USA TODAY – Deadly Hines VA Hospital Cover-up Exposed

Hines VA Hospital

Benjamin KrauseTop female interventional cardiologist Dr. Lisa Nee just came forward to expose VA OIG deception at Hines VA Hospital. VA OIG, a discredited watchdog at Department of Veterans Affairs, whitewashed complaints of reckless surgeries. Some of those surgeries were performed on now dead veterans.

Those reckless doctors implicated at the facility were not held accountable, but VA was quick to attack this whistleblower and others believed to have helped investigators reach the impossible truth – that some VA doctors are horrific surgeons at Hines VA and veterans should be scared. In response, Dr. Nee took the fight to the press.

RELATED: VA OMI Investigates VA OIG Whitewash At Hines VA

Are you surprised?

On Tuesday, USA Today published their investigation into reports from Dr. Nee and others as to wrongdoing at Hines VA and the resultant whitewash. After Dr. Nee came forward, Hines VA officials attacked her career and VA OIG subsequently attacked her credibility following exposing VA wronging to the press.

I was so inspired by the story that I traveled to Chicago to have dinner with Dr. Nee and fellow whistleblower Germaine Clarno, who was also quoted in the USA Today report. This is a new platform I am brining to My goal is to honor brave men and women willing to risk their careers to help veterans by traveling to them to get the real deal after the main stream media moves on to sexier topics.

Here, the stories Nee and Clarno shared of corruption and nepotism at Hines VA were outrageous and saddening. Following the meal, I vowed to help these two heroes expose wrongdoing at the facility at all costs. I strongly encourage you to do the same in whatever way makes sense.

Don’t veterans deserve more? Where is the accountability Secretary McDonald promised? Are middle managers lying to McDonald in the same way they misled Shinseki? What are you willing to do to expose wrongdoing at VA?

WATCH: CBS Evening News – Clarno exposes Hines VA mental health care wait list scam

Back to the story.

Dr. Nee was hired to review boxes of echocardiograms shoved into a closet at Hines VA, some of which were many months old. Echocardiograms are usually requested when a veteran is having heart problems. Since the procedures were not evaluated, many veterans’ lives were put at risk while the evaluations were put in boxes and stored in a closet.

This would be like giving a veteran an x-ray to evaluate a broken leg but failing to read the x-ray and then discharging the veteran without putting the leg in a cast. It is common sense stupid and likely resulted in deaths of some veterans.

RELATED: Clarno Retaliated Against For Whistleblowing

After Dr. Nee came forward, VA moved her office into an asbestos-filled room without a computer and furniture to teach her a lesson. She was literally ordered to review many more boxes of echocardiograms without a computer while breathing in asbestos. Shortly after the potentially lethal retaliation, Dr. Nee resigned.

VA OIG proceeded to whitewash the investigation by restricting the scope of their investigation. Their idiotic strategy was exposed during an interview with USA Today reporter Donovan Slack:

Gromek, the spokeswoman for the inspector general, said investigators did not look at whether providers were improperly trying to boost their production because they didn’t have “credible, specific allegations.” She said they didn’t know at the time that the packet of information they received from the union representative came from a cardiologist — Nee. And she said Nee refused to be interviewed by investigators.

Gromek said the Office of Special Counsel, which directed further investigation of Nee’s allegations, didn’t know at the time that Nee had not provided information directly to investigators.

When asked about the echocardiogram delays, Gromek first said inspectors “did not have specific information about patients alleged to be adversely affected.”

But when pressed she reversed herself, saying “we did receive patient names.” Gromek said investigators did not then review their delayed echocardiogram readings because VA officials were aware of the backlog and “working on it.”

Gromek said the inspector is now looking into current backlogs of echocardiograms at the facility and their quality, and is monitoring Hines reviews by VA officials.

VA officials said last month an investigation was ongoing. Tuesday, VA spokesmanJames Hutton declined to elaborate on the status of the probe.

“VA is preparing a response to the Office of the Special Counsel and cannot provide details at this time,” he said.

After Dr. Nee came forward with USA Today, VA OIG’s John Daigh allegedly made numerous slanderous claims against Dr. Nee with the apparent hope of discrediting her enough to discourage the story. USA Today did not buy the BS John Daigh was shoveling.

Show we write our senators to call for John Daigh’s firing? Where does VA get off hassling whistleblowers so fiercely. Oh, it is because they believe they are above the law. Let’s hope in this case Dr. Nee lawyers up and sues Daigh in his individual capacity for defamation.

Can I get an “amen”?

When will this shameful treatment of irresponsible agency doctors be rectified? Will no one step in to investigate clearly unlawful and harmful treatment of veterans and whistleblowers? What will it take to keep our whistleblowers safe?

Reporter Donovan Slack did a great job covering this. Be sure to read the entire report from the link below and let me know what you think.


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  2. Dr Lisa Nee, my name is Glenda Pusateri and I am A 100% disabled service connected veteran. I want to thank you for your courage in coming forward as a whistleblower.I currently have and 1151 case with the Department of Veterans Affairs. it has been 9 years since I originally filed the claim, and it is now at the Board of veterans appeals waiting for the judge to pick up the C file. Which means it’s about to be decided on. My 1151case is for my open heart surgery and that I had at the VA in Washington DC.I had a valve replacement of which was not an emergency surgery and was not afforded proper consent procedures (i.e. no written consent).During the surgery damage was done to my conduction system which resulted in 3rd degree complete heart block and a secondary surgery for a dual-chamber pacemaker. The veterans law judge obtained an independent medical opinion from a cardiologist from the VA in New Orleans Louisiana. This medical opinion did not help my cause. I obtained a private independent medical opinion from Dr bash which is in my favor; however, I am seeking to obtain a second imo from a cardiologist. After reading the article I thought that perhaps you may be interested in writing my opinion. I have searched everywhere for an IMO cardiologist and couldn’t find one. My last IMO cost 1500 dollars and thats what i have saved for this IMO. If you are interested please email me at [email protected] or call me at 3048864119.

