Posts Tagged ‘VA’

VA inspections show continued exam flaws

Tuesday, June 16th, 2009

From The Washington Times:

“Fewer than half of Veterans Affairs centers given a surprise inspection last month had proper training and guidelines in place for common endoscopic procedures such as colonoscopies – even after the agency learned that mistakes may have exposed thousands of veterans to HIV and other diseases.”

“The random inspections were conducted May 13-14 at 42 VA medical centers across the country. They found that 43 percent of the centers have standard operating procedures in place and have properly trained their staffs for using endoscopic equipment.”

VA says 3 positive HIV tests from follow-ups

Saturday, April 18th, 2009

From Army Times:

Three patients exposed to contaminated medical equipment at Veterans Affairs hospitals have tested positive for HIV, the agency said Friday.

Initial tests show one patient each from VA medical facilities in Murfreesboro, Tenn.; Augusta, Ga.; and Miami has the virus that causes AIDS, according to a VA statement.

Veterans deserve better from VA (Equipment should have been sterilized)

Friday, April 17th, 2009

From The Leaf Chronicle:

What’s been going on regarding safety procedures at Veterans Affairs Department medical facilities in Tennessee, Georgia and Florida?

A failure to properly maintain hospital equipment has led veterans to be exposed to HIV and other potentially fatal diseases. The VA, in fact, has warned more than 10,000 veterans to get blood tests.  VA sites in the three states cleaned but failed to properly sterilize equipment between patient treatments.  In Tennessee, at Murfreesboro’s Alvin C. York VA hospital, the VA blamed most of the problems on unclear or incomplete instructions from the colonoscopy scope’s manufacturer, Olympus American Inc. That company said in a statement that it is helping the VA address problems with “inadvertently neglecting to appropriately reprocess a specific auxiliary water tube.”

Tip For Filing New VA Benefits Claim

Sunday, December 28th, 2008

Maybe you have heard or read about new investigations that revealed that thousands of critical claims documents have been shredded at VA offices all over the country.

What I rarely see mentioned by the VA or VSOs is an online tool that will provide an electronic “paper trail” of submitted claims.

For filing your claim for VA benefits go to:

After you have filed your claim electronically you will have a confirmation number and you can print out your filed application.

This guarantees that you have proof that you filed in case your claim has an “accident” involving a shredder.

Good luck, and if you want send me a note if I can help.


Wednesday, November 19th, 2008

[Source: Katherine McIntire Peters article 3 Nov 08 ++]

Nearly six months after a physicist at the Veterans Affairs Medical Center in Philadelphia discovered that a patient being treated for prostate cancer had received lower-than-prescribed radiation doses, inspectors with VA’s National Health Physics Program have found more than 100 similar cases at four facilities. VA officials have declined repeated requests for information about the department’s brachytherapy programs, in which radioactive seeds are implanted into the prostate. In October, the Nuclear Regulatory Commission, which licenses VA’s radiation programs, announced that the department had suspended treatment at hospitals in Cincinnati ; Jackson , Miss. , and Washington . The Philadelphia program was suspended earlier. VA spokeswoman Laurie Tranter said on 15 OCT that officials would not discuss the program suspensions or any aspect of the investigation until the department issues a press release. VA still had not
issued a release by 3 NOV. “It’s not any particular person” delaying the statement, she said. “It’s the process.” Nonetheless, reports filed with NRC and recently made public shed some light on the investigation.

VA is required by law to notify the commission whenever it discovers radiation dosing errors that vary by 20% or more from the prescribed dose. Reports filed through October show that VA investigators had found 92 cases of improper dosing at the Philadelphia center as of 2 OCT. Nine cases had been identified at the Jackson Medical Center as of 30 OCT; six cases at the Cincinnati Medical Center as of 7 OCT; and three at the Washington Medical Center as of 26 SEP. NRC records are made public within 30 days of filing. The initial discovery of under dosing at Philadelphia stemmed from a brachytherapy procedure that took place 5 MAY. “Seeds of a lower apparent activity than intended were mistakenly ordered and implanted,” according to the initial VA report to NRC on 16 MAY. As the investigation unfolded, the Philadelphia report was updated as new cases of improper dosing were discovered. The most recent update was 2 OCT, when investigators
reported the discovery of an additional 37 patients for whom “medical events” had been identified. That brought the total number of patients receiving incorrect doses at Philadelphia to 92.

