PHOENIX — It started with a series of complaints from a recently retired doctor about delays in care that may have led to deaths at the Phoenix Veterans Affairs hospital. The VA started investigating, similar allegations surfaced in other states, and now the issue has the attention of President Barack Obama. Here is a look at some key facts about the issue:
Who is making the accusations?
Dr. Samuel Foote, a former clinic director for the VA in Phoenix, sent letters to the VA Office of Inspector General in December, complaining about systematic problems with delays in care.
Foote says as many as 40 veterans may have died while awaiting treatment at the Phoenix hospital and that staff, at the instruction of administrators, kept a secret list of patients waiting for appointments to hide delays in care. Since Foote's allegations, two more former Phoenix VA employees have made the same claims.
What is the VA's response?'
The VA Office of Inspector General said late Tuesday that 26 facilities are being investigated.
Phoenix administrators vehemently deny the allegations. The VA has so far found no evidence to substantiate the claims after an internal probe. The Phoenix hospital's director, Sharon Helman, scoffed at the notion that she would direct staff to create a secret list and watch patients die in order to get bonuses. Helman has been placed on leave while the Office of Inspector General investigates.
Some also question the motives of Foote and the others making accusations. One former employee who first raised concerns publicly a few weeks ago was fired last year and has a pending wrongful termination lawsuit against the hospital. Before he retired, Foote was reprimanded repeatedly for taking off nearly every Friday, according to internal emails he provided to the AP.
What is the overall state of the VA?
The VA operates the largest integrated health care system in the country, with more than 300,000 full-time employees and nearly 9 million veterans enrolled for care.
The Phoenix claims are the latest to come to light as VA hospitals and clinics around the country struggle to handle the enormous volume. VA facilities in South Carolina, Florida, Pennsylvania, Georgia, Texas, New Mexico and Illinois, among other states, have been linked to delays in patient care or poor oversight. An internal probe of a Colorado clinic found that staff had been instructed to falsify records to cover up delayed care at a Fort Collins facility. A nurse at a VA center in Cheyenne, Wyo., was put on leave this month and accused of telling employees to falsify appointment records.
The VA has acknowledged that 23 patients have died because of problems related to care since 1999, according to an ongoing nationwide internal VA review which showed that delays often occur when a doctor refers a patient to another physician, such as a specialist. During the same time period of the deaths, more than 250 million of these consults were requested.
The 23 deaths do not include a deadly Legionnaires' disease outbreak in the VA Pittsburgh Healthcare System or three patient deaths blamed on mismanagement at the Atlanta VA hospital.