VA CONCEALS SHODDY CARE, STAFF MISDEEDS
Lax reporting, secret settlements allow problem health care workers to keep treating patients elsewhere
Behind the walls of the nation’s oldest veterans’ hospital, the reports were grim.
Medical experts from the Department of Veterans Affairs blamed one botched surgery after another on a lone podiatrist.
They said Thomas Franchini drilled the wrong screw into the bone of one veteran. He severed a critical tendon in another. He cut into patients who didn’t need surgeries at all. Twice, he failed to properly fuse the ankle of a woman, who chose to have her leg amputated rather than endure the pain.
In 88 cases, the VA concluded, Franchini made mistakes that harmed veterans at the Togus hospital in Maine. The findings reached the highest levels of the agency.
“We found that he was a dangerous surgeon,” former hospital surgery chief Robert Sampson said during a deposition in a federal lawsuit against the VA.
Agency officials didn’t fire Franchini or report him to a national database that tracks problem doctors. They let him quietly resign and move on to private practice, then failed for years to disclose his past to his patients and state regulators who licensed him.
He works as a podiatrist in New York City.
A USA TODAY investigation found the VA — the nation’s largest employer of health care workers — has for years concealed mistakes and misdeeds by staff members entrusted with the care of
veterans.
In some cases, agency managers do not report troubled practitioners to the National Practitioner Data Bank, making it easier for them to keep working with patients elsewhere. The agency failed to ensure VA hospitals reported disciplined providers to state licensing boards.
In other cases, veterans’ hospitals signed secret settlement deals with dozens of doctors, nurses and health care workers that included promises to conceal serious mistakes — from breakdowns in supervision to dangerous medical errors — even after forcing them out of the VA.
USA TODAY reviewed hundreds of confidential VA records, including about 230 secret settlement deals never before seen by the public. The records from 2014 and 2015 offer a narrow window into a secretive, long- standing government practice that allows the VA to cut short employees’ challenges to discipline.
In at least 126 cases, the VA initially found the workers’ mistakes or misdeeds were so serious that they should be fired. In nearly three- quarters of those settlements, the VA agreed to purge negative records from personnel files or give neutral references to prospective employers.
Michael Carome, director of health research at Public Citizen, said removing records from personnel files and providing neutral references create potential danger beyond the VA. “What they are saying is, ‘ We don’t want you to work for us, but we’ll help you get a job elsewhere.’ That’s outrageous,” he said.
The VA settled with a nurse who managers initially found had left a psychiatric patient bound in leather restraints for hours; a medical technician who made errors on critical bone imaging charts; and a hospital director accused of harassing female workers while his facility fell weeks behind in treating veterans.
The VA has been under fire in recent years for serious problems, including revelations of delays in treating veterans in 2014 and efforts to cover up shortfalls by falsifying records.
New VA leaders promised accountability, including increased transparency and a crackdown on bad employees.
In the years since, the VA has fired hundreds of employees who treat pa- tients. Details of each case — including the names of fired doctors — largely remain secret.
In denying requests for information, the agency cited federal privacy law and said protecting employees’ privacy outweighed the public’s right to know about problems with veterans’ care.
Agency leaders who took over after President Trump’s inauguration declined to discuss how their predecessors handled cases uncovered by USA TODAY.
In response to USA TODAY’s findings, VA Secretary David Shulkin ordered that all future settlement deals involving payments of more than $ 5,000 be approved by top VA officials in Washington. Decisions had been left to local and regional officials. The settlements USA TODAY reviewed involved workers at more 100 facilities in 42 states.
The VA said it will review its policy of reporting only some medical professionals to the national data bank after USA TODAY’s questions about its investigation of Franchini, who did not get a settlement.
April Wood lives with a permanent reminder of Franchini’s surgeries. During Army boot camp in 2004, she sliced her hands on a rope in a training exercise and fell 20 feet into a cargo net.
Her ankle did not heal properly, leaving her no choice but to accept a discharge months later. She moved to Maine and sought care for her foot at the VA.
After two Franchini surgeries failed to end her pain, Wood was spending much of her life in a wheelchair, unable to work. By 2012, she said her path seemed clear. “I had to believe that something else was better than that amount of pain,” she said.
On Aug. 28, doctors amputated Wood’s leg. Months later, the VA called. She learned Franchini resigned under investigation. The VA would determine both of her surgeries were flawed. Wood, who lives in Missouri, sued the VA.
Franchini told USA TODAY he did not make medical mistakes. When the VA placed Franchini on leave after finding problems with a sample of his cases in 2010, his attorney submitted two outside reviews saying the VA’s findings were not backed up by medical records. Franchini resigned from the VA while under investigation.