VA Pays Millions To Keep Docs On Paid Leave


 
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By Jerry Mitchell

Taxpayers are paying millions for VA hospitals to keep health care providers with questionable records on paid leave for years, a investigation has found.

In 2014 alone, 2,560 employees at the Department of Veterans' Affairs spent at least one month on paid leave (some the entire year), costing taxpayers $23 million — more than any other federal agency.

“Because of the federal government’s dysfunctional civil service laws that put the job security of bureaucrats ahead of the safety of veterans, the VA doesn’t have the ability to adequately discipline most misbehaving employees,” said U.S. Rep. Jeff Miller, chairman of the House Committee on Veterans’ Affairs. “As a result, the department’s problems don’t get fixed. They fester, as problem employees are either paid to do nothing, shuffled around or not dealt with at all.”

VA Secretary Robert McDonald acknowledged employees remain on paid leave too long.

“Originally, administrative leave was designed to take people out of system while they were being investigated so they didn’t create adversity or harm,” he said.

He said his agency is streamlining the process so employees can be disciplined more quickly.

At the G.V. “Sonny” Montgomery VA Medical Center in Jackson, two surgeons, whose annual salaries total more a half million, have been on paid leave more than two years. They count against the Jackson VA’s budget, but veterans receive no care from them.

Retired Maj. Gen. Erik Hearon, former assistant adjutant general and commander of the Mississippi Air National Guard, said veterans are hurt by this because they can’t see these surgeons and taxpayers are hurt by this because they have to pay for veterans to receive care elsewhere.

Taxpayers have footed the bill for the following:

Dr. Daniel K. Kim, a 59-year-old ophthalmologist, is still employed at the Jackson VA, despite a World War II veteran winding up blind when Kim performed a routine cosmetic surgery in 2006. The VA denied any wrongdoing, calling it a medical mystery.

In 1997, a patient of his, Judy Loveless, died during routine cosmetic surgery in a Georgia clinic. Charged with forging her consent form, Kim surrendered his Georgia medical license and pleaded guilty to a misdemeanor charge.

He has denied doing anything wrong in either case.

Taxpayers continue to pay his more than $190,000 in annual base pay.

These days, he is working at the Jackson VA out of an office for facilities management, which handles housekeeping, safety, maintenance and other duties.

Frederick Kevin Harris, a nurse’s aide, is still employed at the VA Hospital in Alexandria, Louisiana, despite being charged with manslaughter, accused of beating to death a 70-year-old military veteran in March 2013.

Despite the criminal charge, the VA concluded he is not at fault. He continues to draw his $36,902 in base pay and has reportedly been allowed at times to treat patients.

Dr. Jose M. Bejar, a neurologist with the Kansas VA in Topeka, pocketed more than $330,000 from taxpayers while he was on paid leave for two years after five female veterans filed sexual misconduct charges against him in 2011.

He finally pleaded no contest in 2013 to aggravated sexual battery, “conducting inappropriate pelvic and breast examinations on patients.” After that, he surrendered his medical license and registered as a sex offender.

Sen. Charles Grassley, R-Iowa, questioned the VA’s record on paid leave, pointing out the agency kept 46 employees on paid leave for more than a year.

He and other senators have introduced legislation in hopes of curbing that abuse by the VA and other federal agencies.

“There’s a Wild West environment among agencies on paid administrative leave,” said Grassley, chairman of the Judiciary Committee. “Some agencies use it too much, and the taxpayers get short-changed.”

He said such paid leave “shouldn’t be a crutch for management to avoid making tough personnel decisions or a club for wrongdoers to use against whistleblowers.”

Some on paid leave have taken the VA to court.

On July 25, 2013, the Jackson VA suspended neurosurgeon Dr. Mohamed Eleraky from performing any more surgeries at the Jackson VA. Nine months later, the hospital suspended him from seeing any more patients.

He is now suing the Jackson VA, saying the hospital has failed to give him a fair hearing. But the lawsuit gives no reason why he was suspended.

Taxpayers continue to pay his more than $329,000 in annual base pay.

His lawyer, Whitman Johnson III of Flowood, would not comment.

The VA secretary said in the past, the VA relied on the inspector general’s office to do investigations and “were told to stay out of the way.”

Now, he said, “we are starting our own investigations, not putting people on administrative leave but putting them on another job.”

Rocky road to reform

When McDonald took over as VA secretary in mid-2014, he promised to turn the agency around, getting rid of bad employees, including those involved in falsifying documents and manipulating wait times at VA hospitals.

When he appeared on national television, Feb. 15, 2015, he said 900 employees had been “fired since I became secretary. We’ve got 60 people that we fired who have manipulated wait times.”

However another new outlet challenged his numbers, saying the actual number fired in the scandal at that time was eight.

Last August, McDonald told the Senate Veterans Affairs Committee he had terminated more than 140,000 of the more 340,000 VA employees — only to correct himself and say only 1,800 had been fired. Then 1,755. Then 755.

“Isn’t it true it’s almost impossible for you to fire somebody under current law?” asked Johnny Isakson, chairman of the committee.

McDonald said it’s easier to fire employees in the private sector. “You can buy them out. You can’t do that in the public sector.”

