepatitis C, and one was carrying HIV. Testing expanded The discovery in Murfreesboro prompted the VA to review the use of its endoscopes around the country. It discovered problems with how the devices were cleaned at the Charlie Norwood Medical Center in Augusta, Ga., and the Bruce Carter Medical Center in Miami. Tests of nearly 3,000 additional veterans found 20 cases of hepatitis and five who tested positive for HIV. Rep. Bart Gordon, D-Murfreesboro, is not a member of the Veterans Affairs Committee but has been given permission to sit in on the hearing. He agrees with Roe that it will be difficult to determine whether the infections were caused by the mishandling of the equipment, but he wants the sick veterans to get help. "I hope that VA officials will address possible plans to help infected veterans pay for needed treatment in full," Gordon said in a written statement. "At this point, my hope is that the VA will give infected veterans the benefit of the doubt and not require these veterans to pay co-pays for their treatment." Roe, Gordon, and Steve Robertson, legislative director of the American Legion, all said they were generally satisfied with the way the VA handled the problems once they were discovered. "We applaud the VA for its openness," Robertson said. He described the incidents as a "hiccup" in a system lauded as a model for the country. Others are more critical about the way the VA has handled the problem and communicated with patients. Prior infections alleged Rudolph Cumberbatch, a former chief of surgery at the York hospital, has questioned why the VA decided to not re-examine tests that were done before April 2003. "Many patients (may) already have Hepatitis C, Hepatitis B or HIV (before the colonoscopy)," said Cumberbatch, who worked at the Murfreesboro hospital from 2001 to 2005. He insisted that none of the problems could have happened on his watch. VA officials did not respond to questions about his claims. Veteran Larry Scott is founder and editor of VAwatchdog.org, a Web site that focuses on veterans' health care, benefits and other issues. Scott believes the VA should do more to prove that equipment is being cleaned properly at all of its hospitals, and it should be more open about what inspections at other medical centers have found. That sort of openness would be a welcome change, said David Bartlett, senior vice president of Levick Strategic Communications, a crisis management and communications strategy firm in Washington. "What's being done to fix a problem is much more important in the public's mind than what happened," Bartlett said. "I can't imagine they aren't doing a lot of things, but you'd never know it from the communication that is going out." At Tuesday's hearing, the VA has an opportunity to start righting some of those wrongs, Bartlett said. "The last thing they should do is be defensive. The last thing they should (do) is minimize the problem. … For anybody that feels their life is at risk, it is anything but a small problem." Vet switches hospitals R.J. Simmons, an Army veteran from Tullahoma, got a colonoscopy at York in early 2006. He tested negative for HIV and hepatitis earlier this year. Since the concerns became public, Simmons abandoned York in favor of the VA hospital in Nashville. He worries that similar problems may arise there, but he has few other options for medical treatment — at 63, he's not old enough for Medicare, and he can't afford private insurance. "VA's all I got," Simmons said. "I put my trust in them. Then when something like this happens, it's devastating. Mayo, the veteran who tested positive for Hepatitis C, just hopes the VA solves the problem. Last month, the hospital sent him a letter suggesting another colonoscopy. He threw it in the trash. "I hope they don't cause this heartache on nobody else," Mayo said. "Veterans deserve to be treated better. The hospital needs to crack down on whatever it takes to not let this happen again."