Combat veteran Jim Barrows of Brownville says he tried unsuccessfully for years to sound the alarm about poor record-keeping and inadequate disciplinary practices at the Togus Veterans Administration Medical Center in Augusta.
Barrows, who served two tours of duty as a combat medic in Vietnam, is among a group of 88 vets who suffered under the care of Thomas Franchini, a podiatrist at the Togus health center from 2004 until his forced resignation in 2010. So Barrows was gratified to see an alarming recent report from USA Today highlighting Franchini’s “shoddy” practice at Togus finally call Congress, the government and the media to attention.
The report outlined the poor outcomes of many of Franchini’s patients and the institution’s role in letting him resign without any disciplinary action. And Franchini wasn’t alone. The VA systematically failed over time to report and discipline poorly performing doctors and other health providers, instead letting them move on into civilian jobs without black marks on their records, USA Today found.
Barrows, 69, and other veterans harmed by Franchini were informed of their mistreatment years after the clock ran out on their ability to sue, leaving them with no recourse even as their pain continues, he said. Still others are waiting to learn whether their lawsuits against the federal government will move forward.
But now, with the VA and lawmakers promising greater transparency in the wake of the report, long-overdue reform could take hold at Togus and within the VA health care system, he said.
“The more attention to this situation, the better chance we have a positive outcome for younger vets,” Barrows said.
One bad case among many
Barrows’ botched ankle surgery, performed by Franchini in 2006 for a service-related injury, has caused him years of suffering and limited mobility, outlined in medical records he obtained from Togus and shared with the Bangor Daily News. More than 40 subsequent visits to the podiatry clinic at Togus brought no relief and only seemed to make things worse.
Barrows never suspected that Franchini’s treatment was the cause of his troubles.
During one appointment several weeks after the surgery, Franchini realized he had neglected to remove a temporary suture, leaving the operative site open to infection, inflammation and other complications, Barrows recalled.
“When he started pulling it out, the inside of my foot started coming out with it,” he said. “I never had anything hurt so bad in all my life.”
Franchini never mentioned the traumatic incident in his medical notes, Barrows said.
Later, a civilian specialist told Barrows and documented in his medical records that the painful procedure may have caused the rupture or outright severing of a nerve in his foot, significantly increasing the already debilitating pain and loss of mobility associated with the ankle.
It wasn’t until early 2013 that Barrows realized Franchini’s treatment was to blame. He was among 88 patients notified by the VA that they were victims of Franchini’s poor medical care at Togus — more than two years after the podiatrist had resigned. Barrows, who shared the notification letter with the Bangor Daily News, and several others promptly filed lawsuits, only to have their cases rejected for not filing in time.
Maine law establishes a three-year limit after an injury due to medical malpractice. Federal law sets a two-year limit after a plaintiff learns of the incident. Exceptions apply to both regulations.
“Togus knew exactly what they were doing,” he said. “The VA knew the statute of limitations would keep us from getting compensated for what the doctor did to us.”
It’s not known how many lawsuits were rejected on the basis of the statute of limitations. But six cases are pending in U.S. District Court in Bangor, awaiting a decision on the applicability of an extended, six-year window in the event of fraudulent concealment of the basis of the injury.
The complaints, filed in 2014 and 2015, seek unspecified compensation for pain, suffering, permanent disability and economic distress caused by Franchini’s allegedly substandard care while he was employed by the Department of Veterans Affairs.
The agency began investigating Franchini in 2009, according to Portland attorney David Lipman, who represents two of the plaintiffs, including a Gardiner woman who underwent a leg amputation as a result of her injuries.
“None of these people had any idea Franchini had caused their problems [until 2013] … even though the government knew for many years and didn’t tell them,” Lipman said.
The USA Today report draws from an extensive investigation of the VA’s handling of medical errors, medical negligence and substandard care.
In a recent email exchange with the BDN, the VA downplayed the report and said the agency has moved to improve care and accountability.
“These events occurred several years ago,” VA spokesman Curt Cashour pointed out in an an email. Under the new leadership of Secretary David Shulkin, he said, the federal agency has instituted measures to hold employees accountable and be more transparent in reporting problems and disciplinary actions.
These include a new online record of all VA disciplinary actions against medical providers, a strict policy of full compliance with existing reporting requirements and a push to expand those requirements in collaboration with the federal Department of Health and Human Services.
At Togus, the message was also forward-looking.
“Dr. Franchini resigned in 2010 in lieu of being fired,” Ryan Lilly, director of the VA Maine Healthcare System, said in an email statement. In addition, two senior administrators were disciplined in 2013 for their roles in the case: former medical center director Brian Stiller and former chief of medical staff Dr. Tim Richardson.
“We are proud of our improvements in all of our care programs, including podiatry,” Lilly said.
Barrows, now diagnosed with both bladder cancer and colon cancer, says he isn’t anti-VA. The medical care and staff at the Bangor outpatient clinic where he gets routine care are “second to none,” he said.
He has given up for now on his legal options and hopes to keep the heat on the VA in the aftermath of the USA Today investigation. He’s heartened by the media attention and by the response — belated, he says — of the Maine congressional delegation.
Barrows said he contacted the offices of all four of Maine’s congressional members about problems at Togus between 2014 and 2016.
“I couldn’t get one of them to lift a finger,” he said. “Our congressional representatives don’t give a damn about the veterans in this state.” Since the release of the USA TODAY report, he says, they’ve all been eager to weigh in.
Citing privacy concerns, staff at all four delegation offices said this week that they never publicly identify individuals who contact them or discuss the nature of their interactions. But the delegation has reacted to the USA Today report and the upset at Togus.
Second district Congressman Bruce Poliquin recently introduced legislation that would require the VA to report problem doctors to state licensing boards within 5 days of being identified as potential risks for malpractice.
In Maine’s first district, Congresswoman Chellie Pingree posted a statement of concern on her website stating that “these failures in oversight and accountability cannot stand and I will work with my colleagues in Congress to ensure that this does not happen again.”
Sens. Angus King and Susan Collins co-sponsored legislation, before the report was released, to protect whistleblowers within the VA and facilitate the dismissal of employees who perform poorly. President Trump signed the bill into law in June.
“The stories of veterans harmed at the hands of their doctors illustrates that – in these cases – the VA failed to live up to its responsibility,” King and Collins said in a joint statement to the BDN.
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