But VA officials did just that when they paid Rebecca Wiley, the director of the Charlie Norwood Veterans Affairs Medical Center, more than $76,000 when she retired in 2013 — a week after Congress began examining, what, if any, role her administration had played in nine preventable patient deaths in Augusta and Columbia, Georgia.

On Jan. 21, McDonald disputed accusations that too few VA employees have been fired since he took over. “You can't fire your way to excellence,” he said.

This time, he said 2,600 VA employees had been fired.

In 2014, Congress passed a bill that made it easier to fire VA employees guilty of misconduct or poor performance, but some have remained on the payroll.

The director of the troubled regional benefits office in Reno, Nevada, which handled disability applications, did such a lousy job that VA officials sent him home for a year — with pay.

But rather than fire him, VA officials “created a special job for him where he can telework from Reno to be an adviser to somebody here in Washington,” U.S. Rep. Dina Titus, D-Nev., said in a November hearing. “It was a totally created job.”

In 2010, Jed Fillingim, assistant director for the Jackson VA, was involved in a fatal drunken driving accident in a Dallas suburb that killed Amy Wheat, a 38-year-old nurse recruiter for the Jackson VA.

Despite the death, police in Addison, Texas, failed to administer a blood-alcohol test on him until six hours later, at whicht point, he tested at .03, under the legal limit.

He resigned in November 2010. Months later, the VA hired him back.

Wheat’s mother, Annette Berry, stated, “It’s just not right. They should fire him. There’s been no criminal punishment. No VA punishment.”

In 2014, Fillingim made $107,434 at the VA hospital in Augusta, Georgia, plus a $900 performance bonus. VA officials say he is no longer employed there.

McDonald has vowed the agency is turning around, “providing more and better care than ever before.”

He said his vision is for the VA to become “the No. 1 customer-service agency in the government.”

If so, the agency has a ways to go. Since 2000, the VA has paid out more than $1.1 billion to veterans and their families for medical malpractice.

Then-U.S. Sen. Tom Coburn, R-Okla., concluded in his 2014 report that more than 1,000 veterans may have died as a result of the VA’s misconduct over the past decade.

“Too many men and women who bravely fought for our freedom are losing their lives, not at the hands of terrorists or enemy combatants,” he wrote, “but from friendly fire in the form of medical malpractice and neglect by the Department of Veterans Affairs.”

Pay is a problem

Past and present VA physicians say one problem with regard to VA hospitals hiring and keeping qualified doctors is the pay — about half of what can be earned in the private sector.

Dr. Randy Easterling, president of the Mississippi Board of Medical Licensure, said the low pay discourages physicians from seeking a lifelong career of public service when they can earn twice as much in the private sector.

Dr. Timothy Trotter — who worked 13 years at the VA, serving as chief of thoracic surgery at the VA Hospital in Oklahoma City — said some physicians who wind up at the VA have been repeatedly sued or can’t find work elsewhere.

Before leaving for a week in 2012, he warned administrators against letting a surgeon operate alone.

He said the surgeon’s prior solo surgeries had failed to go well. In one case, a patient suffered a heart attack, and in another, the surgeon accidentally left a chest tube inside the patient’s chest.

Trotter, who had been supervising the surgeon, said when administrators questioned his claim about letting the surgeon operate alone, he said he asked them, “Are you willing to kill somebody to make this point?”

While gone, the surgeon operated, and a patient died.

A week later, the surgeon was allowed to operate again, and this time, Trotter said he had to assist after the surgeon stitched together two of the three arteries to the heart.

After this, he said the cardiopulmonary bypass machine operator refused to work with the surgeon, and the surgeon left the VA.

“On one hand, you might say people should get a new start, but in reality, somebody should take their cello away,” Trotter said. “They shouldn’t be playing.”

He would like to see the government make veterans’ health care part of the Medicare program. “It’s a system already in effect, it is already policed like all of health care since it is privatized, more or less, and it is universally accessible everywhere.”

Dr. Robert K. Finley III went to work at the VA Hospital in Huntington, West Virginia, after he paid a $5,000 fine to settle Iowa Board of Medicine allegations that his mistakes contributed to the death of six patients and to the injuries sustained by three others.

The family of Asa Carson is now suing the Huntington VA in federal court for $1.2 million, contending Finley bungled three abdominal surgeries on Carson and failed to fix a perforated colon. Finley has denied any wrongdoing.

Record of problems

The first patient Dr. Daniel Kim saw at the Luna Laserperfect Skin Center in Atlanta was Judy Loveless, a petite flight attendant nearing her 50th birthday.

The day before she went in for the routine cosmetic surgery on Oct. 3, 1997, she talked to her cousin, Nina Harbour of Tyrone, Georgia. “She said he was going to work on the crow’s feet around her eyes.”

The next day, Loveless appeared at the clinic, and Kim started the anesthesia. He realized too late she was struggling to breathe.

When he finally did notice, he called in staff members who performed CPR on Loveless.

Paramedics struggled to get her out of the facility because the elevator was too small to hold a gurney.

By the time she arrived at the hospital, she was dead.

