Congressional hearing reveals 4 more deaths at Tomah, Wisconsin, VA Hospital

Selections from this report on the Reveal website

Four more veterans died under suspicious circumstances than previously reported at the U.S. Department of Veterans Affairs hospital in Tomah, Wisconsin, under the leadership of its chief of staff, psychiatrist Dr. David Houlihan. The deaths, revealed in a rare congressional field hearing today in the small Wisconsin town, bring to 33 the number of unexpected deaths The Center for Investigative Reporting has found occurred during Houlihan’s decade at the helm. The medical center became known as “Candy Land” for the ease with which narcotic painkillers were prescribed.

They include Kraig Ferrington, a 45-year-old Army veteran and union plasterer who died of an overdose of seven medications prescribed by Houlihan in 2007, and three veterans that a VA pharmacist told lawmakers died in the VA parking lot in 2008 and 2009.

“We are doing everything we can to make sure these tragedies don’t happen to others,” Sen. Ron Johnson, chairman of the Senate Committee on Homeland Security and Governmental Affairs, told a packed audience of 400 veterans and family members at the Cranberry Country Lodge. The hearing brought together many of the people who had suffered and complained for years about Houlihan’s practices to no avail. Members of Congress from both parties made the trip to the rural community, which had until recently been more famous for cranberries and cheddar cheese than notorious for narcotic painkillers.

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Today’s hearing marked the sixth congressional hearing where overmedication and abuse of authority at the Tomah VA have been discussed since CIR revealed the problems in a story published Jan. 8.

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Within a week of that story’s publication, Houlihan and Frasher were removed from their positions pending the completion of an internal investigation.

On March 10, they were placed on administrative leave after a preliminary review found that Tomah patients were 2.5 times more likely than the national average to receive high doses of opiates. On March 20, the VA told Congress that Houlihan’s boss, Tomah hospital Director Mario DeSanctis, had been “reassigned to a position at the Great Lakes Health Care System network office, a position outside of the medical center.”

The VA Office of Inspector General, the Wisconsin Department of Safety and Professional Services and the U.S. Drug Enforcement Administration also have opened fresh investigations of Houlihan and the Tomah VA.

Throughout the three-hour hearing, lawmakers expressed exasperation that few alternatives to narcotics are being offered. Rep. Tim Walz, D-Minn., an Army veteran, said he had been pressing the VA to adopt a more nuanced approach to pain management since 2008. [...]

Witnesses included Ryan Honl, a Gulf War veteran and West Point graduate; Noelle Johnson, a pharmacist who was fired in 2009 after she refused to fill prescriptions for high doses of morphine that she believed were unsafe; and family members of those who died, including Heather and Marvin Simcakoski, the widow and father of Jason Simcakoski, a 35-year-old former Marine who died of an overdose in the Tomah VA psychiatric ward in August.

Crime, Drugs And Dead Amish Baby: How A Criminal Underground Is Linked To Harmful Prescriptive Practices At A Wisconsin Veterans Affairs

An excellent report by Benjamin Krause of DisabledVeterans.org

Investigative reporter Aaron Glantz just released the results of his damning investigation into harmful Veterans Affairs prescriptive practices linked to the death of a little Amish baby.

Glantz’s investigation revealed the story of little Ada Mae Miller. A stoned veteran driving home following treatment at Tomah VA struck her and her Amish family. The family was driving to the store in their buggy when struck by Marine Corps veteran Brian Witkus.

Baby Ada Mae and her mom were thrown from the buggy by the impact. Ada Mae was crushed under the weight of her mother, who landed on her. Her autopsy listed the cause of death as “crush injury to the chest.”

Witkus was a known drug addict receiving treatment from Tomah VA and the now infamous psychiatrist named Dr. David Houlihan. Witkus hit the Miller family while stoned on painkillers and tranquilizers from the Tomah VA. He was convicted and served three years in prison following a conviction for homicide.

The death of Ada Mae is but one example of criminal conduct linked to harmful prescriptive practices at VA that gave rise to crimes such as drug dealing, vandalism, burglary and more. Local law enforcement knew men and women committing these crimes by the nicknames “Turtle,” “Airman,” “Black Mark” and “Detroit.” On the inside, these patients of the Tomah VA facility were known as “Houlihan’s Hooligans.”

