VA hospital killed my mom with a BP medicine overdose

[kenny18]

Hello, I just found this forum and am wondering if anyone could give me some advice.

My mom was a disabled Navy veteran. She was an inpatient at the VA hospital for two weeks and was discharged the last day around 5pm. She seemed fine and went out to dinner with a friend. She collapsed in the bathroom later that night around midnight. Her friend heard her fall and called an ambulance. The ambulance brought her to a normal hospital (not the VA hospital) and she died there a few hours later.

The autopsy shows that she died from a massive overdose of blood pressure medicine, amlodipine. Her blood level of amlodipine was 500 times higher than the therapeutic dose. She had normal levels of all her other medicines. I did research about amlodipine deaths and it happens when someone is given too much of the medicine and it builds up in the body over time and then kills them. It takes a while to have the toxic effect so this was definitely caused by something they did at the hospital before she was discharged. There is no way this was suicide - she didn't even have that much medicine and there were no pills in her stomach.

I submitted a request for records but the VA only gave me basic info. I asked for complete info regarding that hospital stay, like specifically what dose of what medicines was she given at what time and by whom. Instead, they sent me a CD with 700 pages of records listing all the dates she had ever had a doctors appointment in her life and the names of the doctor for each appointment, but no specific info about that hospital stay like I asked. 

I went in person to both the VA hospital and to an assistance center and got no effective help. The assistance center had me file a bunch of paperwork that I don't really understand. I got a denial in the mail saying that the VA denies "DIC, Death Pension, and/or Accrued Benefits" because of "you did not provide complete information or evidence". I called them to ask about what info they need specifically. They were not at all helpful and now it is past the appeal date. I'm not sure if this paperwork from the assistance center was even the right stuff to submit.

Does anyone have any advice for what to do in this situation? I want the VA to tell me what exactly happened and why they killed my mom. She was only 44 years old. My little sisters have to grow up without even knowing their own mom.

Edited September 7, 2017 by kenny18

[Berta]

------------Buck, it has been only 2 days I think since Kenny made the post. But you are right….

For some reason ,of the posts we have had that seem to be malpractice issues, over the years, many never return and the ones that do return, often seem to be unwilling to take our  advice.

I am not saying that is the case here but I assume time is of the essence in FTCA filings for this family.

 

And it appears a VARO deadline for appeal  of the DIC , and accrued denial, has passed. That tells me the 2 year FTCA  Statute of Limits is slipping rapidly away or is over already.

There may be nothing this family can do, but when I saw that it appeared the ME said the death was suicide, I bet the ME had no basis whatsoever for saying that .

But only a thorough review by a real doctor, who can prepare a strong IMO would reveal what definitely caused her death.

 

 

[kenny18]

Wow, thank you all so much for the kind words and helpful responses. I greatly appreciate the time you took to help me and I will do my best to communicate fully and follow your advice. I apologize for not responding sooner. This is a difficult topic to think about and I had to look for paperwork. There are a lot of questions in your replies, so I will try to answer them all below. I will set an alarm to log on again soon so that you do not wait again so long for a response from me in the future.'

Berta, in your post you said that the VA caused your husband's death at only 47 years. You have my utmost sympathy and condolences. I am so sorry to hear of such a senseless and avoidable loss. 

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That is 2 years from the date you were aware of the malpractice.

How do they determine this date? The doctors at the VA had me come to a meeting with them right away after my mom died. They never said anything about malpractice. They tried to imply that it was suicide or that it was God giving mercy to her because she was in pain. My family is very religious and we knew in our hearts that she never would have killed herself, so we believed that God loved her so much that he simply took her to be in heaven so she wouldn't suffer anymore.

I didn't request an autopsy report until years later. When I finally did, I didn't understand it so I called the medical examiner's office to ask questions. Even then, no one told me this was an impossibly high concentration of amlodipine. They said the medical examiner who did my mom's autopsy didn't work there anymore and that her death must have been caused by an unexplained interaction between her medicines. It wasn't until I went to graduate school that I learned enough about chemistry to research this online and find out that this was almost certainly a mistake at the hospital.

Although I read about this medicine online, I still don't know 100% for sure it was malpractice. I'm not a doctor and don't even have the detailed records from those two weeks in the VA hospital like I asked for. Getting an independent medical opinion sounds like a good idea. Do you have any guidance for how to find this? Will my own regular doctor be able to do it or is this some kind of specialist? When I googled this term I just found a bunch of personal injury lawyer's websites, not doctors. Regardless of a VA claim, I want to understand what happened. That is the most important thing because this was really shocking and we still don't fully understand what happened or why. But also it would be good if there is some paperwork that can still be filed to help my sisters afford college. If the independent medical opinion says that this was malpractice, could the VA consider that opinion to be the date of me becoming aware of it?