  3. About the SF 95 claim, VA does not always settle for the fair amount of a tort claim without going to court. Case in point is the $21 million award one 78 year old veteran won following his stroke that resulted from VA Malpractice. In that case, VA refused to even settle the claim and did not offer any settlement. What would that veteran have done without an attorney? Not all cases are the same, with the same facts or the same outcome…

  4. This kind of questioning and insinuation that Ben does not do enough to help veterans really pisses me off. This is still a free country, and Ben can meet or represent anyone he wants and does not need to be denigrated because he may not help out with the right cause, or with someone’s pet project. In my opinion, he already does a hell of a lot just by providing such good information on this site. I have read it for some time since first becoming aware of it, and I often think about getting involved again in helping veterans as part of a group, then I read comments like yours and am reminded why I burned out after so many years of doing so. It did not matter what you did, it did not matter how much money came out of your pockets to help others, it did not matter how many suppers you missed, it did not matter that you were taking time away from your kids to help veterans, there was ALWAYS someone bitching about what you did or did not do. Often those doing the bitching were not stepping up to help. To suggest Ben is doing something wrong by not doing what YOU want him to do, and do it in the manner in which YOU want him to do it is absolutely infuriating.
    Have you gone to the DAV, VFW, Legion or any other veterans organization and demanded the same things from them? If not, why not? They have a hell of a lot more resources than Ben does.
    If you go back and read this article again, it says Ben traveled to meet them to HONOR them for doing what they did. I applaud that because it may encourage others to come forward. What have you done to encourage whistle blowers to come forward? I applaud Ben for taking the time and effort he did to actually meet with them to get the details of what happened, and become well educated on the issue. He did not just rely on a news article. What he gained from that meeting may help him in some future effort, yet other veterans think it is more productive to throw bombs at him instead.

    1. Thanks for the kudos on this one, and I appreciate your consistent comments!

      I was disappointed to read Danny and Lee’s comments that seemingly have zero to do with the article and everything to do with being pissed that I support whistleblowers when they are brave enough to come forward. One of my goals is to help future whistleblowers come forward without fear of retribution. This seems like a reasonable result to push for in the future.

      I have no idea what kind of “advocacy” they work on, but I hope Lee and Danny are able to organize that march on DC and class action lawsuit they are so upset out. It’s just not what I do here as a journalist / attorney. Plus I am not convinced any kind of march would be effective. Veterans need to focus on getting press on a more consistent basis, not just for one headline. My website creates more consistency.

      1. No thanks needed for me Ben. I just make some comments once in a while.
        Having been very active on Vets isssues in the past, marching on DC has come up over and over, and I believe one veteran about 12 years ago tried really hard to organize one. I believe maybe 20 vets showed up. About the only march on DC that has gotten close to doing what vets believe a march on DC will do is The Last Patrol motorcycle ride. It is expensive for vets anywhere west of the Mississippi to travel to DC. Hotels along the way and in DC are expensive. It has to be organized months in advance with a date set that works for the largest number, but not a date that vets would be doing other things. Other groups that have organized any kind of march have had millions of dollars behind them for the cost, many people working on the logistics, etc., and even then maybe 100,000 show up and accomplish…what? Some news headlines that last at most 2 days? Can anyone point to significant change or major legislation that has resulted? Same with class action suits. I commented before about a Texas firm that was doing a class action suit on behalf of Gulf War vets. They would always come to our conferences in the ’90s and provide updates. Their efforts went on for years, and may still be going on for all I know, but I don’t believe their suit has ever been heard inside a court room. I believe their plan was to sue US companies that had sold material to Iraq prior to the war. Imagine the political problems behind something like that.
        The most successful effort we found was for groups to go to DC, and spend an entire day or days meeting with Congressional or Senate aides pushing very specific legislation. It was still expensive to do that with almost every vet paying travel, lodging and food out of their own pocket. Even then, other vets organizations would argue against the legislation because it might take money from their pet project. After years of doing this, we got several pieces of legislation passed, only to see the VA and/or DOD ignore it or undermine it. 3 laws passed were requiring the VA to service connect undiagnosed illnesses. For years the VA claimed they could not diagnose Gulf War vets illnesses. After the legislation was passed, the VA immediately began diagnosing vets with any frivolous thing without any medical basis in order to avoid the law. Around 100,000 minimum were not getting a diagnosis, and therefore not adequate treatment, but less than 5000 have been service connected under the Undiagnosed Illness law. 2nd. Getting ALS presumed service connected. Many Gulf War vets were contracting and dying from ALS, usually before their claim was approved by the VA. Now their ALS is presumed to be service connected. 3rd. Getting an independent research committee created and funded. The law was passed in 1998 or 1999, and ignored by the VA for years. It was finally created around 2003, and had a budget of around 5 to 12 million per year to award to independent medical researchers. That committee and the researchers did more to find what medical conditions Gulf War vets have in less than 10 years than the VA or DOD did spending over 200 million over 20 years. Unfortunately the VA has trashed the committee by ousting the chairman and several others that were very focused on Vets, and changed their charter. I don’t see many organizing marches over that.
        Even meeting with Congressional or Senate aides trying to get legislation passed is a huge effort. Take a disabled vet, travel to DC, walk the halls of Congress all day and hope your meetings were not canceled at the last minute, and veterans are worn out by the end of the day. Only a few have done this for years, and the successes are not many. Many disabled vets have a tough time just getting to their VA appointment locally, and paying for gas to do that. A march on DC will do what?

  5. My BEST advice for any time VA lies to you or fails to do their jobs is to go limp and roll up into a ball right there on the VA FLOOR. Let the LYING bastards figure out how to deal with THAT and how to explain it to the news crews.

