The Oklahoma City VA Medical Center must implement changes handed down from a national Veterans Affairs review team before staff can reopen the hospital’s heart surgery program.
Since October, five heart patients at the Oklahoma City VA died within 30 days of their surgeries, prompting the temporary closure of the program in early June.
A review team from the VA’s National Surgery Office came to Oklahoma City in early July and issued recommendations about what needs to be done to reopen the program.
Dr. Mark Huycke, the Oklahoma City VA Medical Center’s chief of staff, said he anticipates the hospital’s cardiac surgery program will reopen in the coming weeks once staff members implement the recommendations.
Huycke declined to share those recommendations, citing a federal regulation that exempts the information from a Freedom of Information Act request.
“When we feel we have in place those things they want us to put in place before resuming surgery, we will seek approval from our network in Jackson, Miss., and they will look at what we’ve done, and we will certify to them that we’ve got things in place as requested,” Huycke said. “Once they agree, they will give us the green light to resume the program.”
Other reviewers found that none of the Oklahoma City surgeons acted improperly.
Since the program was halted, the Oklahoma City VA has referred two patients to the Houston VA and eight patients to local community hospitals to receive care. VA staff plans to send a ninth patient to a local hospital next week, hospital spokeswoman Stacy Rine said.
Huycke said this was the first time in his five years as chief of staff that the National Surgery Office has halted and reviewed an Oklahoma City VA surgical program.
Death prompts review
The hospital’s heart surgery program was halted after leaders from the Oklahoma City and regional VA network learned of a fifth patient’s death after surgery in June. Leaders at the regional and state level then requested the National Surgery Office review the program and the recent deaths.
Documents received by The Oklahoman in response to a Freedom of Information Act request show the fifth veteran died after a surgery that went well. The veteran was in the intensive care unit and then died after his or her blood pressure spiked well above normal levels.
Dr. Gregg Parker, the chief medical director of the South Central VA Health Care Network, wrote in an email June 10 to other medical professionals in the VA system that the Oklahoma City VA’s heart surgery program was being halted pending a review from the National Surgery Office, in part, because the regional network didn’t have the expertise to perform the review internally.
“Quite frankly, we need an external review,” Parker wrote.
Huycke wrote Parker an email later that day, telling Parker the Oklahoma City hospital staff was happy to help in any way to speed along the review process, documents show.
“It goes without saying that I’d like this site visit to be scheduled, and concluded, as quickly as humanly possible,” Huycke wrote.
Information in the documents shows that among the five veterans who died, one suffered complications during surgery. Two of the veterans suffered some “difficulty” after surgery, although the details are redacted.
Shortly after each veteran died, the case was individually reviewed by cardiothoracic surgeons at the Houston, Little Rock, Ark., or Oklahoma City VA hospitals. None of the surgeons who reviewed the cases found that the Oklahoma City surgeons acted improperly.
A review from staff at the Oklahoma City VA of the five deaths concludes surgeons at the VA did their jobs properly: “Based on all above, the Oklahoma City VAMC has concluded the standard of care was met for all Veterans who died following open heart or thoracic surgery completed October 1, 2013, through April 1, 2014,” the documents show.
The VA’s Office of Inspector General also made an unannounced “fact-finding” visit to the Oklahoma City VA on June 27, according to released records. Staff from the inspector general’s office stayed for about three hours and had no findings as a result of the site visit.
Overall, the review process has been a positive experience for the hospital, Huycke said.
“There’s transparency there,” he said. “We want to make sure we’re doing everything properly, and we’re delivering quality care to veterans.”
Although the documents obtained after the Freedom of Information Act (FOIA) request — 21 pages in all — give some detail, they include six largely blacked-out pages. The redacted portions appear to be details of the surgeries performed on veterans who died, any complications they suffered, what difficulties the veterans had after surgery, their causes of death and chronic medical issues they had.
Sharron Schaefer, the Oklahoma City VA Medical Center’s FOIA officer, said the information was redacted because it falls under disclosure protections of “FOIA Exemption 6.”
“VA may withhold information under FOIA Exemption 6 where disclosure of the information, either by itself or in conjunction with other information available to either the public or the FOIA requester, would result in an unwarranted invasion of an individual’s personal privacy without contributing significantly to the public’s understanding of the activities of the federal government,” Schaefer wrote.
A closer look
These documents were included in 21 pages of records provided to The Oklahoman after a Freedom of Information Act request to the Oklahoma City VA Medical Center concerning the hospital’s cardiac surgery program. Several of the pages are heavily redacted to obscure information that VA officials said could result in “an unwarranted invasion of an individual’s personal privacy.”
There’s transparency there. We want to make sure we’re doing everything properly, and we’re delivering quality care to veterans.”
Dr. Mark Huycke,,