According to the report filed with NRC, “35 of the additional medical events involve doses to organs or tissues other than the treatment site.” The other two newly identified patients received doses to the treatment site (the prostate) that were below 80% of what was prescribed. None of the reports filed with NRC is considered “emergency events,” but NRC has hired an independent consultant to assess the effect of the errors on patients’ health. That assessment is ongoing. Viktoria Mitlyng, a spokeswoman with NRC’s regional office in Lisle Illinois said the commission is monitoring VA’s investigation of programs at 13 hospitals that perform brachytherapy, including the four whose programs were suspended. It is possible programs at other hospitals will be suspended, depending on what investigators find there, Mitlyng said. “We don’t have a timeline” for the investigation of all 13 hospitals, she said. “We want to make sure it’s done properly.”

Does reading that leave you with the impression that the VA is providing “World Class Health Care”?

Family Sues VA Over Soldier’s Suicide

Wednesday, October 15th, 2008


Donald Woodward’s tormented life ended on March 3, 2006.

An Iraqi war Veteran suffering from post-traumatic stress disorder, Woodward’s body was found at one of his favorite hiking spots along the Enola Low-Grade Line.

The anguished young man had died of a self-inflicted gunshot wound. He was 23.

While Woodward’s pain is over, his family’s continues, and on Monday, his widow, Tiera Woodward, filed a $2 million wrongful death suit against the United States government.

Her attorneys filed the lawsuit Monday in the U.S. District Court for the Middle District of Pennsylvania.

Tiera Woodward and the entire Woodward family blame Donald’s death on the Lebanon Veterans Affairs Medical Center in Lebanon, where the young man had turned for help.

Will You Believe Me Now?

Wednesday, April 23rd, 2008

You may have heard about the lawsuit.  Evidence presented includes emails from Ira Katz.  He is the main mental health bureaucrat at the Department of Veterans Affairs (VA).

In this email Katz tells Everett (Call me Ev) Chasen to keep quiet about internal numbers on Veterans suicides.

In this email Katz acknowledges what is being widely reported that there are 120 Veterans per week committing suicide.  In that same email, the Under Secretary for Health at the VA, Michael Kussman, states that 120 Veterans per week committing suicide “Sounds awful but if one is considering 24 million veterans.”

So the Under Secretary for Health at the VA, who is an Army Veteran, believes that 120 Veterans committing suicide per week is OK because there are “24 million”.

Since these emails became public, politicians were quick to jump on the bandwagon and feign righteous indignation.

Message to politicians:  Too Little, Too Late.

These same politicians who are now feigning righteous indignation are the same politicians who have heaped praise on these VA bureaucrats for “Doing the right thing for Veterans”.

We have been telling these politicians for a long time that their praise is misguided.  we have been telling them that there is a culture in the VA bureaucracy of Obfuscate, Deny, Manipulate, Lie, Spin, and apply the full weight of the VA propaganda machine to make sure that the VA “message” is one that disparages critics and buries bad press.

These emails are the absolute best evidence to completely obliterate the rosy facade the VA propaganda machine has built to mislead the public.

Our heartfelt thanks go to CBS News, Armen Keteyian, Pia Malbran, and the rest of the crew that worked so hard on the exhaustive investigation into the epidemic of Veterans suicides.

Our heartfelt thanks also go to all of the good people involved in the lawsuit.  Godspeed.

Please join us in telling Congress that we expect that these VA bureaucrats who have lied to Congress, under oath, will be prosecuted for that felony.

Maybe if one or two dozen of the most heinous of these people are given a perp walk, the rest of the VA bureaucrats will take notice and straighten up their act.





Suicides Shut VA Psychiatric Ward

Sunday, April 20th, 2008

More reporting on the Veterans Suicide Epidemic that the VA adamantly denies exists.

“Employees May Be Criminally Prosecuted for Fraud.”

