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Former VA technologist disputes hospital response to Grassley, Ernst

U.S. senators asked for information about improperly canceled diagnostic exams

Jeff Dettbarn, radiology technician, outside the Iowa City Federal Building in Iowa City on Tuesday, Oct. 2, 2018. (Stephen Mally/The Gazette)
Jeff Dettbarn, radiology technician, outside the Iowa City Federal Building in Iowa City on Tuesday, Oct. 2, 2018. (Stephen Mally/The Gazette)

Background

U.S. Sens. Joni Ernst and Chuck Grassley sent a letter Oct. 2 to the Iowa City Veterans Affairs Health Care System with questions about allegations of improperly canceled diagnostic exams.

The letter followed news reports about the VA Office of Inspector General auditing the Iowa City VA, along with eight other VA hospitals nationwide, to determine whether radiology requests were processed in a timely manner and canceled appropriately.

Jeff Dettbarn, a former X-ray technologist at the Iowa City hospital, told The Gazette thousands of exams were canceled, many without the required physician signoff. Dettbarn alleged the canceled orders could cause veterans to miss tumors or other ailments.

After repeatedly expressing concern about the cancellations, Dettbarn was transferred to a lower-paying job at the VA, he said.

What’s happened since

The Iowa City VA did not meet Ernst’s and Grassley’s Oct. 16 deadline to respond to questions about the canceled exams, but did send the senators a letter Dec. 3.

The hospital says in the letter, which The Gazette obtained through a request to Grassley’s office, “from January to February of 2017, there were 4,051 orders canceled in the southern tier of VISN 23.”

Veterans Integrated Service Network 23 includes eight VA health care systems across five Midwestern states, according to the VISN 23 website. Iowa City VA spokesman Bryan Clark said Wednesday the southern tier covers Nebraska and Iowa.

“The total appointments reviewed for the southern tier was 12,868, though we did not break that number down into individual facilities,” Clark said.

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Clark did not respond to a question about why the VA reported just the orders canceled in January and February 2017, when Dettbarn said the cancellations continued into the spring of 2017.

“They are playing hide the ball because they didn’t start canceling hard and heavy until February 2017,” Dettbarn said Wednesday, after seeing the Iowa City VA’s Dec. 3 letter.

Lisa Bickford, Dettbarn’s former supervisor, said in sworn testimony included as part of August 2017 disciplinary proceedings against Dettbarn that she and other VA employees were told in February 2017 to reduce the backlog of old diagnostic orders. Bickford said they canceled thousands of orders in a few weeks’ time, according to the testimony Dettbarn provided to The Gazette.

Ernst said in an email to The Gazette she is concerned about the discrepancy in dates the VA provided for canceling appointments.

“I believe it’s concerning if the VA isn’t being forthcoming on when they stopped unnecessarily canceling appointments,” Ernst said. “I remain focused on the number of canceled appointments and understanding if patient safety was ever compromised. In this case, it appears that one appointment was canceled unnecessarily.”

Dettbarn disputes the VA’s account of that incident, in which a patient came to the Iowa City hospital for a scan of a mass on his kidney, only to find the order had been canceled. The veteran waited three hours for another order to be issued. Dettbarn said he raised the issue with Bickford, who eventually confirmed she’d canceled two orders for the patient, thinking they were duplicates.

The VA’s Dec. 3 letter says two different VA employees canceled the orders.

“Both parties canceling the order believed they were canceling the duplicate order,” the letter states. “In this case, measures were taken to correct the staff mistake and appropriate personnel actions were taken and staff reviewed the cancellations to ensure every order that required action was reviewed appropriately by a radiology provider.”

Dettbarn said there may be cases in which exam orders were canceled before an appointment was scheduled, meaning the veteran may never have known he or she needed follow-up care.

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Grassley spokesman Michael Zona said the senator does not plan to follow up with the VA at this time.

“As the VA OIG continues to look into what happened both at ICVA and at the other facilities that had canceled orders, Sen. Grassley will continue to monitor,” Zona said in an email.

• Comments: (319) 339-3157; erin.jordan@thegazette.com

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