    1. Mr. Nesler even THAT will not change anything. My husband actually WAS left lying on the floor of a VA medical center for at least a recorded 7 minutes (VA documentation) after his THIRD respiratory code blue!!! These THREE code blue calls were made over a 2 day period. There was nothing left of this honorable Marine except for his heart to beat and ironically for Mike to breathe. All that was Mike died that morning. Mike’s body survived for 6 months but died after 33 days in hospice without food or water. ***I informed my attorney that 2 vets +more now have toldme that soon after Mike was removed form the VA medical center visible mold was vacuumed by the VA staff. My attorney said we couldn’t prove it . I was finally allowed to view my file after a very long time requesting to see it. I did find that my attorney had a picture of the AC vents in Mike’s room which sure does appear to be some black substance in the AC vents and some around the control panel. Why would he not have that looked into?
      *******I found a court paper submitted by my lawyer stating that our son’s deposition about his father refutes the defendant’s description of Mike as a “low life.” Really? Is that what the defendant-the United States of America, the VA, and the DOJ feel about their combat Marines? Their vets?
      There is so much to tell about Mike’s case but very few care. I can’t bring Mike back but I could try to improve, even a little, the system so that no other vet will die this way. Mike survived the tunnels of Vietnam but not the VA healthcare system.
      When the 1st code call was made on June 5th, the VA physician assistant wrote he wanted to “AVOID” sending Mike to a higher level of care. When this PA was asked why he wrote to “AVOID” his response was, “It was ALOT OF WORK FOR STAFF.” Approximately 12 hours later Mike was heard trying to call for help. Two vets in an adjoining room heard Mike and ran to get the only VA employee on duty-a VA health tech. (Mike was in a room alone because his nightmares and sleep apnea was so bad-Mike had no roommate, no 911 from room, no call bell, and no other VA staff member but for 1 VA health tech for 33 vets.)
      Vets ran to find tech. This was 1:30 am. (VA documentation)Tech was located as far away from Mike as one can be on that floor, seated on a sheet covered chair. Vet said tech was watching TV, tech said he was sitting in the chair (so not to get his clothes dirty) reading a newspaper scanning the rooms at that far end. Tech”hurriedly” walked to Mike’s room where Mike was sitting on the edge of his bed having a difficult time breathing. Tech witnessed Mike becoming unconscious and THEN went to call 4123 from a code phone located in a box (locked?) halfway down this long hallway.
      Code blue call was placed at 1:36 am (VA documentation). Tech said medical emergency to a recording. It was never clear if he did give location because when the MERT team arrived they arrived at the other end of the hallway away from Mike. After tech made the code call he returned to Mike’s room where Mike was lying on the floor. Tech waited “maybe four, five minutes” before he made a back up code blue call at 1:40 am (VA documentation). VA MERT team arrived at 1:43 am (VA documentation). DURING THIS ENTIRE RECORDED 7 MINUTES MIKE WAS NOT GIVEN CPR OR ANY OTHER AID TO BREATHE. In fact. the tech was not sure he refilled the O2 tank that was used the previous day for Mike’s very first code blue. Tech did say he thought he must have refilled it since it is his duty to do so.
      Tech said he did not check Mike’s respirations that morning but then tech was shown a sheet with “RESP” checked off. He was asked what RESP means and he replied, “Respiratory, I guess.” This is a check off sheet he uses every night for many years!!
      Vet said when MERT got there there was no sense of urgency. Vet stated that respiratory tech found the ambu bag but could not find the mask. He heard her laughing. Respiratory tech never admitted that. She did say they arrived at the other end of the hallway, that she had to go down 4 flights of stairs when code was called. She did say she went out to where the police car is PARKED—COMES–in front of building to pick her up. (So police car was NOT there yet?) She also said that when she got to Mike she “yelled” for more oxygen. Ambulance driver had to go back down the long hallway, down to the 1st floor, out to ambulance, get O2 tank, up to 2nd floor, then back up the long hallway to Mike’s room. No one seems to know how much O2 was in the tank from the crash cart AND the tank from the ambulance! She did say that Mike was blue/gray when MERT arrived but after CPR and ambu Mike’s color was pink. She said they did NOT run out of O2 on the way to the hospital but Mike was again blue upong his arrival to the hospital? Respiratory tech said that a full tank of O2 is 2200PSI and that VA requirements are for tanks to be refilled when they are 1/2 full.
      1:30 am vets heard Mike trying to get help
      1:36 am 1st code blue call of THAT day called
      1:40 am 2nd code blue call of THAT day called
      1:43 am MERT team arrive
      2:09 am MERT leave for hospital
      2:20 am MERT arrive at hospital
      *hospital is less than 5 minutes away-no traffic this morning
      *ALL statements are documented by VA records (police reports, medical reports, VA employee written statement)
      There was a federal bench trial. All of the facts were presented to the court EXCEPT I do not know if court knew about the time the 1st code call was made on the 2nd day (the 1:36 am call).The court DID know that there were 2 code calls made 4 minutes apart as testified by the only VA employee there, the health tech. The ONLY 2 code calls recorded that morning were the 1:36 am call and the 1:40 am call.
      The VA MERT RN was the last to testify. He was asked, by the US Attorney, what time was THIS code called. NOT 1st NOT 2nd just THIS. His response was, “1:40 am.” (SO… RN ONLY admitted to the last code call so it looked as if the MERT responded in 3 minutes-they DID NOT!!!) IT WAS 7 MINUTES Mike was left lying on the floor with NO assistance to breathe. RN was then asked, “How do you know when a code call is made?” RN’s response was, “That he clicks his beep and ALL the CALLS—ALL the beeper—when the beeper goes off.” (SO…there WAS more than one call?!). MY attorney never cross examined this last witness.
      Others have said it odd that my lawyer NEVER cross examined RN, especially about the time of the calls? I replied that my lawyer never got the times correct and it was so important. My lawyer kept saying1:40 am was the time the vets heard Mike calling for help. Then how can he think a SECOND call can be made at the same time? DOESNT MAKE SENSE. This is an experienced medical malpractice attorney. Oh, and our expert failed one of his exams that he was giving testimony as an expert??!! I did NOT find out this afct until the “expert” was giving his testimony!! I asked my lawyer during recess why I was not told this fact when I was standing outside the courtroom with him and the “expert” for approximately 40 minutes before trial? His answer: he just found out the night before!!! What? Then I still should have been told that fact outside the courtroom.
      There are 4 things that have to be proven to win a medical malpractice case in Pa:
      1-A Duty-there was- according to the court’s accepted standard of care,Pa. Duty to Assist, national VHA policy Directives, and Medical Center’s Directives-it was part of VA health tech’s job responsibility to give CPR.
      2-Standard of Care-court accepted VA’s standard of care for a cardiopulmonary emergency-the American Heart Association’s 2005 ACLS Guidelines.
      3-Breach of the Standard of Care-there was-according to the court’s accepted SOC-ACLS- and VHA mandatory Directives and Medcial Center’s Directives-anyone in direct contact withtheir patients are to give CPR while awaiting EMS/MERT team arrival. (you can’t just leave someone there lying on the floor gasping for air!)
      4-Injury/Death-Mike died.
      The fact that my attorney did not ask these questions or prove these important items is of great concern to me. The fact that he was doing the trial on contingency was of concern. Wouldn’t he WANT to be sure ALL of these items would be covered? Am I missing something?
      With all of this said would the court know what Pa. laws are governing healthcare? CPR, Duty to Assist, etc.?
      Would the court know the one exception to expert testimony?
      The exception is stated that “where the matter…. is so simple and the lack of skill or want of care so obvious, as to bewithin the experience and comprehension of even nonprofessional persons.” Chandler v. Cook, 265 A. 2d 794, 796 (Pa.1970). Doesn’t this describe CPR?
      How can the court accept the ACLS as a standard of care, have approximately 1/3 of the ACLS’s parts (chapters) address that CPR has to be given while awaiting EMS/MERT arrival, the life saving properities of CPR, and then rule against us? The court ruled that since MERT arrived three minutes after the initial code (1:40 am) then they arrived within SOC. What happened to the call 4 minutes BEFORE that one at 1:36 am? Time is of great concern here! What happened?
      This was a terrible end to a combat Marine’s life. Mike went there looking for help to do better. Mike wanted to live. I believe what happened after Mike’s death is a great dishonor to him and to others. It is such a lack of respect. To me it is a National disgrace. We should be caring for our vets not destroying them and their families. I DO have all VA documentation to prove what I am saying. This is not about revenge, money, etc. I have said that I would be willing to sign any legal document that I do not want the money. How much is your love one worth? Priceless.It is about Justice, truth, respect, and honor for a combat Marine that did give his life for his country. It is about ALL of you.