Georgia medical officials concluded Kim had no resuscitation equipment, no monitoring equipment and no crash cart. He also had no formal training in anesthesia.

“He had no nurse and no medicine to reverse the anesthesia,” Harbour said. “He overdrugged her.”

Authorities charged Kim with two felonies, accusing him of forging her consent form for surgery after she died.

As part of a plea bargain, he surrendered his Georgia medical license, pleaded guilty to a misdemeanor charge and did 40 hours of community service.

Harbour was horrified to learn Kim still had his medical license and was employed at the Jackson VA. “I thought I got him out of the practice.”

She was even more horrified to learn another patient in his care had suffered harm. “I thought he would be banned for any kind of surgery anymore.”

In 2000, the Mississippi Board of Medical Licensure agreed to let Kim work under the supervision of an ophthalmologist in Hattiesburg. That never happened, but he managed to get a job a few years later at the University of Mississippi Medical Center.

Dr. Shirley Schlessinger, professor of medicine and associate dean for graduate medical education at UMMC, testified in a deposition that Dr. Ching-Jygh Chen, then-head of the ophthalmology department, told her Kim had suffered “some bad patient outcomes” while working there. “Dr. Kim did not consider himself subject to directives.”

She said Kim described himself as “the best ophthalmologist around, that he felt that he was being discriminated against and basically disrespected by all the people he worked with. And when I asked him why he felt that was true, he said that was because he was a clearly superior physician and human being to everyone that he knew anywhere. And that is a direct quote. ‘I am simply better than all of them, and they can’t tolerate my superiority.’ ”

Unable to get a license in Florida or elsewhere, Kim applied to work at the Jackson VA.

Chen told the VA that Kim “would be a great addition to the VA staff. Dr. Kim is one of the best teachers, an excellent surgeon,” according to a memo in the court file.

Chen testified one reason he recommended Kim was how much UMMC was paying for Kim’s malpractice insurance — more than Kim’s salary. (In Mississippi, general surgeons pay on average about 10 percent of their income for medical malpractice premiums.)

In 2006, 89-year-old World War II veteran Charles L. West read the newspaper every morning, cooked and drove himself to a park in Crossgates, where he walked.

“He was as active as you and I,” said his niece, Susan Armstrong.

When he arrived at the Jackson VA, he complained about struggling to see. According to records, he had 20/40 vision in his right eye and 20/30 in his left.

Kim recommended cosmetic surgery for the eyelids’ sagging skin, and West agreed.

On March 10, 2006, Kim performed the routine surgery that was supposed to last 10 minutes.

Instead, it lasted an hour and 20 minutes because Kim decided to do more extensive work on the eyelids.

“When I removed the corneal protectors, I knew right away that something had occurred,” Kim said in a deposition.

West suffered chemical burns to both of his corneas, leaving him legally blind and dependent on round-the-clock care.

“He was just lost,” Armstrong said. “It was a nightmare.”

A VA internal investigation suggested the nurse used a bottle of Betadine with bleach, getting it into the eyes. In court documents, the VA denied any wrongdoing, calling it a medical mystery.

The judge ordered the VA to pay $249,054 in actual damages, and $500,000 in punitive damages. The judge said he would have awarded more, but the statute capped the damages.

A month after the trial ended, West died.

Armstrong, who is a nurse, believes he died because of injuries he suffered from a fall.

Kim declined an interview's, saying that it would “just confuse things.”

Asked about the case involving Charles West, Kim replied, “I can’t remember who (that was).”

After hearing details from the case, Kim said, “I can’t talk about that.”

In a deposition, Kim acknowledged the VA gave him “unsatisfactory” scores for “ethics” and “clinical competence,” which is taking care of patients.

He also acknowledged he performed certain surgeries at the VA without receiving the privileges to do them, but said he didn’t know he lacked the privileges until after he was done.

He said his surgery performing glaucoma tube shunts went fine and that it was a learning process for a doctor training to become a glaucoma specialist.

“How can it be a learning experience for a resident when you didn’t have the qualifications at the VA to perform the procedure?” defense lawyer Dennis Horn of Madison asked.

“Oh, I think I could teach you how to do it,” Kim replied.

“When you performed a toric intraocular lens procedure (to correct astigmatism) did you know you weren’t credentialed?”

“I didn’t know it required credentialing.”

Despite all these problems, the VA allowed Kim to continue to operate.

In April 2012, he implanted the wrong lens in a patient’s eye and had to conduct a second operation to remove it and put in the right one.

VA officials are now reportedly considering a plan to send him to Houston, Texas, where another surgeon would monitor him.

West’s lawyer, William Quin II of Ridgeland, said that plan by the VA “doesn’t bring back Mr. West’s eyesight or make up for their refusal to own up to his mistakes.”

Armstrong criticized the VA for keeping physicians such as Kim on paid leave for years.

“To people who work hard for their money, it’s insulting,” she said. “And it’s insulting that our government, in such a state of unbelievable debt, allows this.”

By the numbers

VA employees on paid administrative leave in 2014:

1-3 months: 2,277

3-6 months: 200

6-9 months: 53

9-12 months: 30


 
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