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Officials at Veterans Affairs hospital in New Hampshire removed over 'substandard care'

| Monday, July 17, 2017, 10:15 p.m.

MANCHESTER, N.H. — Veterans Affairs Secretary David Shulkin has removed two top officials at New Hampshire's only veterans hospital and ordered a review of the facility starting Monday amid allegations of “dangerously substandard care.”

The Boston Globe reported that 11 physicians and medical employees alleged the Manchester VA Medical Center was endangering patients. They described a fly-infested operating room, surgical instruments that weren't always sterilized and patients whose conditions were ignored or weren't treated properly.

The Office of the Special Counsel, a federal whistle-blower agency, found “substantial likelihood” the allegations were true and ordered an investigation, which began in January.

Shulkin also said two agency offices would conduct a “top-to-bottom review” of the hospital, beginning Monday.

Following the newspaper report Sunday, Shulkin removed hospital Director Danielle Ocker and Chief of Staff James Schlosser. A VA spokesman said the two would be assigned other duties in the interim.

“We will stop at nothing short of delivering the best care for our veterans,” said Republican Gov. Chris Sununu, who said he called Shulkin on Sunday morning.

The Globe reported in a recent interview, Ocker and Schlosser acknowledged significant cuts in services, such as the elimination of cataract surgery, and administrative problems, such as ordering a $1 million nuclear medicine camera but never installing it because it was too big for the examination room. As a result, the hospital stopped offering nuclear stress tests for heart disease risk and bone scans that can detect tumors this year.

But Ocker and Schlosser said they were surprised that so many medical staff members reported the problems to federal investigators. They said the hospital was addressing the shortcomings and patient safety hasn't been compromised.

Much of the Globe's report focused on accounts from Dr. William “Ed” Kois, head of Manchester VA's spinal cord clinic, who compiled a list of at least 80 patients at the hospital over five years suffering from advanced and potentially crippling nerve compression in the neck, and using canes, wheelchairs and walkers, instead of getting surgery. He said the condition is easy to diagnose and treat with surgery before it progresses too far.

“It's like if you suddenly saw cases of syphilis — a disease that has long been curable with penicillin,” Kois said.

Dave Kenney, chairman of the State Veterans Advisory Committee, attended a regularly scheduled meeting with other veterans service groups at the VA center Monday. He said he and others urged Interim Director Alfred Montoya to ensure that VA investigators make patients a big part of their probe.

“They really need to get a complete picture, and everyone's going to give them a different story,” he said.

Kenney said he hopes the review leads to improvements.

“They need to put their money where their mouth is,” he said. “They need to put the resources in to get it done and fix it.”

Kimberly Roy of Merrimack said when her husband sought care several times for a crippling headache, neck pain and high fever in May, Manchester VA providers told him it was just a headache and sent him home.

“He lost 15 pounds, he couldn't feel his left side of his body,” she said. “They just kept sending him home.”

Her husband was asked repeatedly if he was abusing drugs, she said, and one doctor told her, “He does have a lot of tattoos.” After she posted a complaint on Facebook, the VA contacted the couple, and her husband was seen by a specialist. He eventually was sent to Concord Hospital, where he was diagnosed with viral meningitis. After a week and a half in the hospital, he is still working to regain his strength.

“It was awful,” Roy said. “He has no faith in the VA, because if he had continued there, he could've died.”

Kenney said the newspaper's allegations were a complete surprise. His group occasionally hears from people complaining about access to care or trouble getting an appointment, he said, but the issues are quickly resolved.

U.S. Rep. Annie Kuster, a member of the House Veterans' Affairs Committee, and U.S. Sen. Jeanne Shaheen, a member of the Senate Armed Services Committee — both Democrats — met with VA doctors last year about their allegations and brought the concerns to the VA's Office of Special Counsel and the Office of the Inspector General for further investigation. Kuster said she was “deeply concerned.”

New Hampshire is one of a few states without a full-service VA hospital. The Manchester center contracts with Concord Hospital and others for elaborate surgery and inpatient care.

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