‘Delay in treatment’ a factor in payouts

DAYTON — As controversy swirls around the Veterans Administration over deaths caused by delayed care, an investigation by the Dayton Daily News found that the VA settled many cases that appear to be related to delays in treatment.

A database of paid claims by the VA since 2001 includes 167 in which the words delay in treatment are used in the description. The VA paid out a total of $36.4 million to settle those claims, either voluntarily or as part of a court action.

The VA has admitted that 23 people have died because of delayed care, and it is facing accusations that hospital administrators are gaming the system to conceal wait times, including using a “secret list” at the VA in Phoenix. Robert Petzel, undersecretary for health care at the VA, resigned on

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Friday, the day after he and agency head Eric Shinseki were grilled by the Senate Committee on Veterans Affairs. Many have called for Shinseki’s resignation, as well.

It’s unclear in the data analyzed by the newspaper how many of the cases match the VA’s definition of delayed care. But there are numerous examples in which claimants allege substandard care related to lags in treatment.

The Dayton VA in 2009 paid out $140,000 for a 2006 claim that was described as “Failure/Delay in Admission to Hospital or Institution; Medication Administered via Wrong Route; Failure to Order Appropriate Test.”

A pending $3.5 million claim from March 2013 was filed by a man who says delayed treatment of his wife’s cervical cancer resulted in her death in March 2012. The names of the veteran and her widower were redacted.

“I’m not personally aware of any deaths that were attributed to a delay in receiving care at the Dayton VA Medical Center,” said Dayton VA spokesman Ted Froats.

More than 100 payments go out every year to resolve claims that veterans died due to mishaps by VA medical centers, according to an investigation conducted in partnership between the newspaper and WSB-TV in Atlanta.

The number of dead veterans could total more than 1,100 from 2001 through the first half of 2013 — including 16 at the Dayton VA Medical Center and 11 at the Cincinnati VA — according to records obtained via the Freedom of Information Act.

Dayton VA officials would not comment on specific cases, but they did issue a statement:

“Unlike many private hospitals, in the rare instance where a situation has interfered in a patient’s medical care, we sit down with the veteran to discuss what happened and notify the veteran of his or her right to file a tort claim,” it says. “As with any other aspect of our facility, we believe that transparency is the best method for handling any potential conflict.”

Ohio American Legion Service Director Suzette Price said the newspaper’s findings are tragic but not surprising.

“When you’ve got veterans that are mistreated, it’s wrong,” she said. “I think the whole system needs an overhaul.”

Price and the American Legion’s national office believe the place to start is with the resignation of Shinseki, especially after allegations came to light that veterans were dying at some medical centers because of delayed wait times.

Shinseki testified before a Senate committee on veterans affairs on Thursday. He said the allegations “make me mad as hell” and promised action if an investigation by the VA inspector general finds wrongdoing. But he evaded calls to step down.

“I came here to make things better for veterans,” he said.

Sen. Sherrod Brown, D-Ohio, sits on the veterans affairs committee and said he has faith in Shinseki.

Brown characterized heat put on the VA as partisan and political attacks on a health-care system so massive — providing 85 million patient-visits a year — that it inevitably will make mistakes.

“We know there have been problems in Dayton, at the VA center there over the years,” he said. “Much of that is corrected, but the size of the VA tells me that there are always going to be some problems. We’ve got to continue to work on it to perfect it.”

U.S. Rep. Brad Wenstrup, R-Cincinnati, sits on the House VA committee. He also is a veteran and a physician.

He said the VA could learn from private providers who put priority on processing patients. Private hospitals can do 10 colonoscopies in the time it takes the VA to do three, he said.

“It’s just a whole different mentality,” he said. “I think we have to change if we’re going to see all of our veterans who deserve to be served and be seen.”

Ohio’s six VA medical centers had a combined 54 malpractice payouts related to deaths since 2001. The Dayton VA Medical Center had the most, though Cleveland’s two medical centers had 22 combined. One case settled in 2003 for $200,000 involved hospitals in both Dayton and Cleveland.

Payouts at the Dayton VA related to deaths since 2001 total nearly $2 million. They range in size from $70,000 to $300,000. The most recent was a May 2012 payment for $140,000 for apparently failing to properly diagnose a patient.

Separate records obtained by the newspaper list all the claims made against the Dayton VA since the beginning of 2011 — including those that weren’t settled or paid — as well as more details on payments made.

The largest settlement in those records was for $85,000 to the family of a veteran who died in June 2010 after his heart monitor leads apparently became disconnected and workers allegedly failed to check on him and respond to an alarm signaling the disconnection.