16 patients died unnecessarily at Memphis VA hospital, report says

16 patients died unnecessarily at Memphis VA hospital, report says

MEMPHIS, Tenn. — Sixteen patients died at the Memphis Veteran Affairs Hospital that shouldn't have, a report said.

That's according to the latest report from the office of the inspector general.

It details how the Memphis hospital continues to be one of the worst performers, receiving a one-star rating out of a possible five.

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Doctors, nurses, administrators, and even the cleaning staff are all scrutinized in this report.

The 75-plus page report, released Tuesday, shines a light on the level of care the men and women who served our country are receiving – and those same veteran’s displeasure with the hospital.

The report says between October 2016 and October 2017, 16 patients died with serious treatable conditions. The VA said they were not properly cleared for surgery, and there was a serious breakdown in communication.

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More than 65 patients developed infections, ulcers, or other issues after hospitalization.  Clinical staff was not properly trained and there were major issued with cleanliness.

One number that sticks out is the 49 percent patient satisfaction, which means less than half of veterans felt confident in the care in the hospital.

“Half the veterans that come to this hospital don’t feel confident in the care they are going to get here,” said veteran and former VA Memphis employee Sean Higgins. “That’s bad. It's a poisonous disregard for safety in the building.”

A spokesperson with the House on Veterans Affairs in Washington, D.C. said Chairman Phil Roe was not able to comment on the on-going investigation.

However, they did issue a statement:

I do find the report's references to patient data worrisome, as some of the things found were likely preventable. That's why we must continue stringent oversight to ensure all veterans receive quality care, no matter what facility they visit.

Of seven patient areas inspected, the report said two had soiled furniture, all had dirty ventilation grills, and five had dirty floors.

According to the report, all 12 examination rooms were dirty and had stained walls. Also, there were “dirty ventilation grills” in food areas so inspectors could not ensure food was not contaminated.

The Memphis VA Director David Dunning declined a request to interview with FOX13, but did issue a statement about the report.

Dunning said most of the findings stemmed from previous leadership “dating back to 2014.”

Memphis VA Medical Center appreciates the inspector general's review, which focuses mostly on events that occurred under the facility's previous leadership dating back to 2014.  Since then, VA has appointed a new facility director, made a number of key leadership changes and lowered the facility's mortality rate to .81 percent – among the lowest of all VA facilities in this region.  Our leadership team continues to make significant improvements in patient care, customer service, and infrastructure. While the inspector general found a number of opportunities for improvement, we welcome the scrutiny and consider this an opportunity to redouble our efforts to serve Veterans. The Memphis VA Medical Center is under new leadership and on a new path, and we look forward to working with Veterans, community stakeholders and local and national VA leaders in order to complete all of the inspector general's recommendations.

Higgins, who has fought his own legal battles after suing the hospital for wrongful termination, has been calling out the VA for years. He is hoping the new report leads to better care.

“Years we've been waiting on change. And we have yet to see it,” said Higgins.

We reached out to Congressman Steve Cohen’s office in Washington, D.C.

Cohen, a long-time supporter of VA Memphis, seemed more optimistic.

“It says that the new leadership is stabilizing the VA and I think it's done that,” Cohen said. “Director Dunning has done a great job with getting things improved. Some of the worst parts of the report occurred before he got there.”

Cohen said some of the reports finding are awful but believes the worst is in the past. He expressed full confidence in the new administration’s leadership.

“I met with him about a month ago...in Memphis. He's very very on top of it. He works every day at improving morale and improving the physical plan. So it's [moving] in the right direction,” said Cohen.