Monday, April 7th, 2008

The article about VA employees spending 2.6 billion dollars on stuff like luxury hotel stays in Las Vegas.

Do you think that any VA employees will be criminally prosecuted for fraud?

He Said, She Said

Saturday, February 2nd, 2008

Mad Dog sent me a newsletter.  In the newsletter was an article.  In the article,       Its (VA) ratings for quality of care and customer satisfaction have risen even as the patient load has increased.”  She goes on in the article to parrot information provided by the  Commission on the Future for America’s Veterans.

Back in June of 2007, we expressed some concerns we had with that “Commission” to the Executive Director, David Sevier. Out of one side of the commission’s mouth they stated: “Dr. Kizer, former VA Undersecretary for Health from 1994 to 1999, is widely credited with turning around VA’s health care system.”

Out of the other side of the commission’s mouth they stated: “In fact, the Commission is intent upon nothing less than the total transformation of a “badly broken agency” (VA). These commissioners are as tired of the disfunction as anyone, probably a lot more since they’ve had to try to make it work in the past.”

 As we said to David Sevier then, we say to

If David, Katherine, Hillary, Barack, or anyone else would like to know the actual truth, without shaping by the VA spin and rotation machine,  let us know.

To Be Fair

Saturday, December 29th, 2007

We’re pretty snarky when it comes to woefully inadequate and bloated bureaucracies like the VA and IRS; However, there are some really extraordinary people that work at the VA. My current Primary Care Clinic (Dane and Jackie) are the best ever. The Mountain Home Social Work Service and Pulmonary Lab both have truly great people working in them that obviously work there because they care about Veterans.

Regrettably, the Career Bureaucrats will eventually beat these good people down and they will quit under the strain.

The OPM Report RECRUITMENT, RELOCATION, AND RETENTION INCENTIVES CALENDAR YEAR 2006 indicates that the Department of Veterans Affairs paid 6,393 incentives totaling $27,201,870 to attract and retain employees. The only Government agency that spent more is Defense.

The VA is number 2 in the “quits” department too. And again, Defense is numero uno. That means that despite spending $27,201,870 to retain employees, the VA still had the second highest number of employees quit.

Merry Christmas? Maybe Not.

Monday, December 24th, 2007

The VA staunchly maintains that there is no suicide epidemic among Veterans. They claim that the numbers that CBS News reported are not reflective of the actual numbers.

For the sake of this argument let’s assume the VA is right. Let’s say that the reported 120 Veterans suicides per week is exaggerated.

Let’s further assume that the actual number of Veterans suicides is only 60 per week. Half of what was reported.

Now, let’s say that we believe the VA when they say that they have the most greatest, biggest, most venerated, fail proof, most respected suicide prevention program in the
known Universe.

Now to the questions: If the assumptions above are true, then why is the entire home page of the VA website largely covered with pictures and stories about the new VA Secretary, James Peake?

Wouldn’t it make sense that if the VA did, in fact, have such a great suicide prevention program, and that it is widely believed that the suicide rate increases during the “Holiday Season”. Wouldn’t it make sense that the VA website, where many people go to try and find helpful resources for themselves or a Veteran family member in crisis.

Wouldn’t it then make sense that instead of trying to find the link to suicide prevention buried in a list between “Job Opportunities at VA” and “ Summary of Benefits for Veterans and Dependents”.

Wouldn’t it then make sense that the homepage of the Government agency charged with preventing suicides among Veterans, the agency that has several Federal laws that mandate more aggressive suicide prevention among Veterans. Wouldn’t it then make sense that the home page of that agency have a very prominent, easy to identify, and easy to access “banner” that leads to suicide prevention information?

Let’s Do a Compare and Contrast:

If you do a Google search for “veterans suicide”, which is probably a very likely search phrase someone in crisis trying to find help, or a concerned person trying to find help for their Veteran, would use, this is what you would get These Results.

However, if you do a Google search for just suicide you get These Results.

OK. More questions:

The VA spends millions of dollars each year on their Public Affairs Propaganda Machine. Why is it they won’t spend a few bucks to get Google AdWords, and other similar advertising programs that cause the issue to be prominently featured in web searches? Like the well managed private suicide prevention providers do.