  6. I am ALL for marches and demonstration. Start one and I will bust my hiney to support you. But, do NOT ask Ben to drop what he is doing and do it FOR you. Ben is a journalist and an Attorney, and in those two functions he has done more GOOD for veterans than any other human being in the history of the VA. Asking Ben to drop what he is doing and organize a demonstration for you, is like asking the world’s greatest chef to throw down his pots and spoons and come over and mow your lawn.

    1. Danny, if there is ANY other attorney or journalist out there giving their ALL to veterans, as Ben is, I can’t find them. Ben traveled 1200 miles at his OWN expense to come to my home to discuss the FREE legal help he was providing my family. Ben is unique. He is also smart, TOUGH and highly principled. Ben has had his law license for just over one full year, and already he is FORCING change at the VA. Hide and watch, if the rats at VA don’t murder him first, he will change American history. .

      1. I echo Ron’s comments. Ben will be famous one day in the public eye and he will be a hero for all those that he has helped for free or nearly free who have been injured, disfigured, shamed , broken, and rendered broke by the VA’s institutionalized negligence and lies.

  7. This is to John, You have the experience and knowledge, would you be willing to team up with Ben to find a team of lawyers to determine what veterans can do to get Justice. I know there are many different wrongs the VA and OIG are doing and have done that need to be addressed. In your opinion what can be done and how can we veterans assist, If you are willing and able we veterans need people that are trained to protect our Civil and Constitutional rights that have been violated or just ignored at will.

    You are very right there are so many different problems and I guess you can not blanket them all together. With this in mind, in your many years of experience Do veterans have anyway or recourse to stop the VA and OIG from Hurting Veterans or can the VA and OIG hurt veterans at will, with no fear of any action against them.

    What advise would you give to veterans whom are being harmed. What can we do to help are selves. WHO CAN WE TURN TO !.

