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Delayed care has one Augusta VA patient fearing for his life

Tuesday, Jan. 14, 2014 10:30 PM
Last updated Wednesday, Jan. 15, 2014 7:51 AM
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Michael Newton had an appointment at the Charlie Norwood Veterans Affairs Medical Center last week to have as many as 12 small tumors removed from his bladder. But instead, the cancer patient canceled and will now travel across four states and more than 1,000 miles to get the treatment he said he should have received six months ago at the Augusta hospital.

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Air Force veteran Michael Newton and his wife Romaine will travel 1,000 miles from Augusta to have tumors taken from his bladder. In June, Charlie Norwood Veterans Affairs Medical Center doctors told him all such cells were gone.  MICHAEL HOLAHAN/STAFF
Air Force veteran Michael Newton and his wife Romaine will travel 1,000 miles from Augusta to have tumors taken from his bladder. In June, Charlie Norwood Veterans Affairs Medical Center doctors told him all such cells were gone.

“I have lost all faith in that hospital,” Newton, 62, said last week at his Grovetown home.

After reviewing the Air Force veteran’s medical records, the National Institute of Health offered to resect the dozen tumors that had formed in Newton’s bladder since June 13, when surgeons at the Augusta VA promised him all such cells had been removed from his system in their “entirety,” according to medical records.

Also offered by the Maryland research institute, and accepted by Newton, was mitomycin, a type of chemotherapy for upper gastrointestinal cancers that Newton said he was denied this summer at the Augusta VA despite lab results showing the tumor originally removed from his bladder was “high-grade.”

“When they saw that the tumor was high-grade, they should have brought me back and given me mitomycin, but they didn’t,” said Newton, who is a 100 percent disabled veteran. “Instead, they told me the tumor was benign and that no chemotherapy was needed. They were basically putting me on a schedule to die.”

Hundreds, possibly even thousands of veterans, including Newton, are becoming more and more fearful that the Augusta VA is shaving years off their lives.

Three cancer patients died and four veterans were injured between 2011 and November 2012 after hospital administration failed to schedule 5,100 primary-care referrals made to the medical center’s gastrointestinal program.

The House Committee on Veterans Affairs is investigating the management error in hopes of holding accountable those who are responsible.

The committee has targeted the administration of former Director Rebecca Wiley, which managed the hospital from 2007 to 2011 – the year Newton’s problems began to escalate.

Newton joined the Air Force in 1972. Almost a year after he enlisted, a biopsy performed by Navy Medical staff found he had rhabdomyolysis, a condition in which damaged skeletal muscle tissue breaks down and is released into the bloodstream, possibly resulting in kidney failure.

“Because of the uncertainty of his illness, Mr. Newton’s life has been disrupted and he needs some measure of emotional support,” Dr. Stanley Bodner wrote in a letter to Newton’s commanders on Jan. 23, 1973.

Newton left the Air Force in 1979, but his health condition persisted for more than 30 years, peaking in June 2011, when he suffered a major episode.

“I thought I had the flu, but then my vision became black, my urine turned the color of Coca-Cola and I started passing lesions,” he said.

Newton said he stayed in the Augusta VA in kidney failure for two days until a nurse intervened and started to give him dialysis. A week later, the hospital released Newton for three months of outpatient dialysis and said a notice would be sent in the mail for a follow-up appointment in two weeks, discharge summaries show.

But Newton said he never got the notice and that the hospital stopped dialysis by the end of 2011. His wife, Romaine, said her husband’s urine flow returned, but that his kidney output was below normal and as a result, he put on 30 pounds.

“He kept saying ‘I’m not feeling well,’ and we visited several different programs in the VA’s nephrology and neurology programs until October 2012, when he began experiencing sharp pains in his right side and started seeing blood in his urine,” she said.
“I bent over in my room and felt like someone had stabbed me,” Michael Newton said, describing the pain.
A CT scan performed at the VA in January 2013 revealed his bladder was distended, but the Newtons said the VA did nothing about it.

“From then until April 2013, there has been a tremendous delay,” Romaine Newton said.

In May, the VA scheduled a cystoscopy and found a tumor in his bladder.

“The bladder was surveyed in systemic fashion and a papillary tumor was noted on the right wall with a clot attached,” progress notes filed May 29-30 at the hospital stated. “Within the pelvis, the bladder is partially distended.”

Newton had surgery June 12 to remove the tumor and surgical information on file states that staff was “able to access the right lateral bladder wall tumor, which was resected in its entirety.”

Medical records state that the plan was for Newton to have a “surveillance cystoscopy every three months.”

In September, Newton’s right side still hurt. He went into the VA for a cystoscopy, but no adverse conditions were reported.

On Nov. 5, Newton saw a private physician in Columbia County to get a second opinion on why his side continued to hurt.

According to diagnostic report from the Center for Primary Care in Evans, an ultrasound found a 2-centimeter cyst and several small stones scattered throughout his left kidney. Newton was prescribed allopurinol, a drug used primarily to treat excess uric acid in blood plasma.

