VA centers in 30 states, D.C. used recalled wipes
JoNel Aleccia of MSNBC.com continues her reporting on tainted and recalled alcohol prep pads, finding that “A quarter of the nation’s Veterans Health Administration medical centers and the agency’s outpatient mail-order pharmacy used recalled alcohol prep pads and other products …”
The FDA has identified problems with contamination and sterilization at the plant where the products were manufactured and hundreds of millions of products were recalled because of the threat of bacterial contamination.
The VA says “38 of the country’s 152 major veterans medical centers in 30 states and the District of Columbia removed recalled wipes, pads and other products from use” and “products were removed from the Consolidated Mail Outpatient Pharmacy, which provides more than 97.4 million prescriptions a year to veterans.”
Previously, the FDA the company that manufactured the wipes refused to identify which hospitals used the products, but Aleccia has obtained and published a list of the affected VA facilities.
Recalled povidone iodine prep pads from the same company also have been included in first aid kits intended for animals, such as this equine first-aid kit.
Previous coverage:
- Parents blame toddler’s death on tainted wipes
- FDA knew of problems at plant that made tainted wipes
- FDA defends actions on tainted wipes
- Colo. hospital blew whistle on tainted wipes
- Pressured firm closes line that made tainted wipes
- Infection risk triggers new recall of wipes
- Two-thirds of alcohol wipes contaminated
- FDA asks maker of tainted wipes to stop production
- Senators question FDA’s response to tainted wipes
- Wipe-maker shuts doors after U.S. Marshals arrive
- Feds seize $6 million in products from wipe-maker
Spreadsheet lists malpractice claims against VA
In its “FOIA Friday” feature, the Project On Government Oversight reveals a spreadsheet (XLS format) of claims against the Department of Veterans Affairs, including thousands related to medical malpractice.
The spreadsheet lists administrative claims, the first step in the VA’s process for filing claims.
Nick Schwellenbach explains more about the data:
The data provided has details on over 12,000 claims against the VA from 1989 to November 2008, although the data appears largely incomplete for the first several years. Not all of the claims are medical malpractice-related, but several thousand are. There are fields for the VA facility involved, the date the claim was received, the date of the last tort status (where the claim is in the administrative process), the date of that status, alleged negligence descriptions (none exist for non-medical malpractice tort cases), and amount paid out, if any. The spreadsheet is over two years old, so the latest tort status field may be out-of-date for many of these claims.
The spreadsheet includes 16 cases in which more than $1 million was paid out. The descriptions of the allegations are pretty vague but those 16 cases include:
- Failure To Obtain Consent or /Lack Of Informed Consent; Improper Technique; Improper Performance; Improper Management; Delay In Diagnosis; Failure To Treat; Failure To Order Appropriate Medication; Failure To Monitor; Failure To Diagnose (i.e., Concluding That Patient Has No Disease or Condit[ion)]
- Failure To Respond To Patient
- Surgical or Other Foreign Body Retained
- Unnecessary Procedure; Intubation Problem; Improperly Performed Test; Improper Management
It’s worth noting that another recent “FOIA Friday” also was related to health. It was a letter sent by the National Institutes of Health to Emory University “after the media exposed Dr. Zachary Stowe’s cozy financial relationship with GlaxoSmithKline (GSK) while also receiving NIH grants to study antidepressants like GSK’s Paxil in pregnant women.”
Story on soldiers’ aches and pains wins member a Mid-America Emmy
Filed under: Government, Health journalism, Member news
A story inspired by a session at Health Journalism 2009 earned member Meryl Lin McKean the 2010 Emmy for Health/Science News at the Mid-America Emmy Awards this year. McKean is the medical reporter at WDAF-Kansas City. Her story looked beyond casualty rates to the everyday aches and pains that come as a result of active military service in Iraq and Afghanistan. The video is no longer available, but the accompanying text demonstrates the scope and severity of such problems.
Soldiers return to a border checkpoint in the Khowst province of Afghanistan. Photo by The U.S. Army via Flickr
A V.A. report found that nearly half of the returning vets from Iraq and Afghanistan have bone, joint or tissue injuries. At Kansas City’s V.A. Medical Center, 17% of the vets seen in the new post-deployment clinic have those injuries. That’s still far higher than in non-vets.
“This age group between 18 and 30 — you might expect five percent at the most,” says Bob Fletcher, V. A. Physician’s Assistant.
Fletcher says the problems are clearly related to the combat load. And the problems for many vets will continue. Those problems include include arthritis pain and stiffness, the inability to hold certain jobs that require much movement, and possible dependence on pain medication.
PTSD or personality disorder? It matters to soldiers
Filed under: Government, Health journalism, Health policy, Studies
The AP’s Anne Flaherty has put together a story that illuminates the Army’s refusal to admit that it could have misdiagnosed (and discharged) hundreds of soldiers who may have had PTSD or traumatic brain injury instead of a personality disorder. Keep in mind that a discharge for “personality disorder” means no veterans’ benefits and a lifetime of stigma. A diagnosis of PTSD or injury, on the other hand, means treatment will be covered by the government.
Photo by isafmedia via FlickrThe Army, for its part, has decided there’s nothing unusual about the following chain of events (taken from Flaherty’s story):
- The Army “discharged about a 1,000 soldiers a year between 2005 and 2007 for having a personality disorder.”
- In 2007, The Nation’s Joshua Kors writes a cover story exposing the Army’s apparent habit of diagnosing soldiers with a personality disorder instead of considering the possibility of PTSD or traumatic brain injury.
