Although none of the settlements included an admission of liability by the Augusta VA, many of the lawsuits make similar claims of neglectful or delayed care. At least one plaintiff’s attorney said he believes the problem might lie with inadequate staffing because of lack of funding.
An Augusta Chronicle search of U.S. District Court records using the designation for personal injury-medical malpractice turned up at least nine cases filed since 2005. Of those, the VA prevailed in two, one was voluntarily dismissed, two are pending and four ended in settlements with no admission of liability by the VA. In both the cases the VA won and those that ended in settlement, there were similar allegations of patients neglect or poor care.
None of the cases appear to be from a recently disclosed consultations’ backlog of more than 5,000 patients in its gastrointestinal program, which resulted in four serious injuries and three cancer patients who died. Augusta VA officials said they have since launched an intensive effort to whittle down that backlog. The VA could not say whether any claims have resulted from that, but information on how to file a lawsuit was provided to the seven families.
In some cases it might not yet be clear whether a case is related to those backlogs, said Chuck Pardue, a military disability and malpractice attorney in Augusta. He is working with a veteran who lives near Dublin, Ga., and was bounced back and forth between the VA there and the Augusta and Decatur VAs for diagnostic tests. He was finally diagnosed with gallbladder cancer, which Pardue said is now terminal, in November 2011 but wasn’t informed until this year.
“One, they didn’t tell him, and two, they didn’t timely follow up,” Pardue said. “Part of the problem was handing it off from one staff to another, and back and forth.”
For its part, the VA operates a system that allows for events and even “near misses” to be reported so that the system can learn from them and correct them, which has won the VA praise in the past, Augusta VA spokesman Pete Scovill said in a statement.
However, it is difficult to get to the point of even filing a medical malpractice lawsuit against the VA, Pardue said.
“We’re talking to three or four people a week, potential clients, and maybe one out of 20 is a pretty good case,” he said.
A patient or family first must file a notice of its claim using Standard Form 95, and then the VA has six months to decide whether to reject or accept the claim. If rejected or if six months pass and the VA has not responded, the patient or family can then file a lawsuit in U.S. District Court.
Among the cases the VA settled in Augusta:
• A 71-year-old veteran with a history of heart problems showed up at an outpatient clinic complaining of chest pains but was not referred to cardiology, according to the lawsuit. The man had a heart attack four days later while having sex with his wife and was pronounced dead at the hospita, The veteran was prescribed both nitroglycerin and Viagra, “a widely acknowledged absolute contraindication of drugs,” the suit says. Without admitting fault, the VA settled for $58,000.
• A 60-year-old veteran had kidney surgery to remove a suspicious mass and was discharged. Eight days later, he returned with severe pain on that side, blood in his urine and a distended bladder, according to the lawsuit. Over the course of the next few days, as pain persisted and more blood was collected, his red blood cell counts dropped and he was found on the floor of his room unresponsive and later died. Without admitting fault, the VA settled for $850,000.
• A 56-year-old veteran who was a paraplegic from his service was admitted for a number of issues, including bed sores, dehydration, a possible blood infection and kidney problems, Within a few days, he had difficulty breathing and was vomiting. The head of his bed was lowered so staffers could clean up vomit that covered his bed and gown, but he was left unattended and he choked on vomit and developed brain and organ damage before he could be revived. Without admitting fault, the VA settled for $1.7 million.
Part of the problem could be the governmental immunity that shields VA physicians and staffers from personal responsibility, Pardue said.
“The liability is picked up by the federal government,” he said. “As a consequence, there is quite a bit of difference between private hospitals and private doctors, who remain fully accountable for what they do. I think it does make somewhat of a difference.”
Scovill, however, said that “although the VA medical centers do not make malpractice payments from their own budgets (it) does not mean that they are less concerned with the quality of patient care they provide.”
“When the possibility exists that a patient may have been harmed in the provision of a health care service, patients are notified and evaluated for ill effects,” Scovill said. “In the event patients may have been injured, VA advises them of their right to seek damages or disability compensation.”
Part of the problem is there are just not enough bodies to provide good care, Pardue said.
“What we’re seeing is just not enough staff,” he said. “They can’t get the people back in for timely appointments.”
Some of the responsibility for that lies outside the VA’s control, Pardue said.
“Congress needs to fund more physicians and nurses for these VA facilities; it really does,” he said. “It won’t eliminate it, but it could greatly reduce injuries.”
Staff Writer Wesley Brown contributed to this article.