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Kenny, was their a living spouse for your mother?

No, she was divorced.

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 And when did she die?

She died in 2010.

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If there is no living surviving spouse to file claims against the VA, did the VA accept you as a claimant and give you a C file # when they denied the DIC?

The letter provides a "file number" which is her SSN and also a "request number". Are either of these the "C file number"? I am the oldest child so I think they should accept applications from me. 

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Did your mother have any children under 18 when she died?

Yes, my two sisters were both under 18. One just turned 18 this summer and the other is 17. They both want to go to college so I am interested to know if there are any education benefits or scholarships they can apply for. Our mom sporadically took classes at a college but never was able to finish anything because she was always in and out of the hospital. I think this was paid by the military. When I was studying for my Bachelors, my mom asked me for some of my college enrollment and transcripts and said it was for some military education benefit. I had a decent scholarship though so I didn't need the education benefits from the military and never gave her the documents she asked for. But now that my sisters are older, I wish I knew what she was trying to apply for with my paperwork so that I could see if my sisters would qualify, or if there is any transferable education benefit from my mom because my mom never finished school. 

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Who prepared the DIC and accrued claims for you?

Someone at the VA assistance center in Denver, CO. They didn't fill out the forms; they just printed a few pages and had me sign them and then they mailed it somewhere. 

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Can you scan and copy that letter (the VCAA letter they sent) and attach it here ?

Yes, I will post it along with two other letters. First letter is from December 10, 2014 saying the claim is being processed. Second letter is from December 12, 2014 saying the claim is denied. Third letter is from May 2017 saying they don't have the medical records.

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Do you have a complete copy of all of her VA medical Records?

No. They sent me a CD with a bunch of junk info that doesn't explain about that two week hospital stay. The letter from May 2017 says to contact the hospital but I haven't done that because it seems like everyone I contact with the VA is just giving me the run-around. The letter doesn't say who at the hospital to contact specifically so it's pretty much guaranteed that I will contact the wrong person, wait six months for an answer, and then get yet another letter saying they can't or won't help.

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I assume that is clearly shown on the toxicology report the medical examiner did.

The toxicology report says the concentration but doesn't numerically compare it to the therapeutic dose. I had to learn about obscure medical terminology and do my own research online to find out that the reported concentration is 500 times more than it should have been.

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Do you still have any of the med bottles ( and any meds in them ) she took, as prescribed by the VA?

No. The EMTs took all her medicines to the hospital with her when the ambulance came. I don't know what the hospital did with them.

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You also need a copy of her complete C file.

What is a C file and how do I request it?

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Are you prepared to get an Independent Medical Opinion, that could be quite costly?

I'm a student so if it is thousands of dollars I probably couldn't afford it until I graduate, but if it is a few hundred dollars then I can get it. What do I need to prepare for it?

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Did the VA recognize your status as a legal claimant for the DIC claim?

They didn't say anything about it. I'm the oldest so I think I am the one who has to apply. And my sisters are too young to deal with this mess anyway.

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Did you file for DIC , accrued  etc on behalf of minor children?

I don't know. I don't have a copy of the application that was sent through the VA assistance center. I wrote down whatever the assistance worker said. I don't remember if he asked about my sisters.

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Was this a specific 1151 claim?

Same as above.

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Is there an 'mg' after the 500 on the autopsy?

I didn't find the autopsy report in my paperwork. I have to go to the storage unit and look for it there. The report measures it in concentration, like XX mg/L, not just mass like mg.

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What other hypertensives were listed on the autopsy?

I don't remember off the top of my head. I'll look for the report this weekend.

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They could have given it intravenously-that information would be in the medical records.

How do I get them to give me such specific information? Do you think if I call the Denver VA hospital again that they will give me the records this time? What terminology do I need to use to get them to send me the correct information and not a list of the name of every doctor she ever saw in her life?

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When did yout mother  die?

2010

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What was the VA hospital admission for ?

Migraines and mental health. She started getting the migraines while she was in the Navy and I think it was considered service-connected. The mental health was related to losing custody of my sisters.

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What state did this happen in?

Colorado

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If the death certificate and findings stated suicide as the cause of death,

I need to look for the death certificate and autopsy report this weekend to double-check but I'm pretty sure the death certificate says the phrase 'amlodipine toxicity'. None of the paperwork says or suggests suicide.

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I do not know who would benefit here with a retroactive DIC award, if the Statute of Limits has passed and if the DIC and accrued claim were never appealed, or never filed within the first year after her death.

