VA officials probe how its hospital treated blind Las Vegas veteran

The long wait compounded by frustration with incomplete radiology orders and alleged rude treatment increased 78-year-old Sandi Niccum’s frustration to the point that she would pound her walking cane on the hospital floor.

“Several times she would just beat it on the floor and say, ‘Please somebody help me.’ But they didn’t. Nobody cared,” said Niccum’s friend, Dee Redwine, who was with her through the ordeal.

The Navy veteran, described by her aide, Shirley Newsham, as a “brittle diabetic,” had been a volunteer for the VA’s Visually Impairment Services Team for at least eight years. She died Nov. 15 at a local hospice.

Before she died, Niccum asked Redwine to write a chronology of the VA experience and submit it to the Review-Journal.

“She said, ‘This is wrong. We’re going to have to put this together and turn in a report so this won’t happen to someone else.’ She said it many times,” Redwine said Monday.

Allegations in the chronology drew criticism from members of Congress who oversee the VA, including House Veterans Affairs Committee Chairman Rep. Jeff Miller, R-Fla., and committee member Rep. Dina Titus, D-Nev.

They also prompted a review by a panel at the VA Southern Nevada Healthcare System, which runs the $1 billion medical center. It opened in August 2012.

‘DISTURBING ALLEGATIONS’

Miller said in a statement Tuesday that his committee “is investigating these disturbing allegations, and we will be asking VA to provide copies of all applicable surveillance camera footage so we can examine the sequence of events in detail.”

“All veterans seeking care at VA hospitals deserve to be treated with utmost respect and compassion. Should that ever fail to happen, VA must hold those responsible accountable,” Miller said.

Titus said in a statement that she was “appalled to learn of the shocking mistreatment of a veteran who had given so much to our country and community.”

“Our VA hospital should be the gold standard in both caring for patients and customer service,” Titus said. “I am eager to learn the results of the hospital’s working group and the actions they plan to take to ensure no other veteran suffers from a similar experience.”

Local VA spokesman David Martinez said VA Southern Nevada Healthcare System officials are reviewing Niccum’s chronology.

“While patient privacy laws prohibit us from commenting specifically on her care at the VA, there are issues brought up in her journal that would be unacceptable for any of our veterans to experience,” Martinez wrote in an email. “To that end, VA Las Vegas leadership has convened a team of both clinical and administrative leadership to review every aspect presented with the sole intent to determine what actually took place and to take corrective action where needed.”

Martinez said the review will focus not only on the clinical aspect “but also the criticality of how customer service is delivered. We are absolutely vested in providing care to our veterans that is reflective of their service to our nation.”

‘HORRIBLE EXPERIENCE’ DESCRIBED

Newsham said the VA’s customer service reputation was tarnished when she took Niccum to the center’s emergency room late last summer and they experienced a four-hour wait before she was admitted.

“It was just a horrible experience,” Newsham said about the five-day span Niccum spent in the hospital while doctors tried to determine whether her colon cancer, which was in remission, had flared up again.

“While she was there, she wanted her aides to stay with her because she did not trust the VA,” Newsham said, explaining that Niccum’s doctor at the VA women’s clinic tried to alleviate her fear by allowing her to bring her own medicine and insulin to her room.

Toward the end of her stay, Newsham said, a security person tried to remove Niccum’s medicine when Newsham wasn’t present. Niccum told her, “ ‘Oh no you’re not. Those are mine. Do not take them. Do not touch my medicines.’ And security at that point said, ‘Well then, we’ll have to escort you out of the hospital.’ So she said, ‘Well fine. Take these tubes out of me. Get my wheelchair and I’m out of here.’ ”

Niccum called Newsham to pick her up, but about 15 minutes later, Newsham learned that a doctor had told the security personnel that Niccum had to stay. She stayed four more days. Before she left, she was given medication for pain and stimulants to increase her appetite because she wasn’t eating.

Niccum continued to experience pain into October, and Newsham complained “every day” to Niccum’s VA nurse.

“ ‘You need to do something,’ ” Newsham said. “I said, ‘You know we’re here, and even though we’re staying 24-7, we’re not really doing anything for her because she can’t eat. She’s rocking. She’s crying. She’s in pain. She’s begging anybody and Jesus to please help her.’ ”

Redwine said Niccum’s condition deteriorated to the point that she was constantly crying and asking for pain pills.

“For Sandi to cry, that never happened,” Redwine said. “I saw her cry two other times: over the loss of her son and her husband. … But she was in so much pain. That was the purpose of us trying to get back into the hospital, at least get her a pain pill so she could sleep.”

WAITING AND WAITING

Finally, Niccum’s primary care doctor told her to go to the VA hospital for a scan and an X-ray.

According to the chronology, Redwine drove Niccum to the VA Medical Center and was with her on Oct. 22 and again two days later for a follow-up visit.

