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Veterans Administration physician accused of botching cancer treatment

| Wednesday, July 22, 2009

The expert assigned by the Veterans Administration to "touch up" the treatment of veterans given the wrong doses of radiation for prostate cancer in Philadelphia was accused in federal lawsuits of botching the radiation treatments for three of his patients.

Court records show Kent Wallner, the Seattle VA physician, was accused in lawsuits against the VA of causing extensive damage to three veterans being treated for prostate cancer. Two of the three cases were settled for $1 million apiece. The third case was dismissed, and an appeal to the Supreme Court is being considered.

"This is truly the fox guarding the hen house," said Ann R. Deutscher, a Seattle lawyer who represented the veterans in the cases involving Wallner. "I'm just astounded," she said when informed the eight patients from Philadelphia were sent to Wallner.

Deutscher said evidence gathered in the Seattle cases showed Wallner incorrectly calculated the radiation doses for some patients and in other cases made no calculation.

Wallner said he was not allowed to comment and referred questions to the VA.

The three cases demonstrated a "total lack of oversight" by the VA for the prostate cancer treatment, called brachytherapy, Deutscher said. Under the procedure, rice kernel-sized radioactive pellets are implanted in the prostate to kill the cancer cells.

VA spokeswoman Katie Roberts said she could not respond to questions about Wallner or the lawsuits but issued a brief statement:

"When the department discovered a problem with the brachytherapy, all affected veterans were informed and treated. The VA is actively using this experience to implement stricter protocols of accountability and transparency throughout the department," Roberts wrote in an e-mail.

An investigation of the suspended program at the Philadelphia VA showed insufficient doses of the radioactive seeds were administered to 57 patients, while 35 received excessive doses. In some cases, according to the report, the seeds ended up in the wrong organ, causing serious internal injury.

VA officials said when the Philadelphia treatment errors were uncovered, eight patients were flown to Seattle, where Wallner performed tests to determine whether additional radiation treatment was needed. According to the VA, the eight received corrective "touch-up" implants.

In Philadelphia, the inaccurate dosages have been traced to a piece of medical equipment used to measure radiation levels that was inexplicably disconnected.

A congressional committee is scheduled to hold a hearing today in Washington to question the lead physician in the Philadelphia implant program. Dr. Gary Kao will be the primary witness before the House Veterans Affairs Committee. Other witnesses include Pittsburgh-based Michael Moreland, head of the VA health program in the region that includes Pennsylvania and four adjoining states.

Michael Barrett, the attorney for one of those patients, said he was unaware of the lawsuits involving Wallner.

An expert's medical report on one of Deutscher's clients, Donald C. Jones, showed he was given twice the normal dose of radiation. In addition, the seeds were misplaced causing damage to the rectum. The expert concluded Jones "sustained unacceptable toxicity."

Jones and Dennis Egemo, another veteran treated by Wallner, had to undergo corrective surgery because of injuries from the radiation treatment, court records show. Their cases were settled in late 2007 for $1 million each, Deutscher said.

Deutscher represents a third veteran, Michael B. Marley, who was treated by Wallner. Marley is considering an appeal of his case's dismissal.

Deutscher charged that an assistant U.S. attorney sent a misleading letter to Marley, an elderly and disabled veteran who lives alone in a trailer in Alaska. As a result of the letter, she said Marley agreed to withdraw his original lawsuit under the mistaken belief that he could refile it. However, the statute of limitations expired.

"Its an absolute miscarriage of justice," Deutscher said.

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