My first priority is to get them to send her full records and have them review it to find out why she died. Or maybe I will need to get the independent medical opinion if they won't review it. We are all doing well with our lives and will be fine if they don't approve any benefits or claims. 

If it's still possible to apply/appeal, it would be appreciated if they will help us financially. I had to drop out of college to deal with the aftermath of my mom's death and was homeless for a while and that definitely set me back in my education/career/life. Fortunately my sisters were shielded from a lot of that, but still their life hasn't been as easy as it could have been and I want them to go to a good college so they can make the most of themselves.

It is definitely not within the first year and I didn't appeal their letters by mail. I called the VA and asked some questions and they transferred me to a line where I had to leave my info to get on a waiting list for a return call. I finally got their return call months later when I was in the shower. It went to voicemail and I saw it when I got out of the shower. I sorta gave up on it after that because dealing with them is so slow and hard and it seems totally pointless to try. Nothing I do has worked at all aside from getting that useless list of doctors names. This seems like a waste of time and effort but it still gnaws at me that I don't know exactly what happened to my mom, and now with my sisters applying to college I feel like I ought to try one more time.

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Their denial letter contains their actual reasons for denial.

It just says "because you did not provide complete information or evidence". It doesn't explain what specific info or evidence they want.

Here are the letters...

First letter saying application is being processed:

Second letter saying application is denied:

Third letter saying they don't have the records:

 

 

[Buck52]

Ms berta

Of  the copies  posted here especially the of the decision letter

'What Did We Decided''

if you can't see the letters clear  just click the middle of the pic  until you can read them...took me three clicks to make it large enough to see....but I have to use reading glasses anyway.

if you already know this...Okie Dokie  ;)

 Kenny 18,

Remember if they reopen this claim please stay on top of it, in Appeals we need to make each timeline & respond back in a timely manner.

I'm pretty sure Ms berta can help you on this.

Good Luck to you and your sister's kenny18

I wish you guys the best with this claim.

 

Edited September 9, 2017 by Buck52

[Berta]

This is more involved than I thought. And I also thought they had deemed the cause of death as suicide based on your statement here:

"There is no way this was suicide - she didn't even have that much medicine and there were no pills in her stomach." I was wrong and apologise.

What was the actual cause of death? on the death certificate?

Were the younger children in her care when she died?

This is beyond the FTCA statute of limits.

You need to get a copy of her complete medical records-

The Denver VAMC should have a Records Access Officer who might have a brief form for you to fill out.You also might have to bring proof of your relationship to the deceased veteran.

Her records might not be at this VAMC due to so much time has passed but they can direct you to where they would be. VA often "retires" reciords when veterans die, unless their was a pending claim at death that a survivor has pursued.

With the cause of death, that would help me try to determine what type of an IMO you would need.

I do not foresee any potential here of DIC if the younger children were not in her physical care when she died.

I will try to find the VA's legal regulation on that.

With an IMO you will either know if tyhis was negligence/malpractice, or if it was not, you would then have  peace of mind and that itself is worth getting an independent medical opinion.

My husband collapsed in our barn and I immediately administered CPR and called the ambulance dispatcher.He had been hospitalized at th VA a few weeks prior to that and  I had purchsed a portable phone and it was right with me when he died, to call for help , as I gave him CPR.

I was shocked at what the coroner had determined was the cause of death- a massive heart attack.

He had been a VA patient since 1983 and by then 11 years later the local VAMC had given him at least 2 EKGs and an ECHO, never advising him or me that he had significant heart disease, even after a major stroke had occurred. He was on a very low dose of HBP meds, whih seemed to indicate  his HBP was controlled enough to prevent heart damage.He also got annual check ups as a VA employee, and monthly therapy for his PTSD. He had a pending claim at death under 1151  and wanted me to continue that claim if he died.

With the shock of his sudden and unexpected death I immediately filed to  become the 1151 claimant and filed an SF 95 for wrongful death. I didnt have his VA  medical records when I filed and the autopsy took time to get.

When I received all of above, I prepared the evidence for my claims.It was a lot of work.I had to start from day one, going to medical libraries, and law libraries, and trying to buy all the medical books I could afford. The malpractice, I learned from the record began 6 years prior to his death.

This was almost 23 years ago,without the internet as we know it now. The autopsy was my prime piece of evidence and that alone was difficult to interpret but I focused solely on the slides of brain and heart because the other autopsy results indicated other normal organs. The full toxicology report done ( because he was an organ donor) contained only his VA meds at normal doses.