- Soon after, “the Defense Department changed its policy and began requiring a top-level review of each case to ensure post-traumatic stress or a brain injury wasn’t the underlying cause.”
- Sure enough, “the annual number of personality disorder cases dropped by 75 percent.”
- At the same time, the number of post-traumatic stress disorder cases has soared. By 2008, more than 14,000 soldiers had been diagnosed with PTSD — twice as many as two years before.
- Army officials “reviewed the paperwork of all deployed soldiers dismissed with a personality disorder between 2001 and 2006″ and said they “did not find evidence that soldiers with PTSD had been inappropriately discharged with personality disorder.”
Report links Gulf War, illness; calls for more study
The Institute of Medicine has released a report, sponsored by the Department of Veterans Affairs, on certain health issues in Gulf War veterans.
The committee behind the report wrote that insufficient data from immediately before and after deployment made drawing clear conclusions difficult, but called for a commitment to monitoring and caring for what the release called “persistent, unexplained symptoms” in Gulf War veterans. It also said that interaction between genes and the environment was likely a factor in veterans’ “multisymptom illness.”
The key paragraph from the press release (emphasis mine):
Military service in the Persian Gulf War is a cause of post-traumatic stress disorder in some veterans and is also associated with multisymptom illness; gastrointestinal disorders such as irritable bowel syndrome; substance abuse, particularly alcoholism; and psychiatric problems such as anxiety disorder, says a new report from the Institute of Medicine, the latest update in a series of reports on the Gulf War and veterans’ health. There is some evidence that service during the conflict is linked to fibromyalgia and chronic widespread pain, amyotrophic lateral sclerosis, sexual difficulties, and death due to causes such as car accidents in the early years after deployment, but the data are limited, said the committee that wrote the report.
Patient data errors force VA to close EMR system
Nextgov’s Bob Brewin reports that errors in patient data have forced the Department of Veterans Affairs to close access to the Bidirectional Health Information Exchange, the Defense Department’s vast electronic medical record system. The bug first surfaced in February when a physician noticed that the system claimed one of his female patients had been prescribed an erectile dysfunction drug. The errors have been blamed on old code in the six-year-old system which could not handle peak usage rates.
The glitch did not cause harm to any patient, but “the potential exists for decisions regarding patient care to be made using incorrect or incomplete data,” said Jean Scott, director of the Veterans Health Administration’s Information Technology Patient Safety Office, in the alert issued on Wednesday.
… The VA clinician may see the patient’s data during one session, but another session may not display the data previously seen,” the alert noted. “This problem occurs intermittently and has been reported when querying DoD laboratory, pharmacy and radiology reports.”
The system is expected to go back online March 9. Until then, Brewin writes, “VA doctors will have to obtain a patients’ health information from their paper medical files, faxes or PDF attachments that are e-mailed to the physicians.”
According to its tagline, Nextgov focuses on “Technology and the Business of Government.”
Legacy of Agent Orange continues in U.S., Vietnam
The Chicago Tribune is in the middle of an ambitious five-part series in which reporters Jason Grotto and Tim Jones seek to shed light on one of the great gray areas of veterans’ medicine: the effects of Agent Orange. The first installment gave background on the use and consequences of Agent Orange.
Subsequent pieces chronicle the veterans’ battle for compensation, the suspected link between the defoliant and birth defects in Vietnam and continued pollution in that country from defoliants. The last, not-yet-published piece will reveal “documents showing that decisions by the U.S. military and chemical companies that manufactured the defoliants used in Vietnam made the spraying more dangerous than it had to be.”
The authors explain how they did it:
With assistance from the Fund for Investigative Journalism, the Tribune spent a month traveling to eight provinces throughout Vietnam, conducting nearly two dozen interviews with civilians and former soldiers who say they were exposed to the defoliants.
The newspaper used a database of every spraying mission, mapping software and a GPS device to help corroborate their stories. And in the U.S., the paper researched thousands of pages of government documents and traveled to the homes of veterans to gauge the impact and measure the cost in both dollars and human misery.
According to the reporters, 65 percent of Agent Orange and its defoliant relatives were contaminated with the super-toxin dioxin, and some even contained arsenic. The full impact of this chemical onslaught is unknown, but the Tribune reporters have tracked down a number of alarming anecdotes and numbers.
“We do not know the answer to the question: What happened to Vietnam veterans?” said Jeanne Stellman, an epidemiologist who has spent decades studying Agent Orange for the American Legion and the National Academy of Sciences. “The government doesn’t want to study this because of international liability and issues surrounding chemical warfare. And they’re going to win because they’re bigger and everybody’s getting old and there are new wars to worry about.”
VA: Consent forms for human studies incomplete
According to a report released by the Department of Veterans Affairs Office of Inspector General, an audit of representative VA hospitals found that about 31 percent of informed consent documentation for human studies was incomplete. In the vast majority (97 percent) of cases, this was due to lack of a witness signature.
Among the report’s other findings:
- An estimated 1 percent (1,023) of the 110,231 non-compliant lacked the subject’s signature or that of their authorized representative, rendering them legally ineffective.
- An estimated 1.7 percent of the 367,103 consent forms could not be located, the report extrapolated the national range to be somewhere between 0.6 percent and 4.5 percent.
- In specific situations, Institutional Review Boards can waive informed consent. In two of the 33 such cases examined, sufficient documentation of this waiver was not found.
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