VA Hides Shoddy Care and Mistakes by Staff Members

Army veteran April Wood chose to have her leg amputated rather than endure the pain, after two VA surgeries that the agency’s medical experts determined were flawed.
(Photo: Nathan Papes, Springfield News-Leader via USA TODAY Network)

Behind the walls of the nation’s oldest veterans’ hospital, the reports were grim.

Medical experts from the Department of Veterans Affairs blamed one botched surgery after another on a lone podiatrist.

They said Thomas Franchini drilled the wrong screw into the bone of one veteran. He severed a critical tendon in another. He cut into patients who didn’t need surgeries at all. Twice, he failed to properly fuse the ankle of a woman, who chose to have her leg amputated rather than endure the pain.

In 88 cases, the VA concluded, Franchini made mistakes that harmed veterans at the Togus hospital in Maine. The findings reached the highest levels of the agency.

“We found that he was a dangerous surgeon,” former hospital surgery chief Robert Sampson said during a deposition in an ongoing federal lawsuit against the VA.

Agency officials didn’t fire Franchini or report him to a national database that tracks problem doctors.

They let him quietly resign and move on to private practice, then failed for years to disclose his past to his patients and state regulators who licensed him.

He now works as a podiatrist in New York City.

A USA TODAY investigation found the VA — the nation’s largest employer of health care workers — has for years concealed mistakes and misdeeds by staff members entrusted with the care of veterans.

In some cases, agency managers do not report troubled practitioners to the National Practitioner Data Bank, making it easier for them to keep working with patients elsewhere. The agency also failed to ensure VA hospitals reported disciplined providers to state licensing boards.

In other cases, veterans’ hospitals signed secret settlement deals with dozens of doctors, nurses and health care workers that included promises to conceal serious mistakes — from inappropriate relationships and breakdowns in supervision to dangerous medical errors – even after forcing them out of the VA.

USA TODAY reviewed hundreds of confidential VA records, including about 230 secret settlement deals never before seen by the public. The records from 2014 and 2015 offer a narrow window into a secretive, long-standing government practice that allows the VA to cut short employees’ challenges to discipline.

Some employees who received the settlements were whistle-blowers or appear to have been wronged by the agency. In other cases, it’s clear the employees were the problem.

In at least 126 cases, the VA initially found the workers’ mistakes or misdeeds were so serious that they should be fired. In nearly three-quarters of those settlements, the VA agreed to purge negative records from personnel files or give neutral or positive references to prospective employers.

In 70 of the settlements, the VA banned employees from working in its hospitals for years — or life — even as the agency promised in most cases to conceal the specific reasons why.

Michael Carome, a doctor and director of the health research group at Public Citizen in Washington, said removing records from personnel files and providing neutral references create potential danger beyond the VA.

“It’s unacceptable,” he said. “What they are saying is, ‘We don’t want you to work for us, but we’ll help you get a job elsewhere.’ That’s outrageous.”

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SOURCE: USA Today, Donovan Slack and Michael Sallah