I feel your mother might have had a hypotensive reaction to her meds that could cause a heart attack, if that was listed as the cause of death. But I am not a doctor-I base that on the fact that Meds by Mail had sent my husband someone elses meds by mistake ( proven- they could have killed this other veteran as well), at a  much higher dosage.We always compared the VA meds to a Physicians Desk reference book we had and I never thought to read the other name on the label until the coroner called me.What a shock that was, one day after the shock of him dying.

The VA doctor who handled the FTCA case did state that this could have caused a hypotensive reaction,contributing to his death but the other evidence of malpractice on heart and brain had more bearing on the case. I filed a few years ago for the HBP to be rated under 1151.In 2015 or 2016 that 1151 claim was granted...there is no time  limit on filing 1151 claims.

My point is you have to start with the actual cause of death.At one point the VA said my husband ( who could not handle money, walk well or see well, and who was always with me except for a few days of VA Day Treatment for severely disabled veterans, died of a possible '"Cocaine overdose" due to a speculative statement the C & P doc had stated.There was absolutely no mmedical evidence whatsoever, to prove that and the autopsy would have revelaed that as well if it were true. But the Va, as within testimony I gave to the House VAC in DC showed, the VA had reeived 12 copies of the autopsy and shit canned them all, even failing to inform the OGC that an autopsy had been done. I guess I am not the usual claimant. I got a number for the OGC, and for the VA opining cardio doctor and faxed them the autopsy as they also had tried to deny my claim. Immediately everything changed. I settled with the USA a few days or maybe weeks later.

I hope everyone out there realises that, if they or their spouse or feels the VA has committed malpratice on them, and they have to depend on a survivor to speak for them after they die, the survivor must take steps right away to gain an IMO and to file under FTCA within the SOL or at least file under Section 1151, 38 USC.

Organ banks here in NY give the autopsy for free to organ donors...at least that was the case for me.

The VA hopes survivors do not get autopsies done,if they file 1151 and/or  FTCA deaths.

yesterday a good friend of mine mentioned the anniversary of my husband's death because he was at the service and a relative of his died suddenly of  a massive heart attack the same year. The spouse did not want an autopsy done yet the family still wonders how he could have died, at a young age, and a few days after a complete cardio work up had been done on him showing no problems.

This was not a veteran. They will always wonder why he died and still have grief and no answers.

 

 

 

[Berta]

Since NPRC does not have the records, they are probably still at the the Denver VAMC.

Denver Release of Medical Records:

https://www.denver.va.gov/patients/roi.asp

 

You can use the first pdf form at the right of this page or if you live close enough , go to their Records Access Officer ( often called their FOIA officer as well) and they should have a brief form for you to fill out.

I would all them first if possible to see what they will ask you for if you go in person.

I don’t know how old this info go to their Records Access Officer ( often called their FOIA officer as well) and they should have a brief form for you to fill out.

I don’t know how old this info is on their web site:

https://www.denver.va.gov/patients/customerservice.asp

But worth a try if you have more problems with the medical records. They may or may not be physically still at this VAMC but let the VA find them for you.

Perhaps you should call this guy before going to see what help he could provide.
Tony Barnes
Chief of Patient Experience Liaisons
303-399-8020 x4607
Or use the suggestion at this link on the Denver VAMC web site:

Alternatively, you may contact us through e-mail using the VA National Inquiry Routing & Information System (IRIS). IRIS is found at the www.va.gov main page ,click on the Contact Us and then click on Ask a question.

An IMO doctor will need all of the VA medical records, to include all blood work, med profile, and of course the Discharge Certificate from the hospitalization and all of those pertinent records and also they will need a copy of the autopsy.Possibly her C file copy as well.

The C file can be requested by mail from the Regional office who made the last decision as to the FDC claim.

 

I certainly feel there is more to the autopsy that the brief info here. The IMO doctor will review that very carefully.

The Claim was not considered a FDC ( Fully developed claim) and that was why it was denied.

You stated:

“My first priority is to get them to send her full records and have them review it to find out why she died. Or maybe I will need to get the independent medical opinion if they won't review it.”

 

I sure would not depend on the VA to review the records to find out why she died.

The only way to even get a review is to file a formal Section 1151 claim, but I had multiple posthumous C & P reviews of my husband’s VA records, all of which were completely deficient and all of which I had to fight back ,with evidence. I would not depend on any thorough review by the VA of any 1151 issue, unless you have sent them as evidence a copy of a very strong IMO in this case.

I do not believe you would be a valid DIC claimant-

You stated your parents had been divorced and that your mom had lost custody of the minor children.

If her divorced spouse has had and still has custody of the minor children, they, their father,  would be eligible to receive any potential DIC for the children. A few months ago we had a case whereby a grandparent tried to get DIC but they were not the valid custodian.

