VA Inadequately Addresses Deficiencies in Cardiovascular Care at Chicago Area Hospital
March 09, 2017
The VA failed to adequately address a whistleblower’s disclosures of deficiencies in cardiovascular care at a Chicago VA hospital.
In a letter to the White House and Congress today, the U.S. Office of Special Counsel (OSC) reported that the Department of Veterans Affairs (VA) failed to adequately address a whistleblower’s disclosures of deficiencies in cardiovascular care at Edward Hines, Jr. VA Hospital (Hines), in Hines, Illinois.
Dr. Lisa Nee, a former cardiologist at Hines, disclosed that serious deficiencies in cardiovascular care and echocardiogram imaging resulted in unnecessary invasive coronary procedures and delays in treatment. Dr. Nee also alleged that a particular physician falsely inflated the number and type of procedures he performed to boost the appearance of his productivity.
In 2014, the VA’s Office of Inspector General (OIG) substantiated Dr. Nee’s allegation that unnecessary coronary procedures were performed on patients. When she felt the VA had not fully addressed the problems, Dr. Nee turned to OSC, which referred her allegations to then-Secretary of Veterans Affairs Robert McDonald for investigation. The VA’s Office of Medical Inspector (OMI) commissioned an independent review of Dr. Nee’s allegations by cardiologists and a vascular surgeon from outside the VA. They determined that certain procedures performed by one physician were not indicated in 70 percent of the cases and the standard of care was not met in 80 percent of those cases. They also found that more than 80 percent of echocardiograms were “technically inadequate.” Despite the findings, the VA concluded that the deficiencies did not pose a substantial and specific danger to public health or safety.
OMI also substantiated that the same physician responsible for deficient and unnecessary cardiovascular procedures also claimed credit for patient visits that did not occur and services he did not perform, thereby falsely inflating his productivity and improperly charging veterans for copayments. While these veterans have been reimbursed, the VA has not taken any disciplinary action against the physician.
Special Counsel Carolyn Lerner noted in her letter that the VA has taken positive actions toward correcting problems at Hines. However, the VA has yet to demonstrate that it has resolved the substantiated deficiencies. A recent OIG review of Hines’s Echocardiogram Lab confirmed that the poor quality of echocardiogram imaging has persisted and may be attributable to the competence of the lab staff. Special Counsel Lerner urged further review to ensure that the problems are fully resolved and thanked Dr. Nee for speaking up: "It's only because of Dr. Nee's persistence that these troubling practices came to light. It's time for the VA to fix them."