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    VA report rejects whistle-blower claims of poor care at Manchester hospital

    Newburyport, MA - 5/10/2017 - Dr. William "Ed" Kois poses for a portrait in his home in Newburyport, MA, May 10, 2017. Kois believes many of his patients at the VA Hospital in Manchester, NH, received substandard care that has left many of them disabled. (Keith Bedford/Globe Staff)
    Keith Bedford/Globe Staff
    “The report is a complete whitewash, done by an organization within an organization,” said Dr. William “Ed” Kois, one of the whistle-blowers and a doctor at the facility. “It is not unbiased.”

    The Veterans Affairs Administration has cleared itself of wrongdoing and neglect related to the care of veterans at the Manchester VA Medical Center, rejecting whistle-blower complaints of medical neglect, dirty surgical instruments, and flies in an operating room.

    A 50-page report from the VA’s Office of Medical Inspector found flies are still present but that the operating room isn’t used, and the instruments weren’t dirty, but simply discolored by the New Hampshire city’s water supply.

    Investigators also found no evidence to back up the most serious whistle-blower complaint: that nearly 100 veterans were neglected and suffering from a rare spinal condition that could lead to paralysis if not treated.

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    The report, completed in June and first obtained by New Hampshire Public Radio, sparked outrage this week from lawmakers and the medical professionals who came forward last year and complained about conditions at the state’s only hospital for veterans.

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    “The report is a complete whitewash, done by an organization within an organization,” said Dr. William “Ed” Kois, one of the whistle-blowers and a doctor at the facility. “It is not unbiased.”

    The investigators did not substantiate most of the whistle-blower allegations, including the claim that veterans were suffering from a spinal condition because hospital officials were not paying attention to the declining health of patients.

    The whistle-blowers said nearly 100 veterans received poor spinal care. But the Office of Medical Inspector found that the treatment of only six patients, out of 97, did not meet the “standard of care,” the report said.

    “While there were several confounding factors contributing to significant challenges, we found that Manchester VA clinical staff members involved in direct patient care are very engaged and appropriately concerned about the clinical care of veterans,” the report noted.

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    Eleven people — including top doctors and nurse practitioners — complained about the facility in 2016 to the Office of Special Counsel, a federal agency that protects whistle-blowers. That agency found a “substantial likelihood” that the allegations were true and ordered the VA’s Office of Medical Inspector to investigate.

    After the Globe reported in July 2017 on the allegations, then-VA secretary David J. Shulkin removed the facility’s two top officials and ordered a “top to bottom” review.

    The Office of Medical Inspector has issued several reports on the Manchester facility. But the Office of Special Counsel found these previous investigations “flawed”and rife with “conclusions at odds with the information” it had gathered in its own preliminary probe.

    The Office of Special Counsel did not comment publicly on the most recent report, which was distributed to lawmakers Friday and obtained by the Globe.

    “The findings are self-serving and outrageous,” said Andrea Amodeo-Vickery, the lawyer who represents the whistle-blowers. “They’re waxing poetic about the leadership who were responsible for 97 patients failing to get proper treatment of progressive disease that if treated properly would not impact their lives.”

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    VA spokesman Curtis Cashour said that, under new leadership, the Manchester VA “has taken a number of steps to rebuild trust, improve care, and provide better service to New Hampshire area veterans.”

    ‘The report is a complete whitewash, done by an organization within an organization.’

    Cashour said the hospital has filled 397 job vacancies and created 70 new positions since the Globe raised the issues in July 2017.

    Representative Annie Kuster, a New Hampshire Democrat, acknowledged “real improvements” at the Manchester VA, but said those were triggered by the “courage of the whistle-blowers,” not VA officials.

    “The findings in this report are at odds with the experiences of well-respected doctors who witnessed firsthand the impact of substandard care for veterans,” she said in a statement.

    Kuster said she will ask the new VA secretary, Robert Wilkie, to hold a town hall meeting in Manchester “to explain to veterans and staff why he supports this report and its findings.”

    The VA medical care system, used by about 6 million military veterans each year, has been roiled by scandal since 2014 news reports that the Phoenix VA Health Care System had engaged in an elaborate scheme to hide months-long patient wait times. Some veterans died before they saw a doctor. Veterans Affairs Secretary Eric K. Shinseki resigned after similar allegations surfaced at other VA hospitals.

    President Trump’s appointee as VA secretary, Shulkin, vowed to stabilize the health care system. He was fired after being accused of using public funds for a European trip.

    The agency has also come under fire for providing substandard care at some of the nursing homes it operates.

    The Globe and USA Today reported earlier this year that nearly half of the VA’s 133 nursing homes were rated only one star, by the agency’s own internal rating system. Among the lowest-rated: the Bedford VA, which has more than 200 long-term care residents.

    Andrea Estes can be reached andrea.estes@globe.com.