Why don’t some of those Veterans Charities that claim to care so deeply about Veterans Issues spend some of the exorbitant amounts of money they spend on fundraising, conventions, executive salaries, executive travel, gourmet meals, and political lobbying on buying some advertising targeted at spreading information about the epidemic of Veterans Suicides?

O, we forgot. There is no suicide epidemic among Veterans.

What Part of DONT TREAD ON ME do you not understand?
–The Reverend Larry D Fagre, Founder

I Have a Dream

Monday, December 10th, 2007

 The Dream that I have… Maybe it is better categorized as a fantasy.  Anyway, I liked
the “I Have A Dream” reference.  Mine is fairly simple.  My dream is that President Dr
Paul asks me to be the Secretary of Veterans Affairs.  He asks me to work with the
Secretary of Defense (Mad Dog Dorin M.) to disassemble both agencies and create a
bureaucracy-proof agency that takes anyone who wants to serve in the military from cradle to grave.  With vision and leadership from Dr Paul, Mad Dog and I are able to create an agency that does three times the amount of work of the existing agencies at half the cost. We maintain the existing military branches but structure them so that their key
mission is, in fact, defense.  Defense of the USA that is.  Not the defense of every
country on earth. We also do this at 1/4th the salary of the existing secretaries.  And,
the most important part, we serve these brave people with actual results.  We provide
them with all of the benefits they deserve and we hold the public servants entrusted with
these jobs accountable.  If you are a screwup, you are fired and not promoted to your
highest level of incompetence. And then I woke up.

Please Clarify

Thursday, December 6th, 2007

We are writing to seek clarification on a statement that the Senator made in his opening remarks at the Peake confirmation hearing. He is quoted as saying: “I am satisfied that VA is staffed by people who seek to do what’s right by veterans.”

The question is, is that true? Is the Senator really convinced of that? Or is it a simple courtesy? We want to know, because we are satisfied that the VA is, primarily, staffed by people who really don’t care one whiff about Veterans.

We arrive at our conclusion with extensive personal experience with the VA and also in respected news organization reports from CBS News, CNN, and others.

When these news organizations conduct independent investigations of the VA, it is almost universal that a very negative image is painted of the agency. We also note that the VA leadership and Public Affairs propaganda machine undertake vitriolic hyperbole attacks against these news organizations when they are not pleased with the reporting. On the other hand, news that the VA is pleased with is quoted and turned into large posters to be displayed at all VA locations.

Joshua Omvig, and many thousands of other Veterans, are not alive today due in large part to the catastrophic failure of the VA system. Senator Akaka was a cosponsor of S.479 which the Department of Veterans Affairs did not support, expressing the view that the bill’s provisions are duplicative of existing programs and initiatives.

Despite the objections of the VA, the Joshua Omvig Veterans Suicide Prevention Act did become law. Not that it matters much though because there are buildings full of evidence that the VA will only comply with laws that benefit the VA, and disregard with impunity laws that favor Veterans.

Does the Senator consider it hypocritical to cosponsor legislation that expresses deep doubts about the VA’s ability to adequately prevent Veterans from committing suicide, and then turn around and say that the VA is staffed by “…people who seek to do what’s right by veterans.”?

Just two days ago I had a visit with a VA resident psychiatrist. He openly stated to me that he had several other appointments and didn’t have time to listen to me “complaining”.

He didn’t state the same objection to the Attending Psychiatrist when he had to wait for thirty minutes to get her to review his findings.

I didn’t leave that appointment with a warm fuzzy feeling that these VA employees want to do what’s right by Veterans. Rather, I left that appointment with a renewed sense of profound disappointment in how Veterans are treated by callous and uncaring bureaucrats.

Anyone with extensive experience with both VA and civilian health care providers will almost always share that sentiment. And ask Ty Ziegel about how much the employees of the VA wanted to do right by him.

The bottom line is that the VA will never be staffed by people who want to do right by Veterans as long as it is easier to do whatever they want. Until all VA employees are held to account for adherence to the law we can expect more of the same.