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Looking back at 2017: Trauma at VA Medical Center

New Hampshire Union Leader

December 31. 2017 12:32AM
Secretary of Veterans Affairs David Shulkin, M.D., answers a question as U.S. Sen. Maggie Hassan, center, and U.S. Sen. Jeanne Shaheen, right, listen during a media session at the VA Center in Manchester in August. (Mark Bolton/Union Leader)

Editor's Note: As 2017 comes to a close, the New Hampshire Union Leader and Sunday News take a look back at some of the top stories in a year marked by unspeakable crime, sex scandal, political milestones and business achievements. This is the final story in the series spotlighting the year's leading news events.

MANCHESTER - Heads rolled, money flowed and burst pipes sent water literally flooding through the Manchester VA Medical Center, which was rocked by whistleblower charges and a complete administrative shake-up in 2017.

The claims lodged by 11 physicians and medical employees about "Third World" care in Manchester had been bubbling internally for more than a year, but came to light after a federal whistleblower agency, the VA's Office of Special Counsel, was contacted.

The longtime employees pointed to bad outcomes for patients with spinal ailments, a fly infestation in an operating room, unsanitary operating equipment and problems veterans faced getting outside care through the Veterans Choice Program.

Ironically, for the first time in years, the medical center had achieved a four-star rating from federal regulators in 2016.

But once the Boston Globe Spotlight Team published an expose on the whistleblower charges last July, the reaction was fast and furious.

President Trump's Veterans Affairs Secretary Dr. David Shulkin removed the top two officials, Director Danielle Ocker and Chief of Staff James Schlosser, and installed White River Junction, Vt., VA medical executive Alfred Montoya as acting director.

Barely a week on the job, Montoya had to deal with a building crisis as a burst pipe in a mechanical room above the top floor flooded a number of floors at the hospital, causing significant damage and resulting in the cancellation of approximately 250 appointments.

"We have had significant catastrophic flooding in the medical center, going from the third floor up to the sixth floor and into the mechanical space," Montoya said as he displayed pieces of the broken pipe.

Some of the clinics suffering water damage included the audiology, optometry and women's health clinics.

The center used portable buildings to conduct some medical appointments while it struggled over the next month or longer to catch up with a patient backlog.

Meanwhile, Shulkin came to the Smyth Road medical center to meet with the staff, the clients, the political leadership and the media, offering a blueprint for how best to reform the 67-year-old complex.

He announced a $30 million investment, a study on how best to give New Hampshire veterans "full-service" care and still more staff shake-ups.

Dr. Ed Kois, at the lecturn, speaks during a Manchester VA Medical Center town hall for veterans in July at American Legion Sweeney Post 2 in Manchester. (Mark Bolton/Union Leader file photo)

As a former private hospital executive, Shulkin said the complaints were alarming but not out of the ordinary.

"I wasn't surprised by any of them. What I was surprised about was why was it taking so long to resolve these and why the clinicians weren't being listened to," Shulkin said.

At a medical center town hall meeting in July, veterans described their care in starkly different terms.

"This hospital has saved my life twice. I'm here to say there's a great bunch of people there," said Candia resident Bud Stimans.

But retired Chief Petty Officer Tony Woody said doctors sabotaged his chiropractic and acupuncture care and protected their jobs at all cost.

"You got great care," Woody said to Stimans, "but I have not. "

Shulkin named a 12-person task force and charged that by January it must come up with a future design for how to provide "full service" to all veterans. He stressed the best solution might be a network - more options within the four walls of the VA but more freedom for retired military to get procedures in community hospitals.

But even that touched off sparks because Shulkin had named as co-chairman Michael Mayo-Smith, the chief executive of the New England VA health care system, who was roundly criticized by whistle-blowers as someone who had frustrated their efforts to improve conditions there.

Shulkin then replaced Mayo-Smith as chairman and placed him back on the panel as an advisory member.

Dr. Jennifer Lee, senior adviser to the secretary of the VA, was the new co-chairman, joining David Kenney, head of the New Hampshire State Veterans Advisory Committee.

Dr. Ed Kois is head of the spinal cord clinic and the only whistle-blower on the task force.

After two months of VA administrative response, Dr. Kois said there were some encouraging signs.

The Manchester VA signed an affiliation contract with Easterseals, brought renowned New England Baptist Hospital neurosurgeon Chima Ohaegbulam to the team of consultants and worked on forging operating agreements with medical device inventor Dean Kamen.

They reached a first-of-its-kind community partnership with Catholic Medical Center, allowing Manchester VA providers to use CMC space for endoscopic procedures. Gov. Chris Sununu signed an executive order letting VA physicians licensed outside New Hampshire practice at community hospitals in the state.

"I think there's an opportunity for the Manchester VA to be a beta site to run a test case of how the VA should be run, one that strengthens care not only for vets in Manchester, but nationally," Kois said.

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