Are V.A. Physicians & Hospitals Up to Par?(Brief Article)

ARE V.A. PHYSICIANS AND HOSPITALS UP TO STANDARD? That question was raised by a federal judge in a recent Texas case in which V.A. physicians failed to diagnose a Major's ischemic heart disease after no less than 27 visits in which the Major complained of virtually all of the classic symptoms which would lead to a diagnosis of corollary artery disease. Yet, not a single one of the numerous physicians and other medical personnel involved in his treatment ordered appropriate testing for coronary artery disease.

MAJOR ANTONIO BUENO PRESENTED HIMSELF FOR MEDICAL TREATMENT AT WILFORD HALL MEDICAL CENTER AND BROOKE ARMY MEDICAL CENTER ON NUMEROUS OCCASIONS FROM APRIL 1995 TO FEBRUARY 1996. He was seen, examined, tested and treated by a small army of physicians and technicians, several of whom were in the formative years of their medical training. Stretched thin, in the middle of ancient Hippocratic devotion to patients and legislative budget parameters, military medical personnel no doubt often feel themselves between the proverbial rock and a hard place. Notwithstanding the early warning signals of undisputed high risk factors and symptoms, testing for coronary artery disease of the Major ceased with the administering of a basic stress test resulting in the patient being told he was free of heart disease, could continue an active exercise regimen, should quit-smoking, and should return to the hospital if heart related symptoms should reoccur. Subsequent visits led to the referral of the patient to the psychiatric clinic and a diagnosis of panic disorder. As the psychiatrists were recommending that the patient return to the medical clinics for gastrointestinal testing, the patient suffered a fatal heart attack on March 14, 1996. As his symptoms worsened on March 14, the patient happened to be close to the Brooke Army Medical Center emergency room, but in spite of his son's suggestion, chose to go home, relying on his perception from the physicians at the Medical Center that had no heart disease. An autopsy revealed the patient was suffering from severe coronary artery disease. Scarring indicated he, in fact, had a heart attack in the many months during which he was under the care of military doctors. His surviving spouse brought suit against the United States under the Federal Tort Claims Act (FTCA) for wrongful death based on military's failure to diagnose the patient's heart disease.

THE UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF TEXAS HELD THAT MILITARY PERSONNEL BREACHED THE STANDARD OF ORDINARY CARE IN FAILING TO DIAGNOSE THE PATIENT'S ISCHEMIC HEART CONDITION. The court found that the United States was liable for medical malpractice both under Texas law and the FTCA by failing to: perform adequate assessment of ...