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story.lead_photo.caption At a news conference Wednesday, Veterans Affairs Secretary David Shulkin reacts to an internal investigation that detailed patient-safety issues at the Veterans Affairs Medical Center in Washington.

WASHINGTON -- "Failed leadership" at the Department of Veterans Affairs under former President Barack Obama put patients at a main hospital at risk, an internal probe finds -- another blow to Secretary David Shulkin, who served at the VA then and is fighting to keep his job.

The 150-page report released Wednesday by the VA internal watchdog offers new details to its preliminary finding in April of patient safety issues at the Washington, D.C., medical center.

Shulkin acknowledged to reporters that the problems were "systemic" but said he was not aware of the issues at the Washington hospital. He pledged wide-scale change across the VA.

Painting a grim picture of communications breakdowns, chaos and spending waste at the government's second largest department, the report found that at least three VA program offices directly under Shulkin's watch knew of "serious, persistent deficiencies" when he was VA undersecretary of health from 2015-16. But it stopped short of saying whether he was told about them.

Shulkin, who was elevated to VA secretary last year by President Donald Trump, told government investigators that he did "not recall" ever being notified of problems.

Among the changes he promised: unannounced audits of its more than 1,700 medical facilities from health experts in the private sector, immediate hiring to fill vacancies at local hospitals and plans in the coming months to streamline bureaucracy and improve communication.

Shulkin pointed specifically to VA medical centers in the New England, Arizona and Washington D.C. regions that needed improvements to address patient safety.

"Not to act when you identify systemic failures, I think, would be negligent," he said.

Shulkin has been struggling to keep a grip on his job since a blistering report by the inspector general last month concluded that he had violated ethics rules by improperly accepting Wimbledon tennis tickets and that his then chief of staff had doctored emails to justify his wife traveling to Europe with him at taxpayer expense.

On Wednesday, the White House affirmed its continued support for Shulkin despite the problems swirling around him, saying he has done a "great job" implementing changes at VA. "We're proud of the work that we've done and we're going to continue to do everything we can to ... help veterans in this country," said press secretary Sarah Huckabee Sanders.

The latest inspector general investigation found poor accounting procedures leading to taxpayer waste, citing at least $92 million in overpriced medical supplies, along with a threat of data breaches as reams of patients' sensitive health information sat in 1,300 unsecured boxes.

No patient died as a result of the patient safety issues at the Washington facility dating back to at least 2013, which resulted in costly hospitalizations, "prolonged or unnecessary anesthesia" while medical staff scrambled to find needed equipment at the last minute, as well as delays and cancellations of medical procedures. The report also noted improvements made at the Washington facility since the inspector general's first report in April, when Shulkin replaced the medical center's director and pledged broader improvements.

Still, VA inspector general Michael Missal cautioned of potential problems without stronger oversight across the VA network of more than 1,700 facilities.

"Failed leadership at multiple levels within VA put patients and assets at the DC VA Medical Center at unnecessary risk and resulted in a breakdown of core services," Missal said. "It created a climate of complacency ... That there was no finding of patient harm was largely due to the efforts of many dedicated health care providers that overcame service deficiencies to ensure patients received needed care."

In the report, Shulkin responded that he had expected issues involving patient harm or operational deficiencies to be raised through the "usual" communication process, originating from the local level and regional office to VA headquarters in Washington -- and that it apparently didn't happen.

"It was difficult to pinpoint precisely how the conditions described in this report could have persisted at the medical center for so many years," Missal wrote.

A Section on 03/08/2018

Print Headline: Report blames VA leadership for problems at D.C. hospital

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