79 VA Miami-area patients never learned of unsterilized equipment risks

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After more than 2,400 veterans received colonoscopies with unsterilized equipment, they were notified and offered treatment for possible illnesses they contracted. But 79 of them never were contacted, the VA said Tuesday.

By Fred Tasker in the Miami Herald

The Veterans’ Administration, which in March 2009 revealed that more than 2,400 Miami-area veterans were given colonoscopies with improperly cleaned equipment, announced Tuesday that 79 veterans mistakenly were not notified they are at risk of contracting a disease such as HIV from the procedure.

The VA said the failure to contact the 79 veterans was the result of administrative errors related to their charts. The VA has temporarily removed Mary Berrocal, director of the Miami VA Healthcare System, until a 30- to 60-day investigation is complete. Replacing her temporarily is Thomas Capello, current director of the Gainesville VA Hospital.

“This is inexcusable. We need to take care of these veterans,” said Dr. Robert Jesse, principal deputy secretary for health of the national VA, who flew in from Washington to announce the investigation.

Berrocal could not be reached for comment. She has been placed in an administrative job while the investigation continues, Jesse said.

Last year, the VA sent letters to more than 2,400 veterans who underwent colonoscopies at the Miami VA Hospital informing them that improperly cleaned equipment might have exposed them to hepatitis B, hepatitis C and HIV.

Three Miami vets later tested positive for HIV, seven for hepatitis C and one for hepatitis B. The VA said there was no way to know whether they were infected by the improperly cleaned equipment, but it promised to provide testing, counseling and medical care for them.

After investigation, VA officials concluded that the problems arose when a Miami staffer rinsed some equipment instead of sterilizing it as specified in the manufacturer’s directions. Berrocal said she disciplined 10 employees.

Similar problems occurred at VA hospitals in Murfreesboro, Tenn., and Augusta, Ga., involving a total of more than 11,000 veterans. In all three hospitals, five veterans tested positive for HIV, 25 for hepatitis C and eight for hepatitis B.

Jesse stressed that the 79 veterans who were not notified that they might be at risk are not additional cases, but previously known veterans who were mistakenly not contacted, offered educational materials or medical testing.

“How they were missed is what we still have to get to the bottom of,” Jesse said. “I have some idea it was in how charts were selected and reviewed. The whole system was on notice that this was extremely important and needed to be done right. It was not done right, and we missed 79.”

He declined to speculate on whether Berrocal might be removed permanently: “That’s what the investigation is for.”

The investigation will be conducted by the VA’s national Administrative Investigation Board.

U.S. Rep. Ileana Ros-Lehtinen, R-Miami, said in a release that “. . . I have heard from local and national VA officials over and over again that this horrible series of mistakes were flukes and that the healthcare that veterans receive is of the highest quality, but this latest fiasco puts those assurances in doubt.”

Some of the veterans whom the VA failed to contact live in Ros-Lehtinen’s district.

She said she would ask Miami VA officials “for an update on what is being done to correct this tragic situation and prevent future errors.” She said she planned to visit the hospital Wednesday.

Jesse said the issue of the missed veterans involves the Miami hospital only, not the other two VA hospitals.

Many of the 79 have been notified now, Jesse said. Staffers are telephoning those they can reach and writing letters to the rest, he said. The Miami VA has set up a call center available 24 hours a day, seven days a week, and asks veterans with questions to call 877-575-8850.

After congressional hearings in August 2009, the VA announced it would spend $26 million at its facilities to buy new medical devices and help staff members to follow stricter standards.

The Washington VA staff also made unannounced visits to every VA health facility in the country to check staff training in cleaning colonoscopy equipment.

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