Veterans' Malpractice Claims On the Rise
Nov 13, 2013
Atlanta Journal-Constitution| by Craig Schneider
ATLANTA -- As thousands of soldiers returned home from overseas in
recent years, American taxpayers have paid more not just for veterans'
medical care but for a surge in malpractice claims against veterans
Settlements and court judgments have cost taxpayers $845 million since
2003 and reached a high of $98 million last year, according to an
exclusive analysis by The Atlanta Journal-Constitution and Cox Media
Group, the parent company of the AJC and Atlanta's Channel 2 Action
Some members of Congress and government watchdogs say the U.S.
Department of Veterans Affairs isn't doing enough to prevent medical
errors. They say the agency's culture lacks accountability and
incentives to improve.
"That's unacceptable," said Rep. Phil Gingrey, R-Ga., a licensed
physician. "It's we the taxpayers that are actually paying out the
claims. And where's the accountability?" Critics decry the VA practice
of awarding bonuses to some doctors and administrators even if they have
been implicated in medical mistakes. In Atlanta, a former head of the VA
hospital received $65,000 in bonuses over a four-year span, a time when
mismanagement of the hospital was linked to the deaths of three mental
Many cases examined by Cox Media Group reporters are heart-wrenching: a
20-year Marine Corps veteran paralyzed after a routine tooth extraction;
an Air Force veteran who died after a surgeon accidentally punctured his
heart; an Army veteran who died after doctors repeatedly failed to
diagnose signs of lung cancer.
Still, the VA may be doing no worse than the private sector, said Dr.
Anupam Jena, a physician at Massachusetts General Hospital and an
assistant professor at Harvard University.
Jena noted that the VA ends up paying plaintiffs in about 25 percent of
cases. Private-sector health systems pay in about 20 percent, according
to a study he participated in that surveyed 40,000 doctors. It was
published in The New England Journal of Medicine.
"Are VA doctors worse than other doctors?" Jena said. "No." The AJC
analyzed payments to 4,426 veterans and family members from 2003 to
2012. Over that period, the number of patients treated each year by the
VA increased. So did the number of malpractice payouts and the dollar
amount. Each of the numbers fluctuated from year to year but trended
Comparing the first half of the 10-year period to the second half, the
average number of VA patients grew by 10 percent, the average number of
annual payouts increased 12 percent, and the average cost to taxpayers
rose 14 percent.
"More and more patients are being seen, and that presents more
opportunities for medical malpractice," said Jerry Manar, deputy
director of national veterans service for the Veterans of Foreign Wars.
For the vets and family members who file these lawsuits, the costs are
devastating beyond dollars. Veterans who survived battle find themselves
fighting against the federal agency intended to help them. Spouses who
celebrated their loved ones' return from war find themselves standing
before flag-draped coffins.
Bill Boritz, a Decatur resident who flew B-52s during the Vietnam War,
trusted his doctors at the Atlanta VA Medical Center.
In April 2010, doctors using laser surgery to fix a flutter in his heart
accidentally burned a hole in it, said his wife, Veronica Boritz.
"I went to see him in the ICU," she said. "He was screaming in pain."
Veronica Boritz, who is 63, believes the doctors sent her husband home
too quickly. His recovery went poorly, leading to numerous trips back to
the hospital. She believes he was placed on the wrong medications. A
month after the operation, on his last visit to the emergency room, she
sat with him hours before doctors attended to him.
His organs were failing and his heart was bleeding. He needed emergency
surgery. As she waited, she heard alarms go off and saw medical personal
rushing in. He died as they were starting the surgery.
Nearly three years passed before the VA settled with her for $300,000.
"Something should change; someone should be held accountable," she said.
VA officials say they have a relatively low rate of malpractice claims,
considering that, with 151 hospitals, theirs is among the nation's
largest medical systems. VA studies show the system outperforms other
top health systems on patient mortality and safety.
"VA takes patient safety very seriously and Veterans Health
Administration personnel remain committed to maintaining a high level of
care, transparency and accountability," the VA said in a statement.
Numerous procedures are in place to catch errors and learn from them, VA
officials said. Internal and external reviews monitor patient safety.
But critics say the VA has no incentive to hold malpractice costs down.
The VA doesn't directly pay for damages; the money comes out of the
"The VA likes to say they're accountable, but I don't believe the word
even exists in the VA dictionary," said House Veterans Affairs Committee
Chairman Jeff Miller, a Florida Republican.
In addition, plaintiffs cannot directly sue a VA doctor. They must sue
the agency, and that provides cover for the doctors, critics say.
"There's a culture of complacency that's going on," said Rep. David
Scott, D-Ga. "But you know what breaks my heart? We focus so much on
sending our soldiers to war. But when they're coming back, we don't have
the same focus on taking care of them." A recent report by the
nonpartisan Government Accountability Office found that in 2011 the VA
gave $160 million in bonuses to medical providers without adequately
linking the extra pay to the quality of their work.
Last year was a particularly costly one in terms of malpractice payouts,
due in large part to a single $17.5 million court judgment. The award,
the largest in 10 years, went to a Philadelphia Marine Corps veteran
left permanently paralyzed by a routine tooth extraction.
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Some experts see bigger bills ahead.
Wounded soldiers are coming home with severe injuries that would have
killed their counterparts in earlier wars. They will need extensive and
often complicated care.
Ohio attorney Stephen O'Keefe, who specializes in VA malpractice claims,
said younger vets also tend to receive higher malpractice awards because
they have more life ahead of them.
Veronica Boritz said it's been hard moving on since the death of her
husband. They were married 40 years. She often finds herself turning the
pages of family photo albums. She hardly feels she received justice. The
doctor who she said made the fatal mistake was never held liable.
The folded flag she received at her husband's funeral is framed and sits
atop a cabinet in the living room.
"He wasn't just somebody I knew who died. He was my whole life," she