Heller wonders if VA delays caused deaths

Heller, R-Nev., expressed skepticism at a hearing where senators reviewed an inspector general’s report on fraudulent scheduling at the Phoenix medical center. Similar scheduling practices, and efforts to cover them up, subsequently were found to be widespread in the VA network of almost 1,000 hospitals and clinics.

The discoveries triggered a scandal that led to the resignation of a Cabinet member and wholesale reforms underway in the sprawling VA medical system.

Also at the hearing, Heller said it might not have been a coincidence that Sandi Niccum, an elderly blind and diabetic Las Vegas veteran, died several weeks after an episode in the emergency room at the VA Medical Center in North Las Vegas.

Niccum waited with abdominal pain for four hours and 45 minutes before seeing a doctor on Oct. 22, 2013. She was given pain medication and returned to the hospital two days later for recommended testing that showed symptoms of cancer, colitis and a perforated appendix.

Niccum died Nov. 15, 2013, in a Las Vegas hospice from a colon disorder. An investigation by the VA inspector general found “no relationship between the length of the patient’s wait and her subsequent clinical course.”

But Heller said, “I have to believe there was a link between the kind of care she was getting at that hospital and her death two weeks later. I think any reasonable person would come to that conclusion.”

Heller said afterward his question was not based on any additional information about the Niccum case but on what a “reasonable person” might conclude.

“I’m just raising the questions,” he said. “I’m not trying to steer it one way or the other.”

The meeting of the Senate Committee on Veterans Affairs, of which Heller is a member, focused on the inspector general’s report on the VA medical center in Phoenix, and an update from new VA Secretary Robert McDonald on reforms he was putting in place in response to the controversy over patient care that spurred the resignation this summer of then VA Secretary Gen. Eric Shinseki.

A whistleblower alleged that potentially 40 veterans died waiting for appointments at the Phoenix hospital. A final report issued Aug. 26 by the VA’s independent office of inspector general said while it found evidence of poor care, “we are unable to conclusively assert that the absence of timely quality care caused the deaths of these veterans.”

The wording was added in the final report after a draft, as is normal procedure, was sent to VA officials for comment. The timing of the edit prompted suspicions by some lawmakers that it was added to exonerate the agency. Acting Inspector General Richard Griffin flatly denied the allegation.

“This question needs to be asked,” Heller said to Griffin. “Did the VA play any part in the inclusion of this line?”

“No,” Griffin replied. He said it was added after further deliberations by his staff, and offered to provide senators with a timeline of the change “to make it very clear what is going on.”

Heller said a “reasonable person” might draw connections between veterans unable to see their doctors and subsequent deaths, particularly in cases where mental health patients were unable to obtain timely care.

The inspector general identified 171 mental health patients on a wait list for appointments in Phoenix. At the same time, 77 veteran suicides were committed between January 2012 and May 2014.

“Would a reasonable person come to the conclusion that the manipulation of those wait times contributed to patient deaths?” Heller asked.

Griffin bristled.

“I would say in general we are not in the business of making odds of whether something did or didn’t cause the death of others,” the official said. “Likely, unlikely, 50 percent, 30 percent, 80 percent, that’s not our purpose.”

Heller said after the hearing he still had questions about the report.

“You could tell from my questioning that I wasn’t buying it,” he said.“ I really want to make sure there isn’t any manipulation of an IG report and that it was as independent as it possibly can be. All I’m doing is raising the questions. I’m just asking what a reasonable person would believe.”

At the hearing, Griffin said his office was investigating allegations of wrongdoing at 93 VA sites across the country. He said 12 reports have been completed and submitted to the VA for review.

“The rest are very much active,” Griffin said.

One of the sites targeted for investigation was the Southern Nevada Health Care System. It could not be immediately determined whether it was one of the dozen already completed.

McDonald called the IG report troubling and said the agency has begun working on remedies recommended by the report.

“I sincerely apologize to all veterans who experienced unacceptable delays in receiving care at the Phoenix facility, and across the country,” McDonald said. “We at VA are committed to fixing the problems and consistently providing the high quality care our veterans have earned and deserve in order to improve their health and well-being.”

In all, the VA has reached out to more than 266,000 veterans nationwide to get them off waiting lists and into clinics, McDonald said.

The Associated Press contributed to this report. Contact Stephens Washington Bureau Chief Steve Tetreault at stetreault@stephensmedia.com or 202-783-1760. Find him on Twitter: @STetreaultDC.