Monday, March 05, 2007

Army Generals Apologize for Walter Reed Failures

Army Generals Apologize for Walter Reed Failures
Maj. Gen. George Weightman, who was recently fired as head of Walter Reed Army Medical Center, and Army Surgeon General Lt. Gen. Kevin Kiley apologized for substandard outpatient care at the medical center and vowed to improve the system at a House hearing Monday.

REP. JOHN TIERNEY (D), Massachusetts: ... hearing title, "Is This Any Way to Treat Our Troops? The Care and Condition of Wounded Soldiers at Walter Reed" will come to order.
KWAME HOLMAN: This morning, a House Oversight Committee undertook Congress's first inquiry into the problems faced by soldiers receiving outpatient care at the Walter Reed Army Medical Center and chose to hold its hearing at the medical center itself.
REP. JOHN TIERNEY: This is absolutely the wrong way to treat our troops, and serious reforms need to happen immediately. Over the past month, the perception of Walter Reed has gone from the flagship of our military health system to a glaring problem. This subcommittee wants some answers.
KWAME HOLMAN: One of the military's busiest and highest-profile medical facilities, Walter Reed came under wide-ranging criticism after a series of Washington Post reports last month detailed substandard living conditions and questionable outpatient care.
In the wake of the reports, last week, Walter Reed's commander, Major General George Weightman, was fired, and Army Secretary Francis Harvey resigned under pressure from Defense Secretary Robert Gates.
And President Bush has ordered a review of conditions at the nation's military and veterans hospitals, inundated with injured troops from the wars in Iraq and Afghanistan.
John Tierney of Massachusetts chaired the oversight hearing.
REP. JOHN TIERNEY: Where does the buck stop? There appears to be a pattern developing here that we've seen before: first, deny; then, try to cover up; then, designate a fall guy.
In this case, I have concerns that the Army is literally trying to whitewash over the problems.
I appreciate the first steps that have been taken to rectify the problems at Walter Reed and to hold those responsible accountable. We need a sustained focus here, and much more needs to be done.
I also, unfortunately, feel that these problems go well beyond the walls of Walter Reed and that they are problems systemic throughout the military health care system. And as we send more and more troops into Iraq and Afghanistan, these problems are only going to get worse, not better, and we should be prepared to deal with them.
Staff Sgt. John Daniel ShannonU.S. Army
We have almost no advocacy that is not working for the government, no one that we can talk to about this process who's knowledgeable and we can trust is going to give us fair treatment and informed guidance.
Accounts from patients KWAME HOLMAN: Committee members heard first-hand stories of patients and their families. Army Staff Sergeant John Daniel Shannon suffered brain injuries and lost his left eye in fighting near Ramadi in Iraq in 2004.
STAFF SGT. JOHN DANIEL SHANNON, U.S. Army: Upon my discharge, hospital staff gave me a photocopied map of the installation and told me to go to the Mologne House where I would live while in outpatient. I was extremely disoriented and wandered around while looking for someone to direct me to the Mologne House. Eventually, I found it.
I had been given a couple of weeks' appointments and some other paperwork upon leaving Ward 58, and I went to all of my appointments during that time. After these appointments, I sat in my room for another couple of weeks wondering when someone would contact me about my continuing medical care.
We have almost no advocacy that is not working for the government, no one that we can talk to about this process who's knowledgeable and we can trust is going to give us fair treatment and informed guidance.
KWAME HOLMAN: Army Specialist Jeremy Duncan was wounded by an improvised explosive device in Samarra.
SPC. JEREMY DUNCAN, U.S. Army: I had fractured my neck, almost lost my left arm. I lost a left ear, and lost sight in the left eye.
KWAME HOLMAN: Duncan resided in Building 18, an off-campus facility where dozens of outpatients stay. After the Washington Post reports, the Army began renovations.
SPC. JEREMY DUNCAN: The conditions in the room, in my mind, were just -- it was unforgivable for anybody to live. It wasn't fit for anybody to live in a room like that. I know most soldiers have -- you've just come out of recovery, you have weaker immune systems.
