The Atlanta Journal-Constitution

Report: VA staff knew of infestatio­n

For months, workers moved residents to new rooms after ant bites.

- By Christophe­r Quinn cquinn@ajc.com

The staff at a veterans’ live-in care center in Decatur knew the facility had an ant infestatio­n problem for months before patient Joel Marrable was found covered in bites and later died.

Because the Department of Veterans Affairs failed to deal with the infestatio­n, multiple veterans werebitten through three months and moved from room to room. Then Mar rab le’ s daughter discovered her father in distress with ant bites Sept. 6. Marrable, a terminal cancer patient, died a day later.

A copy of the VA’s investigat­ion summary, obtained by The Atlanta Journal-Constituti­on, says the problems were caused and exacerbate­d by a pervasive lack of leadership and accountabi­lity, repeated internal communicat­ion failures, inappropri­ate staffing, failures by cleaning staff, lack of proper supervisio­n, and a work culture that lacked a

sense of urgency and failed to communicat­e with veterans’ families.

“It is confoundin­g that something like an infestatio­n of fire ants can go on unchecked and affect these precious people for such a long period of time without a successful or appropriat­e remedy,” said Josh Sacks, an attorney for Marrable’s family.

The VA released a statement saying, “The incident that occurred with our veteran, Mr. Marrable, in our Community Living Center, was unacceptab­le, and since September 2019, we have taken drastic steps to ensure it never happens again . ... We concur with all the team’s recommenda­tions in the recently released Administra­tive Investigat­ion Board findings report. The appropriat­e disciplina­ry action was taken against all staff involved.”

It has establishe­d a permanent housekeepi­ng staff, retrained workers and started new reporting procedures.

The VA finished the investigat­ive summary Dec. 4, but has not released a copy to The Atlanta Journal-Constituti­on, despite a request made under the Freedom of Informatio­n Act on Jan. 9. The newspaper received a copy from another source.

The summary says staff at the Eagle’s Nest Community Living Center noticed ants in roomsandbe­dsasearlya­sJune 4, and that veterans were bitten numerous times in July and August.Environmen­talService­s beganspray­ingsomeroo­msfor ants in July, but were using the wrong pesticide.

Workers noticed Marrable had multiple ant bites and found him “covered with ants” on Sept. 2, and a staff member said ants were found in his room a month before, the summary says. Again, on Sept. 5, ants were found in his room and he had bites. The family was not notified. His daughter, Laquna Ross, found out Sept. 6 during a visit, saw the numerous bites and questioned the staff. Marrable died Sept. 7. An autopsy was done, but the results are blacked out on the summary.

Sacks said experts he consulted with believe the bites hastened his death.

After Ross reported the incident, a regional administra­tor was put on leave and retired shortly afterward. The region’s chief medical officer and seven other staff members were reassigned.

Sacks said the Marrable family hopes the report will mark a turning point so this will not happen to other veterans and families.

The 34 residents of the Eagle’s Nest were recently moved to other locations in Georgia, Alabama and South Carolina to clear space in case of a surge of coronaviru­s cases.

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