Marion VA hospital resumes some outpatient surgeries after 8 months

ST. LOUIS -- Limited outpatient surgeries have resumed at a Southern Illinois Veterans Affairs hospital more than eight months after the entire surgical unit was shut down because of a reported spike in post-surgical deaths, officials said Monday.

Officials at the VA Medical Center in Marion, Ill., announced the move in a one-sentence statement, saying only that low-risk, outpatient surgeries had resumed last week. The procedures include knee arthroscopies, prostate biopsies, vasectomies and hernia repairs.

The VA halted all surgeries in Marion last August after it found that at least nine deaths between October 2006 and March 2007 were "directly attributable" to substandard care.

Of an additional 34 cases the VA investigated, 10 patients died after receiving questionable care that complicated their health, officials said. Investigators could not determine if the actual care caused those deaths.

Becca Shinneman, a spokeswoman at the hospital, said "a couple" procedures already had been done since last week. She wouldn't elaborate, citing patient confidentiality, but insisted the surgeries "have been very successful."

There was no immediate timetable for resuming more complicated, inpatient surgeries at the hospital, which serves thousands of veterans from Southern Illinois and parts of Indiana and Kentucky.

"At this time, we're resuming our outpatient surgeries and focusing on that," Shinneman said. "We'll make an announcement when we start doing more complex surgeries."

In January, separate reports by the medical inspector of the Veterans Health Administration and the VA inspector general described the hospital's surgical program, before it was shut down, as in disarray and with shoddy administrative oversight.

Inspectors found that the hospital undertook many surgeries it was ill-equipped to handle because of staffing or lack of surgical expertise, and hospital administrators were too slow to respond once problems surfaced.

Interim administrators have been in place since September, shortly after the site's director, chief of staff, chief of surgery and an anesthesiologist were moved to other positions or placed on leave. The anesthesiologist has since quit.

Warren Hill, the hospital's interim director, said a week before the site resumed the outpatient procedures for low-risk patients that the VA was comfortable in doing so.

During the surgical shutdown, the hospital has "taken the opportunity to reassess our oversight policies and procedures, provided additional training to staff [and] had critical-care training," said Hill, who has served in the Navy and the Marine Corps reserves. "Yes, it is safe. I'm a veteran. If I needed surgery, I would have no reservations about having surgeries here."

Stan Heller, a Chicago cardiologist-turned-attorney whose law firm represents four families of people who have died under apparently questionable circumstances at the Marion VA, said he needed more specifics about the hospital's reforms before discussing Monday's announcement.

"I don't know about what new staff they've recruited, what policies they've put into place or what. You just don't know," he said. "I'd love to know what they've done to change things other than the cosmetics."

Sen. Dick Durbin of Illinois, who last month voiced frustration that the Marion hospital still has no permanent leadership, called resumption of the outpatient surgeries encouraging and pledged Monday he would "continue to keep a close eye on their progress."

"Access to surgical procedures at Marion is important for our veterans," the Democrat said.

He urged the VA to work with Congress to enact legislation expanding accountability in VA hospitals nationwide. In November, Durbin and his Illinois colleague -- U.S. senator and Democratic presidential candidate Barack Obama -- introduced legislation meant to bolster hiring practices and quality-control measures at VA medical sites.

------

On the Net:

Marion VA hospital: http://www1.va.gov/directory/guide/facility.asp?id82