    1. I have some suggestion but this would require some changes in the Law and thus every veteran would have to lean heavily on their congressmen. First, every Doctor practicing in the VA is to be licensed by the state in which they are practicing. I tried to find some of the doctors names who have treated me in the California State Licensing Board and they were not named. Many come from second or third rate medical schools. This practice has to stop. No more using the Veterans for training and in any case where a Veteran is to get a resident this must be disclosed to the Veteran of his or her approval before they see what I call the student doctor….this name I use on them really pisses them off. Next rather than the Doctors being over seen by the VA they must be overseen by the State Licensing board and subject to Medical Malpractice Law suits in which they have to pay part of the damages. May half assed Doctors find the VA as safe haven. Hey great hours get there about 7:30 or 8 and out of their by 4 unless they have other shifts. This new Civilian oversite committee and there will be one at each VA will be responsible for the hiring and retention of Doctors. They will do the interviews and determine who is hired. If residents are used at the hospital they will be overseen by a competent Doctor. The Veterans have a right to ask for an MD and not a resident or intern. I think they are going to go nuts and since I will be half or all the way out I will have no way of knowing but for my next colonoscopy I am going to demand that the Doctor and not a resident or intern perform it. I go for epidual shots in my back for pain and after raising hell that the residents were not placing it right and 4 wasted trips and shots the VA has now decided that THE HEAD OF THE CLINIC will do my shots and they are helping when he does them.
      We need a Civilian oversite committee at each VA who participate in the hiring and retention of Doctors and participate in all decision regarding the hospital. I have been suggesting this to the head of the VA in Long Beach with out much success. I said that Veterans should be on every board that the hospital has but it does not seem to be going anywhere.
      The VA was created by the Government and thus needs to be fixed by the Government. If our senators and congressmen had to use the VA for their Health Care…things would change very rapidly. This should be required…no private health care coverage for the people in government. They have to go to the VA. How will this happen? Only be legislation. Do I think this will ever happen….No not in my life time…….I am hoping that there are majore law suits for medical malpractice being filed but the VA has nice little tricks for getting out of the them. The Statute of Limitations for Medical Malpractice Suits should not appy to Veterans or their families.
      This is all wishful thinking on my part. I am switching over to Private Doctors here shortly! The VA has us because in order to get benefits we have to see their Doctors for exams etc. I think they will allow outside Doctors reports and I would suggest if a Veteran can afford this that they have a private doctors report added to the VA doctors report which will be given to the powers that be to make a decision on disability ratings etc.
      Some how we need to get to our brother Veterans and get them all involved. When you are young and if not injured and come get out of the military you do not think about the VA and then when you get older and need medical care then you may think to go their….we need to get the young healthy veterans involved. There is power in numbers and we would be a huge voting block if we could get organized.

    2. My BEST advice for any time VA lies to you or fails to do their jobs is to go limp and roll up into a ball right there on the VA FLOOR. Let the LYING bastards figure out how to deal with THAT and how to explain it to the news crews.

  8. I had no idea that the residents could be fully in charge of these surgeries. No wonder my heart surgery was a failure and I ended up with complete heart block. Is there anywhere I can research to find more info on the scope of what residents are allowed to do at the va…it could help with my claim. Thank You

    1. Glenda Pusateri says

      May 9, 2015 at 10:31 am

      I had no idea that the residents could be fully in charge of these surgeries. No wonder my heart surgery was a failure and I ended up with complete heart block. Is there anywhere I can research to find more info on the scope of what residents are allowed to do at the va…it could help with my claim. Thank You

      I did not see any replies to Glenda’s P. ?? I need the same research (what residents are allowed to do) I was told by a resident @ the U of M that residents are only allowed to do surgery in their 4th year and it has to be supervised by a MD, (can not find this info in writing or medical standards) as I have told you before Ben, a 1st yr resident (maybe 1st week) did my sinus surgery and poked a hole in my scull and caused a CSF leak, my records state that when she noticed the CSF leak the surgeon who was suppose to be supervising was not even in the same room and had to be called in. The VA uses a Bait & Switch routine, I was told 4 x’s a certain surgeon with experience would do the surgery and the morning of she greeted me and said she would be doing the surgery BUT after I was knocked out they switched and allowed a 1st week res to do the surgery. They do this all the time and are Deliberately putting vets lives in GREAT DANGER! They have allowed res DR,s to poke so many holes in vets sculls that they gave the head surgeon the nickname of “Head Leak Specialist” One vet I met told me the hole they poked in his scull was so big they had to use a piece of his ear to plug the leak.
      The BVA paid a Neurologist to state that nearly dyeing from untreated deadly meningitis for 39 days which more than likely caused a TIA stroke …. was just a “walk in the park” not a traumatic event.

      What do you think Ben??? (what residents are allowed to do) + just a “walk in the park” not a traumatic event.

      Thks …. Mark

  9. I recall contacting VA OIG several years ago, about a psychologist at Pittsburgh VA who was (and still is) falsifying official reports to deny claims for compensation. Instead of investigating the fraud, VA OIG replied that they don’t get involved in claim disputes. It was of course not a claim dispute. Convenient for VA, however, to spin it that way.

  10. i have met soo many veterans, from pre-Nam to current, that have a bad story about their experience(s) with VA & VARO. with Internet now, the scope of this is massive. myself included, whereby VA(s) would not diagnose correctly no matter what overwhelming medical evidence was presented – common reasons are to ensure no disability from service-connected injury/illness. from outright deny, bits of incorrect medical wording to deflect, to off-the-wall diagnosis to detriment the veteran…always that neg-psych connection the VA loves to toss around. decades later via legal help and non-VA medical community then the VA correctly accepts correct diagnosis. then VARO has to start their tricks-2-trip. most veterans with VA/VARO experience knows exactly what i’m speaking of.

    >What will it take to keep our whistleblowers safe?

    the current WH won’t do anything. and i venture to say past WH’s didn’t either as veterans and whistleblowers have voiced many of these issues countless times over the years. if Congress can’t/won’t do anything, as seems to be the case, then you and any other sane human knows it will be up to the people to ensure whistle-blowers and veterans are safe.

    think about it, and i know you have…folks can’t rely on WH, Congress, lawyers, police, VA/VARO, nat-media, etc., so who ya gonna call? history books show the people (veterans & whistleblowers) are now backed into a corner, and get this — by the very entities supposed to protect them — so your guess is as good as anyone’s how to keep em safe. great historical question though, “just who is gonna keep veterans and whistleblowers safe?”, in this context, from the VA/VARO.

