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Report: VA center in Philadelphia had widespread problems

The staff in a surgical unit at the Veterans Affairs Medical Center in Philadelphia was so inattentive that a patient who died in a toilet was not even discovered until his body had turned cold, according to an inspection report obtained by the Tribune-Review.

The report from the VA's Medical Inspector, obtained under the federal Freedom of Information Act, recounts the complaints from a surgical resident who told inspectors of the dead patient and another case in which a patient at the facility was allowed to sit in a bed of urine.

The report, dated Dec. 12, 2007, cites the poor care on the thoracic surgery unit as the reason that doctors routinely shifted major chest surgery cases to the nearby University of Pennsylvania/Presbyterian Medical Center.

"The general surgery resident physician voiced 'no confidence' in the care provided on the ward and went so far as to say that the surgical ward was 'not a nursing unit,' care was non-existent," the 10-page report states.

Dale Warman, spokesman for the Philadelphia center, said the problems cited in the report have been corrected.

"Many improvements have been made over the past three years for the well-being of our veterans, and this situation does not at all reflect the current state of patient care," he said in an e-mail.

U.S. Rep. Joseph Sestak, D-Delaware County, said some of the findings in the report were "completely intolerable and reflects a gross lack of accountability at many levels."

The Philadelphia facility is awaiting a decision by the Nuclear Regulatory Commission on penalties stemming from the mistreatment of prostate cancer patients who were given incorrect and misplaced doses of radioactive seeds.

"That those two programs were simultaneously sub-standard is more than another wake-up call -- it is indication that the equivalent of a two-alarm fire was raging without the appropriate knowledge of Veterans Service Organizations, Congress or even the VA," Sestak said.

The inspectors found that problems in the unit, which includes 32 post-operative beds and an intensive care unit, contributed to a backlog in cases with many surgeries being delayed or canceled.

Employees interviewed by the inspection team complained of staff shortages and the lack of support services such as respiratory therapy.

"One nursing staff(sic) stated that 'the staff was tired, overworked and understaffed," the report states.

The surgical resident who complained about the dead patient also cited cases of doctors not being informed that their patients had been admitted and who were getting no food or care as a result.

Nine of ten patients interviewed 'voiced concerns about a non-caring, rude and lazy staff" and complained of "having to lie in urine and stool for hours before being cleaned up."

Other issues raised in the report include a lack of electronic or telemetry equipment to monitor patient conditions and excessive staff absenteeism.

Warman said in his e-mail that a new director had been hired, staff increased and "a new, full-time thoracic surgeon has been hired to provide better continuity of care. "

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