Panel Scores VA Hospitals for High Mortality Rates

Patients may have died needlessly in Veterans Administration hospitals because of preventable mistakes made by doctors, a report by a congressional panel said Saturday.

The report concluded that medical accidents are increasing, and the committee accused the VA of failing to take steps to lower its high mortality rates.

The report blamed higher risks for VA patients on what it said was the failure to adequately analyze and then correct high death rates, failure to adopt measures to reduce avoidable malpractice and failure to certify and discipline VA physicians.

Medication Errors Cited

It said incidents such as unexpected deaths, medication errors, patient suicides and falls have increased 11% since 1983, rising to 85,357 in 1985. The report said a review of selected unanticipated deaths after heart surgery found 50% involved “preventable errors” that may have caused death.

VA officials took issue with the report, saying some parts appeared to be based on faulty comparisons between patients at VA hospitals and private hospitals.

The report was released by the House Committee on Government Operations, based on an investigation by one of its subcommittees.

One incident cited in the report involved a 51-year-old veteran who checked into the VA medical center in La Jolla, Calif., in 1983 and died after a liver biopsy performed by a physician in training.

Dr. Francis Conrad, director of quality assurance for the VA medical system, said in an interview that the VA has moved to correct some problems, including new oversight of physician credentials.

Patients Older and Sicker

“The VA is aware of surgical mortality as an issue and does monitor . . . VA surgical mortality rates against rates in the non-federal sector,” he said. “Instances in which variations exist are very few and involve a remarkably small number of patients.”

The VA last year reviewed its heart surgery facilities and closed units at four hospitals because of concerns about high death rates. The congressional report, however, raised concerns about mortality rates at 10 other VA heart surgery units, saying they were above VA standards or had mortality rates in 1986 that were nearly twice the national average. None of the 10 was in California.

The VA maintains that its mortality rates may be higher in some cases because its patients are older and sicker than the average.

Nine Republicans on the panel dissented, saying the committee “paints an overly bleak picture of the type of care veterans are apt to receive at VA medical centers.”