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Disabled VA doctor's assignment criticized

Managers of the Lake City veterans hospital endangered patients' care by assigning a physically impaired doctor to daily rounds, according to a review by Department of Veterans Affairs inspectors.

The VA's inspector general concluded that dying patients may have missed a "second chance" because the hospital assigned a physician who was unable to revive patients or perform other rigorous procedures.

The doctor in question, Joseph Warner, told the Times earlier this year that the hospital's managers gave him "medical officer of the day" duties even though they knew his spinal condition limited his mobility. He said his wife sometimes pushed him in a wheelchair through the hospital on his rounds.

In a January 1996 case, Warner said he and a colleague were unable to revive a man having a heart attack. The VA's health care inspectors reviewed the case, and said the hospital fell short of providing the best care possible.

"It is difficult to speculate whether the patient would have survived had more skilled clinicians been available," the report by the inspector general said. "However, given the complainant's physical impairment, the patient was denied the services of a fully capable medical officer of the day who may have possessed this skill."

The inspector general's report _ the third focusing on Lake City's troubles in recent years _ is being released a few weeks after hospital director Alline "Genie" Norman indicated that she plans to retire soon.

Norman did not return a phone call seeking her response Friday. Dr. Robert Roswell, the top VA health official in Florida, said that "as always, we welcome the oversight" to help the department improve service to veterans.

During the last several months, Norman has been criticized by current and former employees for placing a dentist in the position of chief of staff of the hospital. That task is normally held by a medical doctor.

Norman is not mentioned by name in the recent inspector general's report, but "medical center managers" are criticized.

Giving the impaired doctor the responsibility, the report said, "was not in the best interests of patients, nor of nursing and other ancillary employees who might need to rely on the (medical officer of the day)."

Warner had back surgery in 1992. His doctor wrote the VA in 1993 and 1994 that he couldn't move around much without getting tired or experiencing pain. He complained to the VA's inspector general, which sent a team of inspectors to Lake City in November and December of last year.

In explaining their decision to assign Warner the job of medical officer of the day, hospital officials told the inspectors that the duties of the medical officer of the day are "not excessively demanding" and that a back-up doctor was always available to revive patients in an emergency.

The inspectors disagreed, saying the managers underestimate the importance of the officer of the day responsibilities.

"If the back-up physician could not rapidly respond," the report said, "or was unable to intubate the patient, or if two critical situations occurred simultaneously, patients may have been denied the opportunity of a "second chance' if the complainant was (medical officer of the day) at the time."

Warner, a neurologist, has since left the VA. He and several other current and former Lake City employees have filed a federal lawsuit against the VA. He believes he was given the responsibilities of medical officer of the day as an act of reprisal.

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