The scope of the drug problem in the sleepy town of Tomah, Wisconsin is truly shocking. According to Glantz’s report:

“In recent years, hospital staff have discovered younger veterans stealing from elderly patients and others dealing VA-prescribed painkillers and shooting OxyContin and heroin on hospital grounds. Inside the hospital, VA police reports document the fallout: strung-out veterans tossing wheelchairs across rooms and a trash can out of a window, setting fire to magazines, wielding a meat cleaver.

“A search of Tomah police records by The Center for Investigative Reporting and the La Crosse Tribune found that employees at the Tomah VA had called 911 more than 2,000 times in the past five years, seeking local law enforcement help with cases of battery and burglary, an attempted kidnapping and 24 unexpected deaths.”

This report is a must read for any veteran advocate or veteran concerned about doping practices at Veterans Affairs facilities across the nation. Glantz covers the soup-to-nuts implications of the harmful practices at the Tomah VA facility and digs deep into the criminal underbelly of Tomah, Wisconsin.

READ IT: The death of baby Ada Mae and the tragic effects of addicted veterans

In 2013 The Wall Street Journal discovered a cache of files that revealed the U.S. government lobotomized over 2000 veterans against their will after WW2.

The veterans were lobotomized for reasons such as PTSD, depression, schizophrenia, and occasionally homosexuality.

Here is the Link to Part 1 of this important investigation: The Lobotomy Files

Here is the introduction to this important story

Roman Tritz’s memories of the past six decades are blurred by age and delusion. But one thing he remembers clearly is the fight he put up the day the orderlies came for him.

“They got the notion they were going to come to give me a lobotomy,” says Mr. Tritz, a World War II bomber pilot. “To hell with them.”

The orderlies at the veterans hospital pinned Mr. Tritz to the floor, he recalls. He fought so hard that eventually they gave up. But the orderlies came for him again on Wednesday, July 1, 1953, a few weeks before his 30th birthday.

This time, the doctors got their way.

The U.S. government lobotomized roughly 2,000 mentally ill veterans—and likely hundreds more—during and after World War II, according to a cache of forgotten memos, letters and government reports unearthed by The Wall Street Journal. Besieged by psychologically damaged troops returning from the battlefields of North Africa, Europe and the Pacific, the Veterans Administration performed the brain-altering operation on former servicemen it diagnosed as depressives, psychotics and schizophrenics, and occasionally on people identified as homosexuals.

The VA doctors considered themselves conservative in using lobotomy. Nevertheless, desperate for effective psychiatric treatments, they carried out the surgery at VA hospitals spanning the country, from Oregon to Massachusetts, Alabama to South Dakota. Roman Tritz talks about the scars from his lobotomy.

The VA’s practice, described in depth here for the first time, sometimes brought veterans relief from their inner demons. Often, however, the surgery left them little more than overgrown children, unable to care for themselves. Many suffered seizures, amnesia and loss of motor skills. Some died from the operation itself.

VA to look into overmedication reports at Tomah center

From an AP Report in the San Francisco Chronicle

The U.S. Department of Veterans Affairs is launching an investigation into reports of overmedication and retaliatory management practices at the VA Medical Center in Tomah, the agency said Thursday.

Veterans Health Administration specialists plan to visit the western Wisconsin facility within two weeks to review medication prescription practices, the federal agency said in a statement Thursday afternoon. They also plan to send representatives from the Office of Accountability Review to look into allegations of retaliatory behavior.

"My sense is that this isn't just unique to Tomah," U.S. Rep. Ron Kind, a Democrat whose district includes Tomah. "We have a system-wide issue that needs to be addressed when it comes to pain management with our veterans."

Kind and other Wisconsin lawmakers had sent requests to Veterans Affairs Secretary Robert McDonald this week seeking an investigation

Tomah VA spokesman Scott Farley said in a statement the medical center will fully cooperate with the investigation.

A recent story from The Center for Investigative Reporting noted the number of opiates prescribed at the Tomah VA had more than quintupled between 2004 and 2012, even as the number of veterans seeking treatment there has declined. Health care professionals have complained about the medical center's practices for several years.

Here is more info from The Center for Investigative Reporting Looks like the main culprite is, of course, another damn psychiatrist Dr. David Houlihan

Politicians from both parties and government bureaucrats are rushing to look into allegations of rampant overmedication, retaliatory management practices and preventable overdose deaths at the U.S. Department of Veterans Affairs Medical Center in Tomah, Wisconsin, that The Center for Investigative Reporting revealed last week.

In the story’s wake, the VA has begun “actively reviewing allegations of retaliatory behavior and overmedication at the Tomah VA Medical Center,” said agency spokesman James Hutton. He said the facility’s chief of staff, psychiatrist Dr. David Houlihan, has been temporarily reassigned to the VA regional office while an internal investigation takes place.

