Bay Pines Va Does It Again.

[john999]

The Bay Pines VAMC in St. Petersburg, Fl has almost killed another veteran who went there for treatment. Read about it in the St. Petersburg Times. These people at the VAMC are dangerous.

[Scottyp65]

I don't know how to do the posting thing so here is the story.

Patient charges spark Bay Pines inquiry

A World War II veteran files a long complaint list, many centering on his care by the hospital's dialysis unit.

By PAUL DE LA GARZA, Times Staff Writer

Published February 9, 2006

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SARASOTA - It was early December when World War II veteran Eugene Bostrom checked into Bay Pines VA Medical Center to learn how to use a prosthetic leg.

During his three-week stay, the 79-year-old suffered a heart attack and a fractured leg. He developed bed sores and a fungal infection. The hospital eventually sent him home without his prosthesis.

Bostrom's family contends his health complications were aggravated by poor dialysis treatment at the VA hospital in St. Petersburg, noting he gained a dangerous amount of weight.

This week, the VA inspector general said it would investigate Bostrom's complaints. Word of that investigation came as Congress and the inspector general began another round of inquiries into the long-troubled hospital, based on an anonymous letter alleging mismanagement and poor patient care.

Bostrom says he filed a complaint because veterans deserve better care. "When there's a wrong," he said, "it has to be righted."

Bay Pines declined comment.

Bostrom's visit to Bay Pines occurred as the VA inspector general was wrapping up an investigation of the 17-member dialysis unit at Bay Pines, which performed 5,261 treatments from October 2004 through June 2005.

That investigation, prompted by an anonymous complaint last summer, claimed staff was not properly trained and did not follow generally accepted policies and procedures, resulting in poor care.

The complaint also said patient safety and infection control violations frequently occurred, and that dialysis treatments were falsely documented.

Investigators substantiated several of the charges. In a report released last month, investigators found that the unit "has not developed sufficient internal policies and procedures and lacked an adequate organizational structure to ensure that the quality of care provided to dialysis patients meets acceptable standards."

Investigators also found that Bay Pines "did not adequately document dialysis patient care, properly report incidents and errors, or correctly report dialysis workload data."

Other key findings:

Technicians not licensed to dispense medications mixed solutions for dialysis treatment by "eyesight" rather than more accurate means. Equipment used in the process was not bacteria-free.

A lack of clear policies and procedures resulted in staff following inconsistent practices.

Staff used protective clothing and equipment incorrectly, with gowns open, sleeves rolled up, and without protective face shields.

"We also observed (Bay Pines) electricians placing their tools on top of a dialysis machine and working in close proximity to a dialysis patient while not wearing protective equipment, which presented both a patient safety hazard and an infection control issue," the 21-page report said.

Patients generally were "very satisfied" with dialysis treatment at Bay Pines, the report said.

In its recommendations, the inspector general said Bay Pines needs to improve the operation of the dialysis unit by strengthening staff training and developing comprehensive policies and procedures.

In response, Bay Pines said it would implement the appropriate changes immediately.

After losing his right leg to diabetes last summer, Bostrom was admitted to Bay Pines Dec. 6 to learn how to walk with his prosthesis.

During their visits, the family noticed something peculiar. "He kept getting fatter and fatter and fatter," said his wife, Jeannine.

Before long, she said, the prosthesis no longer fit because he had gained too much weight. All along, she was assured he was undergoing dialysis.

On Dec. 20, Bostrom called home to say he didn't feel well. He also said he had fallen in the bathroom and that "something cracked."

It would be several days, Mrs. Bostrom said, before he was fitted with a soft cast for a broken leg.

Later that night, the family got bad news: Bay Pines called to say he had suffered a heart attack and that it didn't look good.

"I was hysterical," Mrs. Bostrom, 73, said.

On Dec. 28, Bostrom was discharged.

He said he was put on a bus and sent home in his pajamas. He said he asked for his prosthetic but that it had been misplaced. After a two-hour trip, Bostrom said he was left in front of his house, in his wheelchair, alone and cold.

"Unbeknownst to me, they never called Jeannine that I was coming home," Bostrom said. "Jeannine didn't have the vaguest idea."

After nearly two hours, a neighbor saw him and reached his wife on her cell phone. A week later, Bay Pines delivered him the prosthetic.

Immediately after he was discharged, Bostrom sought treatment at a private hospital. In three days, the family said, 18 pounds of fluid were drained from his body because of improper dialysis.

The Bostroms are angry with Bay Pines, which only a year ago was the target of multiple federal inquiries into mismanagement and poor patient care.

"He could have sat outside all night and be dead in the morning," said Bostrom's son, retired Air Force Lt. Col. Larry Bostrom. "Somebody needs to be held accountable for that."

On Jan. 26, with the help of his son, Bostrom filed a complaint with the VA inspector general.

He says his goal is to improve the quality of care at Bay Pines. "It would be a pity if it happened to anybody else," he said.

Paul de la Garza can be reached at delagarza@sptimes.com or 813 226-3432.

[Guest Berta]

http://www.va.gov/oig/51/news.htm

That is there press release page of investigations up to May 2005.

I still haven't heard from them on my complaint letter-

It was a two part letter-involving my husband's death and also I griped about the way my claim was being handled-as it is indicative of how many claims are handled and that this is a travesty for veterans and men and women in Harm's way today paying taxes for a system they might well need yet that is broken.

The second part- I have heard via the VA 800# that they prepared a response to the IG and then things started happening with my claim.

The first part is extremely important to me and it will take them time- I asked them for something that might not exist.

The second part- I dropped a 'dime' on the way this VARO handles claims-I am sick and tired of their ability to pick and choose, or ignore evidence, they add to the back log because some of them cant read---I gave the IG permission to access anything they want from the years and years of claims experience I had-

I feel that it must represent the way they handle Many other claims because the VA doesn't discriminate.

[Pete53]

Having Diabetes II I worry about burning out a kidney and needing dialysis. I would hate to have to do it at the VA.