  11. Ben, my name is Glenda Pusateri and I have an 1151 case with Dept of Veterans Affairs for a valve surgery at VA that left me in 3rd degree Complete Heart Block. I am interested on contacting the cardiologist Lisa Nee to hire her for a medical opinion. I did not see any information on your site to email you directly. I read in your report that because of this she is now working part time. Please email me @ [email protected]
    I am a 100 percent disabled vet and could use a little help with this. Thank you, Glenda Pusateri

    1. Glenda, if you look at the hand on the left side of this site you will see an envelope above the little finger (to the right of the “in”). You can use that to e-mail Ben and hopefully he will be able to help you. Good luck.

  12. I hope the names of the veterans were disclosed and if not then a class action suit on behalf of them all should be filed to obtain the names so that they are provided to the heirs to sue of Medical Malpractice. In most states that I am aware of the Statute of limitations is tolled by such conduct and this all appears to be recent? Those families should find a lawyer…in fact…major law firms should be lining up to take these cases…….

  13. You know a long time ago, when the prevalent philosophy was FTA in Viet Nam, and yes that was what most of us thought. The VA was brought up and how they rumored to use VETERANS as guinea pigs. After being lied to by the Army, the US Government and a host of others (what else is new). I thought that there might be some truth to the rumors but did not pay any attention to them after I returned home. I never utilized the VA for 40 plus years until some of my buddies advised I should go get my Agent Orange Physical. I didn’t know anything about AO or the repercussions of being exposed to the chemicals. Until 3 years ago, when I took my physical and had a host of ailments. Do I trust the VA now? Nope, never did and never will, especially after these on going revelations are made. I am truly saddened beyond words at how a GRATEFUL GOVERNMENT can permit this continued travesty to continue. What it comes down to is very, very simple… It’s all about the money! These assholes are able to collect at the expense of and because of the Nation’s Veterans. Welcome Home!

  14. Very simple, quick post on this one…

    … it is because they believe they are above the law.

    This is it exactly, Ben. The problem is that no one seems willing to prosecute the dirty people in this agency.

  15. How much damn longer do we as veterans have to put up with this sh$t!!!!! Do you people even care or listen?!?!?!?!? How can you say “I care” when scandal after scandal happens and the VA OIG is helping covering this shit up!!!! maybe a bullet in the head is in order!!!!!!!!!!

  16. THIS IS ALL the same for kaiser employees & patients with.asbestos, mold, MRSA, C-diff.etc.., exposures to get rid of older experienced higher paid employees who worked hard.while kaiser starting in 1986 under David Lawrence, Instituting a climate & environment of fear, fear & then more fear of severe retaliation with a myriad of unhealthy & unsafe environmental exposures with predatory management like certain nurses & docs and the same happened in the holocaust by those who were supposed to care. saying “I was just following orders”!. Experimenting ON PATIENTS that will be guaranteed to not come out alive..diabetic patients were number 1. Who hired the David Lawrence who set this all up in motion and with the VA too & YES, it is crimes against humanity via medical care. Yes, a RICO, yes to a Nuremberg trial, Yes to all of it. Our medical care, all over IS JUST NOTHING BUT A PROFIT MAKING MACHINE EARNER FOR TOP INVESTORS.
    AND don’t forget those that make the pesticides, the bio products,etc.. those are investments too for the 1% NOT ONLY IS WAR a profit making business so is all the rest of it, related to….
    All vets have the opportunity to open it all up, ALL OF IT!!!!!!!.

  17. Every time I think the VA cannot get any worse in their blatant lawbreaking, Ben writes another post.
    YES, Daigh needs to be fired. When will this end? It will end when Congress not only fires these hacks, but starts prosecuting them for their actions. Get off your ass and do your job Miller!
    Next, Congress needs to zero out the budget of the VA OIG and their Office of General Counsel. Both are wastes of time and money, and by their actions, actually costing taxpayers money by their illegal actions.
    Finally, Nee needs to contact OSHA and file a complaint after being willfully exposed to asbestos in her place of employment. The VA is shockingly out of control, and Congress twiddle while providers and vets suffer.

  18. Take these investigations out of the hands of VA OIG and put in in the hands of DOJ, vets are being murdered systematically, much as is the case of genicide.

    1. The main problem with that is the Dept. Of Justice, Attorney General, and our current President of The United States **is HAPPY with job the VA OIG is doing**…and The Pres. was just quoted as saying so YET AGAIN earlier this week.

      The Attorney General’s Office has been compromised by Obama’s new agenda going after police doing their jobs…never mind the Veterans being treated like crap!

  19. Should I trust the Bronx VA resident eye doctor to properly perform a cataract operation on me? I understand that a similar operation in CT led to blowing up the veteran’s eye.

    1. Hell No! Please don’t trust the VA with your cataract surgery. I had cataract surgery last week at St. Luke Eye Clinic, Tarpon Springs, FL, and it was a successful cataract surgery. You can email me at [email protected] for additional information. Jeanette

      1. The problem is that these are residents doing the surgeries at the va. the same residents that are at loyola hospital .. They are still learning and thats why they make all these mistakes. they should be better supervised.

      2. @linda-
        There lies the VA ‘rub’…the VA is utilized massively as a *TRAINING PLATFORM* for newbie resident medical practitioners to the extent that those supervising them have been AWOL for quite a long time, grown completely *dependent* on these ‘residents’ **doing heir jobs FOR them** and when a newbie is supervised by last in their class doctors, there really IS NO REAL “supervising”.
        Do you get ‘training residents’ in the Private Medical Arena? Yes, but the BIG *BUT* is they are supervised by COMPETENT Dr.’s that actually can be sued for malpractice. In ‘VA Land’ (not to be confused with Disneyland), they HAVE NO FEAR OF FAILURE because trying to hold anyone accountable under auspices of malpractice is near impossible when the VA Employee’s Union makes them untouchable nor easily accountable.