“38 CFR 3.57 defines a “child” of the veteran as an unmarried person under the age of 18 who is a legitimate child, a child legally adopted before the age of 18 years, an unmarried stepchild who acquired that status before the age of 18 years and who is a member of the veteran's household or was a member of the veteran's household at the time of the veteran's death, or an unmarried illegitimate child. It goes on to say that a child can also be one who is between the ages of 18-22, unmarried and attending school (referred to as a “school-child”). Additionally, 38 CFR 3.58 includes as a “child” one who is over the age of 18 and who, prior to reaching the age of 18, is found to be permanently incapable of self-support because of physical or mental disability and is unmarried (Referred to as a “helpless child”). {NOTE: grandchildren may NOT be recognized as dependents unless formally adopted by the veteran or surviving spouse, even if they are living with and totally dependent upon the veteran for support.}

Parent(s): 38 CFR 3.59 defines "parent" as a natural mother or father (including the mother of an illegitimate child or the father of an illegitimate child if the usual family relationship existed), mother or father through adoption, or a person who for a period of not less than 1 year stood in the relationship of a parent to a veteran at any time before his or her entry into active service. It is important to note that only one of each parental line (father and mother) can be recognized in any one case.”

 

Source 38 CFR 3.57

 

 

 

An autopsy usually always has conditions listed that could have been contributing factors to death.Also a death Certificate under Primary Cause often lists other contributing factors.

 

It is always possible that a death would have a direct service connection, ultimately,and not negligent death,  but that is something an IMO doctor would be able to determine.

 

I assume- and might be wrong again- that your father has custody of the minor children.

If so have you advised him of the potential of a VA claim for DIC?

 

Are you sure he himself has not applied for DIC for the children?

 

A VSO training guide further makes this point:

 

“Child: Must be established as a child of the veteran. If living with the surviving spouse (mother/father), the surviving spouse receives additional DIC on that basis. If there is no surviving spouse or the child is not in the custody of the surviving spouse, DIC is paid for the child to the custodian of the child. If over 18 and entitled to DIC, benefits paid directly to the child (“school-child” or “helpless child”).”

The only review the VA will do at all, will be generated by a Section 1151 claim. This is something the person who holds custody of the minor children, should file.I assume this is your father , divorced from your mother, and maybe he would be willing to help pay for an Independent medical Opinion, because that is the only thorough review of VA medical records that any of us can get…and I was victimized many times by a system that was geared to denying my claims until I gave up. BS to that.

The VA hates 1151 and FTCA issues. You are out of any FTCA statute of limits.

If we know what the autopsy and death certificate stated as the prime cause of death, with any issues contributing ( that is in # 2 on the death certificate cause of death area, and there might be a list of other factors contributing ,on the autopsy,perhaps we can recommend a good IMo doctor with expertise in the field of the actual cause of death. 

 

 

 

 

[Berta]

Also I opened the downloads and the FDC claim correctly states that there are no accrued benefits due-

but it states that they did not receive a copy of the death certificate.

FDC Fully developed claims need probative evidence right away.

However the 1151 claim can still be filed by whoever has custody of the minor children,with a strong IMO,based on all of the medical records.

Did anyone file for burial expenses? Often an undertaker handles that. Sometimes they dont however.

 

https://www.benefits.va.gov/compensation/claims-special-burial.asp

In part it states:

"Service-related Death

VA will pay up to $2,000 toward burial expenses for deaths on or after September 11, 2001, or up to $1,500 for deaths prior to September 11, 2001. If the Veteran is buried in a VA national cemetery, some or all of the cost of transporting the deceased may be reimbursed.

Non-service-related Death

VA will pay up to $749 toward burial and funeral expenses for deaths on or after October 1, 2016 (if hospitalized by VA at time of death), or $300 toward burial and funeral expenses (if not hospitalized by VA at time of death), and a $749 plot-interment allowance (if not buried in a national cemetery). For deaths on or after December 1, 2001, but before October 1, 2011, VA will pay up to $300 toward burial and funeral expenses and a $300 plot-interment allowance. For deaths on or after April 1, 1988 but before October 1, 2011, VA will pay $300 toward burial and funeral expenses (for Veterans hospitalized by VA at the time of death)." 

One more thought.....did anyone apply for SSA for these children if they were under age 16? The criteria for eligibility for that is at the SSA web site under Mother's and Father's benefits for children of the deceased.

SSA also makes a lump sum death payment. I believe it still is $255.

https://www.ssa.gov/forms/ssa-5.html

Also the State of Colorado might have some educational programs for children of deceased veterans. They would have a web site about that.