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VA Blasted at Hearing on Contamination Scandal
Date Published: Wednesday, June 17th, 2009


At yesterday’s hearing before a House Veterans Affairs (VA) committee, the VA
was roundly criticized for not increasing safeguards and improving procedures at
VA health facilities after shoddy colonoscopies and endoscopies were potentially
linked to the spread of dangerous, deadly pathogens.
Officials with the VA offered apologies and promised to make changes, and House
Veterans Affairs Committee Chairman Bob Filner (Democrat-Californi a), said that
VA Secretary Eric Shinseki would take disciplinary action, reported the AP.
Regardless, the fact remains that despite a nationwide scare, media attention,
and suspected links to HIV, hepatitis B, and hepatitis C, less than half of all
VA facilities were operating under appropriate procedures based on surprise
investigations spurred by the scandal, which broke months earlier, noted the
Associated Press (AP).
According to the VA, six veterans have tested positive for HIV, the virus that
causes AIDS; 34 have tested positive for hepatitis C, and 13 have tested
positive for hepatitis B, said the AP.
The surprise inspections were conducted last month reported the AP yesterday,
adding that less than half of the facilities were found to have had proper
training and guidelines in effect for endoscopic procedures, which include
colonoscopies; of serious concern, given that inspections were conducted after
the mistakes were made public and it was widely reported that the VA might be
responsible for the transmission of the deadly pathogens.
HIV and hepatitis B and C are spread by contact with infected body fluids,
especially blood. HIV—the human immunodeficiency virus—is the virus that
causes AIDS (acquired immunodeficiency syndrome); AIDS is the final stage of HIV
infection. Hepatitis B and C are liver diseases that can lead to cirrhosis or
cancer of the liver. Vaccines exist only for hepatitis B. HIV/AIDS and hepatitis
B and C can all be fatal.
The VA has admitted to the mistakes, which, it said, were caused by human error,
reported the AP, but says that it is unable to prove if the infections are
directly linked to VA procedures. The VA did warn nearly 11,000 veterans who
received care at three of its hospitals to undergo blood testing. Many believe
dirty equipment is to blame and, last month, the AP reported that other VA
patients were not warned about similar mistakes with the same equipment at more
than 12 other VA centers.
The shoddy tests were conducted as far back as five years ago and put VA
patients at risk because they were treated with equipment that was not
appropriately sterilized, thus exposing them to the bodily fluids of other
patients, noted the AP in a prior report. The VA acknowledged in its warnings
letters that the invasive procedures potentially exposed them to other
patients’ bodily fluids. Also, the VA admitted in late March that water tubes
and reservoirs it used in colonoscopies and endoscopies were rinsed—not
disinfected—between procedures, which could expose subsequent patients to
contamination.
VA assistant inspector general and review lead, John Daigh, said the findings
“troubled me greatly …. We think there are systemic issues,” quoted the
AP. “You certainly would think that after the initial discoveries and the
directive from the VA that medical directors would make sure that all of their
equipment and procedures were brought into line and yet this investigation shows
that many, many did not …There will be a public accounting of this
situation,” the AP quoted.


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