        One of the seasoned Civilian Gastro Spec. Dr.’s I see was asking me a few questions prior to my first Colonoscopy about how the military gave me Hep B and other “little medical gifts”, and he happened to be ex-USAF as well…he was a Medical Dr. doing exactly what he does now for 20 years and retired then went into private practice. (remember, he told me he had 20 YEARS experience as a Dr. in USAF) He told me that when the Iraq War started post 9/11 he thought he could “help Veterans” and even take a reduction in pay and go work for the VAMC’s. HE WAS TOLD HE WAS ***OVER-QUALIFIED*** and they refused to hire him!! He then told me I was doing the most WISE thing in deciding to ONLY use Medicare and Private Dr.’s rather than the VAMC’s, as I was one of MANY that had been victim of the VA/Military’s medical screw-ups that he has seen in the private sector. (I am 100% Svc. Connected P&T Disabled Vet with Medicare/SSDI).

        That was INSANE to think the VA turned down a 20 year USAF Officer Medical Dr. for being OVER-QUALIFIED!!! So there IS such a thing as being **too competent** to even WORK at the VA…that said it all for me!
        He’s the one whom told me I would be safer using a Haitian Witch Dr. than the VAMC’s because he stated that MOST of the Dr.’s have their medical residency completely WAIVED by the VA…so most of those M.D.’s that you cannot understand hardly anything they verbally say would actually require YEARS of additional academics and medical residency to even work in the civilian medical field…they can ONLY work for the VA.
        Scary but unfortunately very true.

  20. An example; had knee surgery May 13th, got stitches out the 23 And still waiting for rehab! RED-Tape !going back to work may 21! With or without rehab!

    1. Your rehab should have been scheduled at the same time as your surgery. Someone there is not doing their job. You are lucky if you can go back to your job. Some companies will not accept employees back until the doctor signs off on your ability to return.

  21. Yes the OIG is helping VA employees hurt veterans, when the VA first accused me of being disruptive on many occasions the VA had called the OIG and the OIG told the VA to punish me and also to call the FBI and my local police Department. This is in my medical records. I have been fighting the VA for ten years to clear my good name and no one wants to listen and do a proper investigation. If a proper investigation would be completed they would find out that the person (employee) that reported this to them was flat out telling them a (LIE) and the employee was not asked to provide any proof (PERIOD). When I disagreed with their findings and asked for the proof they admitted they have no proof and only used the employees Hear say. As I have been saying for the last 10 years that the employee only reported me to the disruptive committee because when I worked for the VA, I had stated that I felt she could have done a better job with a committee she was in charge of. This pissed her off enough that after I left, it keep nagging her that I said this and she took it upon herself to report me, in order to get back at me and the Denver VAMC let her do it and they punished me and it has not stopped to this day.

    There are so many government agencies that deals with VA complaints OIG,OPM Etc and each seems to be the agency that does not handle that certain complaint and they refer you to another agency. By the time its all over with or I should say unresolved and someone does make an inquiry and the VA admits wrong doing there is no one who will take action on the veterans behalf.

    The VA admits that there is no evidence at all that shows I had ever been disruptive and the Director of the Denver stated in writing ” Mr. James records were never coded for disruptive Behavior, His medical records were never Red Flagged and there has never been any investigation completed. Even though they admit they have nothing that ever shoed me being Disruptive, they did punish me and continue to do so by threats of arrest and banishment from all VA care. The Director Lied with those statements my Records were in fact Coded for Disruptive Behavior and my Records were Ordered to be Red Flagged and it is recorded in the record that it had been done.

    BOB McDonald office did nothing to help me, The Acting Director stated in a letter “Mr. Mcdonald asked me to reply to your letter. The Matter is that when reported that you had been disruptive “THOSE WERE THE FACTS AT THE TIME “. The truth of the matter the only real FACT is that an Employee lied to the Disruptive Committee and they when ahead anyway, “With out any proof and acted upon it. They can not even admit they were wrong (COWARDS).

    How can anyone just take Administrative action against anyone accused of something and not require any type of proof and only use Hearsay and punish someone for something they never did.

    My Friends the VA has fallen to the lowest depths possible and they are committing crimes against humanity.

    This Disruptive Committee must be held Accountable for the wrongs the are committing !. Is there anyone that will help and stand up for veterans that have been falsely Accused.

    What do you think of this matter my fellow veterans, You can be Next.

    1. Sir, I’ve had very much the same experience as you with the disruptive flag.

      They put me in the fiduciary program, even contacted the FBI and ATF, who eventually seized my firearms.

      Because I was filing complaints with the OIG and talking to the patient advocate about them not treatting the MRSA that they gave me.

      I once got off an elivator to find an officer waiting for me, called by one of the appointment makers.

      After telling him my story, he took me to the patient advocate himself.

      It got to the point that I started recording every interaction I had with the VA.

      The craziest thing was I found out one of the advocates wasn’t even recording my visits at all, and that several doctors had flat out lied in my records.

      Somehow, we need to get a class action law suit, or a million individual federal tort claims act suits.

      The thing is, they will attack you, share your records, screw with your income, even destroy your reputation; in order to get any outside help you have to be lily clean.

      They’ve put guys in the fiduciary program just for saying their wives managed the checkbook.

      As fat as in concerned the VA regularly violates at least seven of the ten rights outlined in the bill of rights, impacting millions of Veterans.

      Judicial due process? Ha.

  22. This quote from the very end of the USA Today article, quoting Clarno, “This is the agency we’re supposed to trust to investigate on behalf of our veterans,” Clarno said. “I have no faith in them. None. They’re part of the whitewash, they’re part of the cover-up. It’s the VA watching out for themselves.”

    In the same article it is said that President Obama has TOTAL TRUST in the work the VA OIG does and he specifically stated that he thinks of ALL gov’t watch groups. he has THE MOST FAITH AND RESPECT for the VA OIG!!!!!!!!!!!!!!!!