But the problems disclosed should not have surprised politicians or federal officials: Health care professionals at the hospital have complained for at least five years about Houlihan’s prescription practices and his retaliatory management style – filing numerous reports with those in charge of oversight.

“It’s about time,” said Robin Weeth, a former social worker at the hospital who wrote to the VA inspector general in 2012 with a long list of allegations, including that “veterans are overmedicated and have been driving while impaired, fallen asleep while smoking and set themselves on fire.”

Today, Weeth reports that he never heard back from the inspector general.

The CIR story reported that the number of opiates prescribed at the Tomah VA had more than quintupled between 2004 and 2012, even as the number of veterans seeking care at the hospital declined. It included details of the August death of a 35-year-old Marine Corps veteran, who overdosed while in the hospital’s inpatient psychiatric ward.

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The VA inspector general had closed an investigation into the Tomah VA before Baldwin even got in touch, in March 2014. The inspector general’s report noted that Houlihan’s narcotic prescriptions were “at considerable variance compared to most opioid prescribers” and “raised potentially serious concerns” that should be brought to the attention of the federal agency’s leadership. But the report suggested no punishment.

Weeth said he believed that Jason Simcakoski, the 35-year-old former Marine who fatally overdosed in the Tomah VA psychiatric ward in August, still would be alive today if the inspector general had come down harder on Houlihan.

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Much more information at the links

Former Veterans Affairs Psychiatrist Pleads Guilty to Medicare Fraud

As seen in this press Release from the US Department of Justice

Department of Justice
Office of Public Affairs
FOR IMMEDIATE RELEASE
Wednesday, October 30, 2013

Former Veterans Affairs Psychiatrist Pleads Guilty to Medicare Fraud

Dr. Mikhail L. Presman, a licensed psychiatrist employed by the Department of Veterans Affairs (VA), pleaded guilty today to health care fraud for falsely billing Medicare for home medical treatment to Medicare beneficiaries and agreed to forfeit more than $1.2 million in illegal profits.

Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney Loretta Lynch of the Eastern District of New York, and Special Agent in Charge Thomas O’Donnell of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement.

According to court documents, from Jan. 1, 2006, through May 10, 2013, Presman submitted approximately $4 million in Medicare claims for home treatment of Medicare beneficiaries notwithstanding his full-time, salaried position as a psychiatrist at the VA hospital in Brooklyn. Contrary to his representations, Presman did not provide any treatment to a substantial number of the beneficiaries he claimed to have treated. For example, Presman submitted claims to Medicare for home medical visits at locations within New York City even though he was physically located in China at the time of these purported home visits. Additionally, Presman submitted claims to Medicare for 55 home medical visits to beneficiaries who were hospitalized on the date of the purported visits.

Presman is scheduled to be sentenced by U.S. District Judge I. Leo Glasser of the Eastern District of New York on Feb. 13, 2014, and faces a maximum sentence of 10 years in prison.

The case was investigated by the HHS-OIG, with assistance from the Department of Veterans Affairs Office of Inspector General, and brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of New York. The case is being prosecuted by Trial Attorney Bryan D. Fields of the Fraud Section and Assistant U.S. Attorney Patricia E. Notopoulos of the Eastern District of New York.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,500 defendants who have collectively billed the Medicare program for more than $5 billion. In addition, HHS’s Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team (HEAT), go to:

http://www.stopmedicarefraud.gov

VA faulted in diagnosing suicide candidates, Senators want VA's mental health chief to resign

There are plenty reports on this to choose from. Here's one from the Seattle Post Intelligencer

Sen. Patty Murray, D-Wash., on Tuesday called for the chief mental health official of the U.S. Department of Veterans Affairs to resign, saying he tried to cover up the rising number of veteran suicides.

Murray, the senior member of the Senate Veterans Affairs Committee, said Dr. Ira Katz, the VA's mental health director, deliberately withheld crucial information on the true suicide risk among veterans.

"Dr. Katz's irresponsible actions have been a disservice to our veterans and it is time for him to go," Murray said. "The number one priority of the VA should be caring for our veterans, not covering up the truth."

Murray and other Democratic senators said they were appalled at e-mails showing that Katz and other VA officials tried to conceal the number of suicides by veterans. An e-mail message from Katz revealed at a lawsuit this week starts with "Shh!" and refers to the 12,000 veterans per year who attempt suicide while under department treatment.

"Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?" the e-mail asks.

