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Top 2 officials out at Manchester VA hospital

The Manchester VA Medical Center in New Hampshire. (Keith Bedford/Globe Staff)

Keith Bedford/Globe Staff

The Manchester VA Medical Center in New Hampshire.

Veterans Affairs Secretary David J. Shulkin on Sunday removed the two top officials at the Manchester VA Medical Center and ordered a “top-to-bottom” review of New Hampshire’s only hospital for veterans.

Shulkin’s action came within hours after The Boston Globe published a Spotlight Team report detailing what several doctors and other medical staffers allege is dangerously substandard care given at the facility.

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The hospital’s chief of medicine, Dr. Stewart Levenson, said he had “never seen a hospital run this poorly.”

The staffers, who reported the Manchester hospital to a federal whistle-blower agency, described an operating room infested with flies, veterans with crippling spinal damage that might have been prevented, and surgical instruments that are obsolete and sometimes unsterile.

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“These are serious allegations and we want our veterans and our staff to have confidence in the care we’re providing,” said Shulkin in a written statement. “I have been clear about the importance of transparency, accountability, and rapidly fixing any and all problems brought to our attention, and we will do so immediately with these allegations.”

Shulkin removed the hospital director, Danielle Ocker, and replaced her with Alfred Montoya, the current director at the White River Junction VA in Vermont. He also removed chief of staff James Schlosser, saying he would name Schlosser’s replacement soon.

Ocker and Schlosser have been removed pending the outcome of the review. They remain VA employees and will be assigned other duties, according to a VA spokesman.

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The Globe reported that 11 physicians and medical employees at the Manchester VA — including the hospital’s retiring chief of medicine, former chief of surgery, and former chief of radiology — had contacted a federal whistle-blower agency and the Globe to say the facility is endangering patients.

The Office of the Special Counsel, the whistle-blower agency, already found a “substantial likelihood” that the whistle-blowers’ allegations were true.

It ordered the VA’s Office of the Medical Inspector to launch an investigation, which started in January.

Dr. James Schlosser (left) and Danielle Ocker (right) during interviews last month.

Keith Bedford/Globe Staff

Dr. James Schlosser (left) and Danielle Ocker (right) during interviews last month.

But on Sunday, Shulkin went further, ordering the Office of Medical Inspector and the VA Office of Accountability and Whistleblower Protection to head to Manchester on Monday to conduct a thorough investigation of the facility and the employees’ complaints.

Dr. William “Ed” Kois, the head of the Manchester VA spinal cord clinic who galvanized 10 other medical staff to join him in blowing the whistle about problems at the hospital, said he was “cautiously elated” by the news.

“There’s no way, if an honest VA investigation occurs, that they’ll be brought back,” said Kois of Ocker and Schlosser. “It’s just overwhelming, the evidence of the dissatisfaction of staff members, but up until we broke the ice, people have been very afraid of retribution and retaliation.”

Kois said that he believes the VA’s Office of the Medical Inspector has so far done only a cursory job digging into the problems. And he hoped Shulkin’s vow to do a top-to-bottom investigation means the VA will drill deeper.

‘We want our veterans and staff to have confidence in the care we’re providing.’

David J. Shulkin, Veterans Affairs secretary 
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Despite the problems at the facility, it was in 2016 given four out of five stars by the Department of Veterans Affairs, which, before the story was published, defended that decision.

The whistle-blowers have alleged that the four top administrators, including Schlosser, the only doctor, were more concerned with performance ratings than with properly treating the roughly 25,000 veterans who go to Manchester for outpatient care and day surgery annually.

But Stewart Levenson, the retiring chief of medicine, downplayed the significance of quality ratings for a facility such as Manchester, which stopped providing inpatient care in 1999 and refers its patients to other VA hospitals or private specialists for an increasing number of services.

Levenson is one of seven high-ranking doctors who have given up leadership positions or decided to leave the hospital this year.

Andrea Amodeo-Vickery, a Manchester lawyer who helped organize the 11 whistle-blowers, urged Shulkin to come to Manchester himself and meet with the whistle-blowers personally.

“Shulkin needs to come and meet with these guys and hear from them first-hand what the problems are,” she said.

A fly zapper in a now-closed operating room (left) at the VA hospital. At right, faint spotting of either blood or rust can be seen on surgical instruments at the hospital that had not been properly sterilized.

A fly zapper in a now-closed operating room (left) at the VA hospital. At right, faint spotting of either blood or rust can be seen on surgical instruments at the hospital that had not been properly sterilized.

Andrea Estes can be reached at andrea.estes@globe.com. Jonathan Saltzman can be reached at jonathan.saltzman@globe.com.
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