    WTF? The Whitehouse also is in need of a massive enema! November, 2016 cannot come fast enough, IMO. Why has their remained ONLY an *acting* interim VA OIG Chief and not a permanent/official appointment after all this time?

  23. The VA is full of these types of people. I see no change in this as it is hard to change a conglomerate. It is hard to find the person in charge of something like this hold them accountable. If the person is not “going with the flow” then they are removed and another person is put in their place. This continues until they find the person who will be the scape goat. Then when that person is no linger needed, the process is repeated.
    The VA needs to be torn down and either rebuilt from the ground up by a different organization or us vets need to have a choice of where we want to get our HealthCare with no limits.

  24. The VA OIG sure seems in need of a GROUP ENEMA…time to get rid of all the “Inmates Running The Asylum”, and this failed investigation and horrific treatment of VA Whistleblowers is outright unacceptable and these people need to be tried by the courts for Crimes of Negligence and we need NOT hear them all scream, “We were just following orders”, as we only need to go back in history to immediately at end of WWII and the infamous Nuremburg Trials where the captured Nazi leaders ALL used that exact excuse of, “We were only following orders!”

    NO CHANGES FOR THE BETTER will *ever happen* as long as those responsible for policing the VA cannot even do the job competently they are paid big bucks to do. Time for a complete change of the guard of the entire VA OIG and sad to say, this goes for spineless VA Sec. McDonald and Undersecretary Hickey…they, am sorry to say, are only an extension of the dysfunction of the VA.

    How about filling ALL those VA OIG positions with fellow Veterans…and NOT West Point Officers that will only do the bidding of the very dysfunction…no, VETERANs…those that were ENLISTED.

    This cannot continue because we have seen enough of systemic stonewalling by the VA OIG and believe the current status quo has absolutely no integrity and are only protecting the VA, NOT VETERANS.

    1. How about all veterans fallen victim of these unlawful act join together and file a class action against the VA? I am a victim myself and I am tired of hearing all these veterans sufferings. Let us all ask Benjamin Krause if we have a cause of action for filing a class action. If we do count me in.

      1. I hear you loud and clear and that my Friend is the only way the VA and Government will take notice and action given to all of us whom the VA has Attacked and punished. If anyone should know its Ben and your idea is the best way for the Country to hear us. Thanks Jose

      2. What would the nature of the class action be? You need to think this through …Ben might be inclined to but the problems are so vast you need to make sure you know what your are suing for…what is the remedy you are looking for? Damages? money to be paid to widows in this case where people died in surgeries? This has to be much broader than that to change things…I am a retired attorney over 40 years in the practice of Law……I am having a hard time getting my mind around such a broad class action that would help all of the Veterans…nation wide past present and future….you can pick that them…a suit here for damages and there for damages….but one that is going to solve the whole problem….sorry I do not think so….This is about Politics and mismanagement…..getting on your congressional leaders to replace people in the system or they get replaced??? hummmmm….that has a certain ring to it….I am not sure Sec. McDonald is a bad guy….I think he has been on various VAs covering their ass…and lying etc….there should be perhaps a committee of independent Doctors, Veterans, and Lawyers going to each VA Facility to talk with the Veterans at that place and then look into things…if things do not look right or they think they are being lied to then people lose their jobs….perhaps like in the case where Veterans died…criminal actions….civil suits for wrongful death if the statute of Limitations has not expired. I see this on websites….on facebook etc…….CLASS ACTIONS……everyone is yelling….you need to know what your goals are and what you want to achieve and then lawyers need to try to come up with a way to do it….IT IS NOT AS SIMPLE AS IT MAY SOUND….

      3. You are correct that it is not that simple. Many years ago an attorney in Texas was supposedly filing a class action on behalf of Gulf War vets. I don’t recall the suit going anywhere.
        What is your opinion on a class action suit claiming civil rights violations, with an independent oversight body as the end goal? If a cop stops me, no matter if I resist or have a felons rap sheet a mile long, I can sue for civil rights violations and likely not only get money, but federal oversight of the police department. As a vet, I can be injured or killed by malpractice, have severe medical conditions ignored, have benefits wrongly withheld and be punished by a Disruptive Committee without judicial review, and people yawn.

    2. You are exactly correct John. May I add that McD had to learn alot about this horror show we call the VA – and the U.S. Government (every part of it, and all the other goverments in the world) McD has to comprimise with every one in order to exist and not turn into ashe puff. In order to get anything done at all, he can’t make everyone his enemy in the entire VA system. CEOs in the business world can not do that in their organizations either – or they are dust. He has to put up with the most putrid people on the face of the planet and somehow get them to start doing some needed changes. Will he succeed? Maybe in certain areas. Not going to be a widespread reorg. though. And he ain’t gonna do it alone. We do need panels of experts to run the VA, and vets themselves as stakeholders of their own health. The problem is the government and the corporations, financial institutions, super rich, and politicians that own it ,run it, and hang it on the wall. Ever notice how edgy people are in the U.S. these days about everything? How the feeling of trust in anything is not there at all? How the feeling of unrest is permeating the majority of us thoroughly, where we are all upset about everything? We have to be on one message to revolt, and we have to nail it on the head.

  25. I am proud of these two ladies. I can say “Amen” and not surprised at all. They do it to veterans all the time. Good job ladies! Praying for you. Keep up the good work. Thank you for taking a stand!

    Secretary McDonald needs to wake up. He is in a rattle snake pit. I write him at least once a month and at first was getting responses.

    The Fayetteville, NC VAMC has been in all my letters. The director, I believe feels she is above the law. I recently learned she wrote her staff and told them not to remove a very dangerous VPL lift from our home. It has had problems including electrical since its installation. As I shared with Secretary McDonald, Ms. Hickey and Ms. Clancy, if anyone gets injured, I sincerely hope they will take the lead in being sued.

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