A lawyer for a veterans group showed the e-mail as part of a lawsuit being heard in San Francisco that alleges the VA failed to properly treat thousands of veterans for mental illness.

An e-mail revealed at the trial said an average of 18 military veterans kill themselves each day - and five of them are under VA care when they commit suicide.

"It is completely outrageous that the federal agency charged with helping veterans would instead cover up the hard truth - that more and more Americans coming home after bravely fighting for their country are suffering from mental illnesses and in the most tragic circumstances, committing suicide," said Sen. Tom Harkin, D-Iowa. "Anyone at the VA who is involved in this cover-up should be removed immediately."

Harkin, Murray and Sen. Russ Feingold, D-Wis., introduced legislation Tuesday calling on the VA to track how many veterans die by suicide each year. Currently, VA facilities record the numbers of suicide deaths and attempts in VA facilities - which have increased from 492 in 2000 to 790 in 2007 - but do not record how many veterans overall take their own lives.

The new bill would require the VA to report to Congress within 180 days the number of veterans who have died by suicide since Jan. 1, 1997, and continue reports annually.

"We are looking at a real crisis among our veterans and it is high time the VA recognizes it," said Harkin. "Tracking the number of suicides among our veterans will help us to better understand the true depths of this crisis, so we may ensure we are doing everything we can to address their mental health needs."

A spokesman for the VA declined immediate comment Tuesday.

A government lawyer on Monday urged a judge to dismiss a class-action lawsuit against the VA, saying the agency runs a "world class" medical care system.

Two veterans groups filed suit against a sprawling VA system that handled a record 838,000 claims last year. A federal judge in San Francisco is hearing the case in a two-week, non-jury trial.

Haley VA Hospital Complaint Points To Psychology Trainees

In the past we had have a number of stories about psychiatrists and psychologists who plainly miss the boat when it comes to patient diagnosis and evaluations. Given that those clueless wonders were licensed professionals, we cannot help but be alarmed at this report. From the Tampa Tribune.

Veterans who go to James A. Haley VA Medical Center for mental health care are unknowingly treated by psychologists who are inexperienced and not fully licensed, according to a complaint filed last week with a state board.

Hiring unlicensed psychologists is legal, but Haley is skirting the state's requirements by not sufficiently supervising them as they treat patients, the complaint alleges. It was filed with the Florida Board of Psychology by Brian Nussbaum, one of Haley's licensed psychologists.

Nussbaum claims there are 12 unlicensed psychologists on a staff of 34. John Pickens, a regional VA spokesman, acknowledged there are unlicensed psychologists at Haley, but said there are only nine and that they are all closely supervised.

Even nine, if that number is accurate, is too many, Nussbaum said Tuesday.

"Being that they're freshly out of school, and when you're working with a population that is so complex and sensitive as combat veterans, this is not a population that you throw in people who don't have the necessary expertise," he said, adding: "I would hope that the VA would hire the most experienced, qualified psychologists to provide this care."

Nussbaum filed the complaint with the state Board of Psychology, part of the Florida Department of Health, in an effort to draw attention to what he says is a patient care issue.

The board ultimately, though, has no power over the VA hospital, said a health department spokeswoman.

Nussbaum also takes issue with the unlicensed psychologists using the title of "psychologist." Patients don't know they're being treated by someone who is essentially a post-doctoral resident in training, he said. It's not illegal, but it's unethical, he said.

Patients "may not want to see a trainee," said Nussbaum, who is the only psychologist with a license on the staff of four who work in Haley's Post Traumatic Stress Disorder Clinic. "If you're getting heart surgery, you want the licensed, expert surgeon."

The hospital says its unlicensed psychologists are on track to get their licenses, by completing the required 2,000 hours of supervised work - including two hours a week that is directly supervised and one hour a week that is face-to-face supervision.

In his complaint, Nussbaum alleges the unlicensed staffers are not getting that supervision, and that some work in clinics in New Port Richey, Brooksville and Zephyrhills and never even come into the Tampa hospital.

"If you have a complex patient, you need to have a mentor, a colleague that you can go to," Nussbaum said.

Pickens disputed the complaint and said psychology residents get even more than the two hours of direct supervision a week. All notes taken by those psychologists after every session are reviewed and signed by the lead psychologist, he said.

The mental health care veterans are receiving is not suffering, Pickens said, and he pointed out that Haley is a prime place for post-doctoral residents to study.

"Where better for graduate psychologists to learn, to work with veterans who have post-traumatic stress disorder?" he said.