The veteran said he took the prescription to the VA to get it filled on Dec. 10, when a cystoscopy confirmed multiple small tumors – possibly as many 12 – had formed in his bladder, according to progress notes filed by the medical center nine days after the appointment.

Newton, however, said he was told he could not get the medication unless he had gout. Four days later he returned to the VA with a swollen right foot. An assessment by the hospital found he had an “acute gouty attack,” according to progress notes filed Dec. 19. The hospital scheduled another resection for the tumors.

“I felt like my life was in danger,” Newton said of canceling the appointment. “The VA ignored everything the doctor in Columbia County wanted to do. If the tumor had gotten to the muscular layer, I would have had three years – plus or minus one year – of my life left. I didn’t like my odds.”

Hospital spokesman Pete Scovill said it is not uncommon for patients to seek treatment from both public and private facilities, but said it is rare for VA staff not to explore every treatment plan possible. He urged any veteran who wishes to appeal their case to call his office at (706) 733-0188.

“If they come to us and give us a chance to review their case, we will do our best to resolve any issues they may have,” he said.

The Newtons said they are unsure if they plan to sue the hospital. However, Romaine Newton said all this could have been avoided.

“If Michael presented them with a symptom, the VA would order a MRI or an ultrasound, but the underlying cause of the problem, they would not try to determine what it was,” she said. “That is the way they work.”

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OutrageousCitizen 01/18/14 - 05:51 am
Vet2... I'm glad your gander is up... use it to help people.

Vet2, You said, "There could be a worthwhile story (here)..." So make it worthwhile by helping people to understand it rather than condemning it.

By the way, which article are you talking about? The Online article or the Print Article? Obviously you don't know that the online article is edited FROM the Print Article due to limited space. The online articles are rewritten from the Print Article by a different group of people. The print article piece was front page news. Did you compare them?

Also, if you read the bio on the staff writer, you will find that he is no slouch. That writer is a graduate of Georgia College and State University with a Bachelor of Arts in Print Journalism. He has won eight state awards in three years at two daily papers.

Do you know anything about Journalism? Or the structure of a print article?

It is obvious to me that the writer wanted to see some evidence of what Newton was claiming. Newton apparently showed him copies of medical records. One photos states Newton has 6 boxes of medical Records... and the information in those records are PRIVATE. But the reporter saw them and may have been given copies of those medical records. Every major newspaper has a group of lawyers, one of which, previews information that it prints. I ask you again, do you think the Staff Writer wrote lies... when he specifically states that he was referring to Newton's medical Records?

The Augusta Chronicle paper was founded as the weekly Augusta Gazette in 1785. Give them a break, they have never stopped publishing and is "The South's Oldest Newspaper." You don't get this far by publishing false or reckless news.

Finally, your last comment about me is an ad hominem attack that has nothing to do with the issue or facts. Ad hominems are fallacies.

An Ad Hominem is a general category of fallacies in which a claim or argument is rejected on the basis of some irrelevant fact about the author of or the person presenting the claim or argument. Typically, this fallacy involves two steps. First, an attack against the character of person making the claim, her circumstances, or her actions is made (or the character, circumstances, or actions of the person reporting the claim). Second, this attack is taken to be evidence against the claim or argument the person in question is making (or presenting).

Good Luck.

OutrageousCitizen 01/18/14 - 05:57 am
Will Newton die or be a cripple from the alleged VA Abuses?

Vet2, SJL1204, Corimom, thauch12:

Of all the articles about VA Hospital Abuses and Mis-Mangement, The comments about this article seems to have an air of bias about it. The Veterans featured thus far have been of one race. Newton is obviously not of that race.

First, I'm never seen a group of people that show emotional thinking and not critical thinking or reasoning ability.

Second, Newton didn't criticize everyone at the CNVAMC. It appears his issues center around delay of care, denial of care and some incompetency within the Urology Dept. A casual read indicates no treatment was ever attempted for his chronic rhabdomyolosis a serious condition that existed from the first year of his enlistment. I would like to know more.

Vet2: You must be an employee of the VA. How do you know what this man has gone through? Do you know his family? Have you peeked into his medical records? Has someone at the VA shared some privacy issues about Newton? Your carom shot ad hominem attack on Newton is the type of sleaze that motivate hospitals to have "real" doctors write up a patient and then have a resident sign their name to the write up. The affiliation between GRU and the VA hospital is this: Allegedly, the VA supply aging Vets to Resident or Fellows to practice on; and most times no attending doctor is there to oversee what the residents are doing. As a Vet, Newton is owed the best care for volunteering to serve this Country. I'm sure no insurance company would give him health insurance to cover his issues, including medicine. Finally, you said, "The NIH is in Bethesda, Maryland which is around 560 miles from Augusta not 1,000. This article is poorly written, full of irrelevant information and has factual errors." Well, a round trip to Bethesda is more than 1,000 miles... and would you let the same doctor who misdiagnosed you work on you again? The Article was highly informative and attempted to give an overall view of the situation. Apparently Newton has more problems with the VA than the Article was able to cover.