The black mold can do damage to people, the holes in the walls. I wouldn't live there, even if I had to. It wasn't fit for anybody.
Passing the buckKWAME HOLMAN: Annette McLeod helped care for her husband, a severely wounded Army National Guard corporal.
ANNETTE MCLEOD, Husband Wounded in War: My life was ripped apart the day that my husband was injured.
KWAME HOLMAN: She was questioned by California Democrat Henry Waxman.
REP. HENRY WAXMAN (D), California: What's your reaction, when you've been trying to get people's attention to the situation for your husband, and now, when we have it so clearly laid out in the press, and there's attention being paid to it, the higher-ups say that they were just surprised to hear about all this?
ANNETTE MCLEOD: I have one question: Were they deaf? Because I worked the chain. I worked anywhere they would listen. So if you don't want to hear it, you don't want to hear it.
REP. HENRY WAXMAN: Specialist Duncan?
SPC. JEREMY DUNCAN: There's no way they couldn't have known. I mean, everybody had to have known somewhere, just if they wanted to actually look at it or pay attention or believe it, it's up to them.
KWAME HOLMAN: Tennessee Republican John Duncan asked whether any officials took responsibility.
REP. JOHN DUNCAN (R), Tennessee: Did you find that to be true, that everybody was blaming somebody else with the problems that you had?
ANNETTE MCLEOD: I feel that everybody's passing the buck. You go to one, and they say, "Well, it's not my problem; you need to go to so and so."
I did everything but camp out, I mean, honestly, and if I could get away with that, I probably would have done that, too. You can't keep looking and not getting answers.
Lt. Gen. Kevin KileyArmy Surgeon General
We're taking immediate actions to improve the living conditions and welfare of our soldier-patients, to increase responsiveness of our leaders and the medical system, and to enhance support services for families of our wounded soldiers.
Testimony from former officialsREP. JOHN TIERNEY: I'd ask if you'd rise and raise your right hand, please.
KWAME HOLMAN: The committee then heard from Army officials most recently in charge. Major General George Weightman was relieved of command last Thursday.
MAJ. GEN. GEORGE WEIGHTMAN, Former Commander, Walter Reed Army Medical Center: I was the Walter Reed commander. And from what we see, with some soldiers' living conditions, and the administrative challenges we faced, and the complex medical board-physical evaluation board processes, it is clear mistakes were made, and I was in charge. We can't fail one of these soldiers or their families, not one. And we did.
KWAME HOLMAN: Lieutenant General Kevin Kiley, the Army's surgeon general, was in charge of Walter Reed from 2002 to 2004.
LT. GEN. KEVIN KILEY, Army Surgeon General: Simply put, I am in command. And as I share these failures, I also accept the responsibility and the challenge for rapid corrective action.
We're taking immediate actions to improve the living conditions and welfare of our soldier-patients, to increase responsiveness of our leaders and the medical system, and to enhance support services for families of our wounded soldiers.
REP. TOM DAVIS (R), Virginia: You have the Army not talking to the V.A.
KWAME HOLMAN: Virginia Republican Tom Davis tried to get to the bottom of when the problems came to the attention of those commanders.
REP. TOM DAVIS: So it really wasn't the Washington Post. You knew these were problems. You may not have known specifically what it looked like, and you may not have been able to put faces and stories behind it, but this was an ongoing concern, wasn't it?
LT. GEN. KEVIN KILEY: Well, yes, sir. And it was not just at Walter Reed. We were concerned about medical holdover operations and medical hold operations at all of our installations.
KWAME HOLMAN: Davis asked Kiley what he did about problems with outpatient care he learned about last October.
LT. GEN. KEVIN KILEY: My staff informed me that the Walter Reed staff was working it, that they recognized that there were issues, and that they were taking action.
REP. TOM DAVIS: Yes, please.
MAJ. GEN. GEORGE WEIGHTMAN: ... address some of the specifics on that? We realized that to address some of the problems with how long it took our patients to get through the medical board process, that we needed more physicians trained on the MEB process, and to help move those records.
