VA rules let in trou­ble

Doc­tors with mal­prac­tice claims in their past still might be hired to care for vet­er­ans.

The Commercial Appeal - - Front Page - Dono­van Slack USA TO­DAY

Neu­ro­sur­geon John Henry Sch­nei­der racked up more than a dozen mal­prac­tice claims and set­tle­ments in two states, in­clud­ing cases al­leg­ing he made sur­gi­cal mis­takes that left pa­tients maimed, par­a­lyzed or dead.

He was ac­cused of cost­ing one pa­tient blad­der and bowel con­trol af­ter plac­ing spinal screws in­cor­rectly; he al­legedly left another par­a­lyzed from the waist down af­ter plac­ing a de­vice im­prop­erly in his spinal canal. The state of Wy­oming re­voked his med­i­cal li­cense af­ter another sur­gi­cal pa­tient died.

Sch­nei­der then ap­plied for a job ear­lier this year at the Depart­ment of Vet­er­ans Af­fairs hos­pi­tal in Iowa City, Iowa. He was forth­right in his ap­pli­ca­tion about the li­cense re­vo­ca­tion and other mal­prac­tice trou­bles. But the VA hired him any­way. He started work in April at a hos­pi­tal that serves 184,000 vet­er­ans in 50 coun­ties in Iowa, Illi­nois and Mis­souri.

Some of his pa­tients suf­fered com­pli­ca­tions.

Sch­nei­der per­formed four brain surg­eries in a span of four weeks on one 65-year-old vet­eran who died in Au­gust, ac­cord­ing to in­ter­views with Sch­nei­der and fam­ily mem­bers. He has per­formed three spine surg­eries on a 77-year-old Army vet­eran since July — the last two to try and clean up a lum­bar in­fec­tion from the first, the pa­tient said.

Sch­nei­der’s hir­ing is not an iso­lated case.

A VA hos­pi­tal in Ok­la­homa know­ingly hired a psy­chi­a­trist pre­vi­ously sanc­tioned for sex­ual mis­con­duct who went on to sleep with a VA pa­tient, ac­cord­ing to in­ter­nal doc­u­ments. A Louisiana VA clinic hired a psy­chol­o­gist with felony con­vic­tions.

As a re­sult of USA TO­DAY’s in­ves­ti­ga­tion of Sch­nei­der, VA of­fi­cials de­ter­mined his hir­ing — and po­ten­tially that of an un­known num­ber of other doc­tors — was il­le­gal. Fed­eral law bars the agency from hir­ing physi­cians whose li­cense has been re­voked by a state board, even if they still hold an ac­tive li­cense in another state.

VA spokesman Curt Cashour said agency of­fi­cials pro­vided hos­pi­tal of­fi­cials in Iowa City with “in­cor­rect guid­ance” green-light­ing Sch­nei­der’s hire. The VA moved to fire Sch­nei­der on Wed­nes­day. He re­signed in­stead.

Cashour also said the VA would look into whether other doc­tors had been im­prop­erly hired.

“We will take the same prompt re­moval ac­tion with any other im­proper hires we dis­cover,” he said.

A USA TO­DAY in­ves­ti­ga­tion in Oc­to­ber re­vealed how the VA has for years con­cealed shoddy care and mis­takes by med­i­cal work­ers when they leave the agency.

The re­sults of the in­ves­ti­ga­tion of Sch­nei­der and other VA prac­ti­tion­ers with prob­lem pasts re­veal po­ten­tially dan­ger­ous short­falls when they join the agency as well.

Cashour said the agency also is ini­ti­at­ing an “in­de­pen­dent, third-party clin­i­cal re­view” of the care Sch­nei­der pro­vided in Iowa City that was re­layed to USA TO­DAY by pa­tients or fam­ily mem­bers.

In an in­ter­view, Sch­nei­der blamed poor out­comes for pa­tients on other providers in­volved in their treat­ment or on un­for­tu­nate com­pli­ca­tions not caused by his care.

Sch­nei­der said his in­surance com­pany de­cided to set­tle some of his prior cases re­gard­less of their merit, and he filed an ap­peal of the Wy­oming re­vo­ca­tion, a case that’s still pend­ing.

The case that cap­tured the at­ten­tion of Wy­oming Board of Medicine of­fi­cials was Rus­sell Monaco, a fa­ther of two who went un­der Sch­nei­der’s knife in 2011 for a pro­ce­dure to de­crease pres­sure on nerves in his lower back, ac­cord­ing to a wrong­ful death suit filed by his wife, Kathy.

Af­ter the op­er­a­tion, he was pre­scribed a litany of nar­cotics that can de­press breath­ing, in­clud­ing fen­tanyl, oxy­codone, val­ium, and De­merol.

He went home and took the med­i­ca­tions as pre­scribed, the law­suit says, but his fam­ily found him dead the next morn­ing. The coro­ner found the cause of death was “mixed drug over­dose.”

“I tried to wake him up and yelled and the girls came down scream­ing,” his wife, Kathy Monaco, told USA TO­DAY. “It was hor­ri­ble, I mean, I live that day over ev­ery day.”

IOWA CITY PRESS-CI­TI­ZEN/USA TO­DAY NET­WORK

The VA al­lowed its med­i­cal cen­ter in Iowa City, Iowa, to hire a physi­cian with a his­tory of mal­prac­tice claims.

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