thauch12: Your reply indicates you have some bitterness about something and you are concerned with money. If the government promised our military men and women medical attention, by golly they should give it to them. The failure, by any means or reasons, is an act of Broken Trust and Broken Promises. Abraham Lincoln established the Veterans Department and you should read his Second Inaugural Address when he spoke about Veterans and their families:

"With malice toward none, with charity for all, with firmness in the right as God gives us to see the right, let us strive on to finish the work we are in, to bind up the nation's wounds, to care for him who shall have borne the battle and for his widow and his orphan, to do all which may achieve and cherish a just and lasting peace among ourselves and with all nations" ... Abraham Lincoln.

SJL1204: Obviously somewhere mistakes were made. Maybe they should put Attending doctors with a Resident each time a resident sees a patient. Newton is but one. How many more didn't know what to say or know that the protocol wasn't right? Until others speak up, you, me and others will never know. And in most cases we would never know because hospitals don't release patient information and news that they settled a lawsuit.

Corimom: I saved you for last. You don't display a bit of compassion in your posts. I hope you never was a nurse's aide or nurse. You are critical of everything without foundation to your premise.

Newton, has "borne the battle" and he and his family should be cared for by the VA. I don't care if Newton was peeling Potatoes to be served in the chow hall, working in a hospital or slopping buckets at a field sanitation pit. He stepped up to the plate when many ran to Canada or hid in the deep rich pockets of their fathers.

To Everyone: Do more for others than you do for yourself!

Vet2 01/18/14 - 12:27 pm
OC : You get your dander up, not your gander

I'm fully aware that the 2 articles are different. I have the print edition on my desk. I never said anyone was printing lies, but there is a lot of missing relevant data and a good deal of assorted irrelevance which seems to be added to the print edition solely to throw some more mud around and see if any of it sticks.
Here is a relevant time line:
January 2013 CT shows bladder distension. How severe? Probably not too bad since the cystoscopy report from May merely refers to it as partially distended.
April 2013: Tremendous delay- not really, a 2-3 month wait for a routine specialty appointment isn't great but its not a tremendous delay either.
May 2013: Cystoscopy shows tumor
June 2013: Tumor entirely resected
Summer 2013: lab shows tumor was "high grade" That could be good or bad depending on the context, which of course is left out.
September 2013: Surveillance cystoscopy shows nothing adverse
December 2013: Now there are as many as 12 tumors. How were these detected? It does not say.
We do get to hear about gout and kidney stones.
Why is the NIH offering treatment? There's nothing wrong with that, but its an odd choice with all the other options available. That might make an interesting story by itself. There is something unusual and undisclosed here.
As to the ad hominem stuff, you're quite the pot to be calling my kettle black. You made a backhanded accusation of unethical behavior at me and then referred to my second post as "sleazy". Take a look in the mirror.

OutrageousCitizen 01/18/14 - 10:10 pm

Thank you for correcting my spelling caused by whatever and not proofing my comments... But I surely wasn't talking about your dandruff.

Why are you concerned about this case? Do you work for the VA?

Are you another writer at the Chronicle and see competition?

Are you one of the VA's Urologist and know ALL about this case?

Do you know how long this case has existed?

Have you ever had Bladder Cancer?

Do you realize a tumor should be "staged" to determine how bad it is regardless of the fact that it was "High Grade."

Something you said exposed yourself... You said: "Why is the NIH offering treatment? There's nothing wrong with that, but its an odd choice with all the other options available. That might make an interesting story by itself. There is something unusual and undisclosed here."

Let me ask you this: Would you let the same doctors who misdiagnosed you or denied treatment to you operate on your body again?

Since you appear to know Newton's entire case, what other options are available to him? If a research hospital accepted him shouldn't that tell you something? I say there is more going on than has been reported.

Your knee-jerk comments criticizes the article... but where is your concern for Newton's life? You probably think he doesn't deserve anything. Just let him die.

OutrageousCitizen 01/24/14 - 03:34 pm
Malice Medicine?

It's on the local grapevine that an allegation has been made that Newton was intentionally NOT GIVEN Mytomycin C after his first tumor removal and that his prostate was cut during the procedure. "The installation of Mytomycin C after a cysto is standard protocol if the bladder is not punctured."

The question is why wasn't Newton given the Chemotherapy? Only one of two reasons concludes that question. Either Newton's bladder was punctured or his prostate was cut during the procedure and that fact wasn't reported in his medical records, OR the chemotherapy was malicious withheld to start another cancer infection by unseen cancer cells that were already in his bladder or cancer cells that fell away from the main tumor when it was being removed.

It has also been alleged that there was ill-will between Newton and one or more of Newton's doctors (providers) in the urology clinic.

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