So we added three different physicians part-time to work on those records. We also realized that we didn't have enough of the case managers, as well, to work with the patients within the medical hold and medical holdover companies, and we began active recruiting efforts for those, as well.
REP. TOM DAVIS: Our problem, I think, is a systemic problem, that we have more people coming back than was anticipated. We have antiquated systems integrating the Reserves, and the Guard, and the Army back and forth.
It's a paperwork nightmare. It's a labyrinth that you'd need a PhD and a law degree, and you still couldn't navigate yourself through.
Maj. Gen. George WeightmanU.S. Army
I'd just to apologize for ... having so many bureaucratic processes that just took your fortitude to be an advocate for your husband that you shouldn't have to do. I promise we will do better.
Fixing the problems KWAME HOLMAN: Connecticut Republican Christopher Shays.
REP. CHRISTOPHER SHAYS (R), Connecticut: What I wrestle with is that there's not anyone involved in this that didn't know there were challenges. Because, frankly -- I'll just make this last point -- these problems are huge.
The only reason why this story got attention is there was something visual: There was mold on a wall. But the mold on the wall is, in fact, the tip of the iceberg.
And so help me out, because you're going and people are going to say it's going to be taken care of. And in two weeks from now or two months from now, how do we know it is?
LT. GEN. KEVIN KILEY: Sir, I agree with you. The mold is a brick-and-mortar issue. We've got it fixed in Building 18. We are examining all the rest of the brick and mortar in medical command to make sure we don't have those kinds of issues.
REP. CHRISTOPHER SHAYS: See, I think that's the easy part.
LT. GEN. KEVIN KILEY: Yes, sir. The second piece is the thing I referenced, which is the heretofore not fully realized complexity of the injuries of these great young Americans.
I'm a co-chair of the Mental Health Task Force. Senators Boxer and Lieberman were coming to closure on our work this last year. The issues of mental health, PTSD, late-emerging PTSD, the issues of TBI, traumatic brain injury, how to diagnose it...
REP. CHRISTOPHER SHAYS: I don't know what you're saying to me now.
LT. GEN. KEVIN KILEY: What I'm saying is, these are very complex patients that are severely injured in multiple emotional, physical and mental ways. And then, finally, sir, we're going to have a long-term challenge to continue to care for these soldiers and their families.
KWAME HOLMAN: And Kiley acknowledged some patient care problems were exacerbated when the Army contracted out much of Walter Reed's facilities management and non-medical care to private companies.
DEL. ELEANOR HOLMES NORTON (D), District of Columbia: Â Would it have been the better side of wisdom not to privatize everything here, except the clinical and medical workforce, and therefore add to the stability or the instability that inevitably comes with WRAMC?
LT. GEN. KEVIN KILEY: It did increase the instability.
KWAME HOLMAN: And at one point this afternoon, the generals were asked if they wanted to address those who testified earlier.
LT. GEN. KEVIN KILEY: I feel terrible for them.
MAJ. GEN. GEORGE WEIGHTMAN: I'd just to apologize for not meeting their expectations, not only in the care provided, but also in having so many bureaucratic processes that just took your fortitude to be an advocate for your husband that you shouldn't have to do. I promise we will do better.
KWAME HOLMAN: Tomorrow, the Senate's Armed Services Committee will hear more about living conditions at Walter Reed and soldiers' outpatient care.


At 8:59 AM, Blogger Beltway Progressive said...

This story broke in Salon in 2004 when Tom Davis (R-VA), Reform Committee Chair, oversaw the outsourcing of Walter Reed to Halliburton. Like many of the contracts described in another Post series by Scott Highman and Robert O'Harrow Jr., he would not allow auditing or oversight of the ocntractors. This is the same company that took 6 days to get water to the Louisiana Superdome. Is it any wonder they can't get treatment from a hospital? This si Tom Davis's shame. Our troops should be thankful for Waxman. Here's the Salon series:


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