When they arrived at the radiology department at 3:40 p.m. Oct. 22, they were told there were no doctor’s orders in the computer.

The nurse who prepared Niccum’s insulin syringes was contacted, and she called the VA endocrinologist, who informed the VA employee at the patient window that the orders were being typed up.

“The VA employee hung up the phone, stepped back and slammed the window shut and then came out the other door with his (personal) items and left for the day,” Redwine wrote.

Shortly after 4 p.m., Niccum checked in at the center’s emergency room, following orders from her women’s clinic physician.

“We signed in and the lady said, ‘Go over there and wait.’ And Sandi said, ‘How long?’ And she said, ‘I can’t tell you anything, I don’t know.’ So we did go wait,” Redwine said. “One hour. Two hours. Three hours. Eventually a lady did come out of the triage and took Sandi’s blood pressure and her glucose and the numbers were very low.

“The lady did offer Sandi some orange juice. I asked the lady if I could get a blanket and, here are two chairs, can I lay her down? She’s exhausted. She can’t do this. She’s too weak. And the lady said, ‘No. Absolutely not. You cannot lay her down and there are no beds … available for her back here,’ ” Redwine recalled Monday. “So I went back and told Sandi that, and she was still crying.”

Two other women and three men were in the waiting room, Redwine said.

“We waited and waited. The men that were in the waiting room had been there probably two hours. They left. They said, ‘We’ve had enough. We’re going to a local clinic and get taken care of.’ And then there was only three of us in the waiting room, and we still waited another two or three hours,” she said.

The emergency room doctor finally called for Niccum about 9:30 p.m.

“Sandi was so weak at that point I literally had to hold her head up to talk to the doctor. She was exhausted. She had severe pain, and she just kept crying and saying, ‘All I need is a pain pill. That’s what I came for.’ ”

The doctor told her she couldn’t give her a pain pill because it would interfere with tests that were planned but couldn’t be performed earlier because proper information hadn’t been entered into the computer system.

Niccum “just cried and said, ‘I can’t even sit up. I cannot do the tests at this time of night.’ ”

The doctor told her to go home and return “in the morning at 6:30 and be one of the first ones in line at X-ray. I said, ‘Ma’am, when we have an episode like this, Sandi needs 24 hours to recover with her diabetes and whatever is going on with her body right now,’ ” Redwine said.

FINALLY SHE HAD ENOUGH

Two days later, on Oct. 24, Redwine and Niccum arrived at the medical center’s X-ray facility about 7 a.m. They were told the facility wasn’t open yet and to wait.

“Once we did get in, we were told it was not entered in the computer correctly — ‘We cannot do your tests.’ ”

Redwine said she wheeled Niccum into the hallway outside the small waiting room “and explained to her what was going on. And she just cried and cried. And some wonderful gentleman came by and he said, ‘You know what. Give me a minute.’ And he went in X-ray, and I don’t know what he did, but when he came back, he said, ‘Ms. Niccum, I’m going to take care of you.’ ”

Though the test orders weren’t entered correctly in the computer, this man with a VA employee badge arranged for Niccum to take a partial test and go home.

“I went and got the car and loaded Sandi again. She was still crying in pain. We’re driving home on the freeway and Sandi’s phone rings. It was the Veterans (Affairs) hospital. They did not identify themselves. ‘You need to come back right away. This is an emergency. You have cancer.’ I pulled off the highway, and I just let her cry.”

Then Niccum’s endocrinologist called to tell her that he didn’t believe she had cancer. He told her to go to St. Rose Dominican Hospital, Redwine said, “and so we did. … We went to St. Rose, and they took her right away. They were wonderful.”

The St. Rose staff told her there was a large mass on her right side that they thought was a tumor. She also had a medical issue with a ruptured abscess in her colon. They decided not to operate, however, because of her history of congestive heart failure.

Even on the last day of Niccum’s life, Redwine asked a doctor at Nathan Adelson Hospice to “tell this lady the exact diagnosis that is on paper. Please don’t say, ‘I think this is what’s wrong,’ because every doctor had said that to Sandi. I said she needs to know.”

Redwine said that to the end of her life Niccum feared that, because of diabetes, she would go into a coma and die.

Her blindness stemmed from diabetes developed during her fifth year of active duty with the Navy Medical Corps as a medic for the Marine Corps at Parris Island, S.C. She was honorably discharged in 1958. She lost vision in one eye in 1983 and the other eye three years later.

Suffering from septic shock from the ruptured abscess in her colon, she died in her sleep about 2 a.m. on Nov. 15. The exact cause of death was unknown, Redwine said.

Niccum’s ashes will be buried at the Southern Nevada Veterans Memorial Cemetery in Boulder City at 10 a.m. on Dec. 12 with full military honors.

Donations can be made in her name to the Blinded Veterans Association, P.O. Box 46272, Las Vegas, NV 89114.

Contact reporter Keith Rogers at krogers@reviewjournal.com or 702-383-0308.