MADISON, Wis. — The chairman of the Senate Homeland Security and Governmental Affairs Committee says those responsible for risking the health of nearly 600 veterans at the scandal-plagued Tomah VA Medical Center must be held accountable.
“The fact that a VA employee put veterans’ health at risk is unacceptable. Those responsible for ensuring the integrity of patient care procedures must be held accountable,” Sen. Ron Johnson, R-Oshkosh, said in a statement Thursday.
News broke this week that 592 veterans may have been exposed to HIV, hepatitis C, and other infections after a dentist at the Tomah hospital failed to follow standard infection control procedures for months.
The U.S. Department of Veterans Affairs is not releasing the name of the dentist. Victoria Brahm, acting Tomah VA Medical Center, told news outlets this week that the risk of infection is low but officials wanted to alert those who may be affected.
It’s the latest chapter in a tragic story of alleged abuse at a government-run medical facility infamously known as “Candyland” because of the high volume of painkillers prescribed to patients. A 35-year-old Marine veteran in August 2014 died of a toxic cocktail of prescribed drugs while at the medical center.
Dr. David Houlihan, the hospital’s chief of staff, was fired last year but maintains his Wisconsin medical license. He and members of his administrative team also were accused of retaliating against whistleblowers who brought the allegations of abusive medical practices to light.
“My office has been in direct contact with Tomah VA Acting Director Victoria Brahm as well as the VA inspector general’s office regarding these allegations,” Johnson said. “As my 17-month investigation into the Tomah VA documented, there are serious problems with patient care at the facility.”
Johnson released a 359-page report in May detailing “systemic failures and preventable tragedies” at the medical center.
Officials say the latest health concerns in Tomah could have been prevented, too.
Brahm told News8000.com in La Crosse that the dentist in question knowingly did not follow VA standards for a year, between October 2015 and this October. A dental assistant blew the whistle on the misconduct.
“He had a replacement dental assistant, and she noted this particular piece of instrument being used … He brought in his own burs and cleaned them with Virex solution, salt and a wipe, which is nothing we endorse,” Brahm told the news site. “She reported it the next day, Oct. 20, to the dental chief who reported it to senior leadership. We took action Oct. 21.”
Former and current medical center employees tell Wisconsin Watchdog not much has changed following all of the investigations and a change in leadership.
“What people need to know is that they changed some of the chairs on the Titanic,” Ryan Honl, one of the whistleblowers who first brought the opioid abuse to members of Congress, told Wisconsin Watchdog earlier this month.
While Brahm has been lauded by top VA brass for her work on the internal investigation of the hospital, Honl said Brahm could have done something earlier to confront the reported opioid abuses.
“She was very much part of the ‘investigation’ of what was going on at the VA. Dr. David Houlihan had a direct phone line to her. So she knew of the complaints,” Honl said. “And what does the VA do? They make her interim Tomah VA director.”
A current employee who asked not be identified said Brahm “puts on a good face,” but the hospital is “still bad and full of drug abuse and employee abuse.”
“I have even spoken with the director about this and how veterans are harassed in Tomah due to the VA. All that has been said is, ‘There’s still work to be done.’ The same tag line that is always used,” the source said.
Brahm did not return Wisconsin Watchdog’s calls.
She told told News8000.com the culture is changing.
“There was a culture issue here, one of non-psychological safety, one of opioid abuse,” she said. “Those things are changing.”
Johnson said it is more than time for accountability. The first priority is taking care of the impacted veterans.
“I urge all potentially affected veterans to utilize resources available to them to receive the care they need during this time,” the senator said.
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