Despite recent improvements to veterans' health care, those who served our country still have to navigate red tape and referrals for care outside the VA. This is one veteran's story of how his surgery came to a screeching halt while he was in the process of being prepped for the operating room.
He was deployed in 1979 throughout Asia with Seal Team One and was also part of underwater demolition team 11. John Latham takes tremendous pride in his Navy service.
"When you serve our country, the best way I can put it is parts wear out at an early age," Latham explained. "You're signing to serve your country with the promise that in the future, you'll be taken care of for your service, your injuries, your disabilities that come out of it."
Latham's flags hand proudly outside his house, but he's lost a little faith in that promise.
John was injured in a boating accident last May. He fell on the corner of his elbow and severed his tricep. The muscle recessed up inside his arm and the VA medical center couldn't perform the surgery to fix it.
"When a higher level of care is needed or we don't have a specialty that is available within our facility, we will send through care that is facilitated through a third party provider, which is TriWest Healthcare Alliance," according to Chuck Ramey, VA Public Affairs.
TriWest coordinated his care with a local surgeon and the date for Latham's surgery was set.
"You have to have the Achilles tendon of a cadaver that's available for the surgery that's a match. So all these things had to take place at a certain time," Latham added.
John fasted, shaved his arms, got mentally ready and went to the hospital. He put on a hospital gown, compression socks and had IVs started. Three nurses prepped him and he was hooked up to monitors. He had even met with the anesthesiologist.
But then John's phone started to buzz and he received a voicemail message from TriWest.
I'm calling regarding your authorization for surgery today. That surgery has to be canceled. It has been canceled because the VA did not approve the secondary authorization request that your provider sent in. Thank you for your service to our country and I apologize for the inconvenience and the difficulty.
"I just wanted to get my arm fixed. And I just could not believe... the hospital, the doctor's office, the surgery center at Southern Highlands all were working to try to get somebody to make a decision to move forward with all this money that's already been spent. These people worked hours to get prepped!"
According to Ramey, "the provider scheduled him for a procedure without coordinating approval through the proper channels."
John was sent home only to get the actual final approval six days later.
"There was a mistake and it was a huge mistake and it affects people's lives," Latham added. He said he contacted the VA to give them a piece of his mind.
John was able to complete his surgery and recover successfully. VA partner TriWest sent him an email apologizing and stating: "We share in the desire to make sure no other veteran finds themselves in a similar experience like this again."
Here's the full statement we received from TriWest Healthcare Alliance.
TriWest is privileged to work alongside the Department of Veterans Affairs (VA) in support of its mission to deliver needed health care services to Veterans. We take our responsibility of providing VA with access to care in the community when VA is unable to do so directly very seriously and work hard to schedule needed care for Veterans as quickly as possible.
As a partner to VA, TriWest’s responsibility is to support VA when it determines it does not have the capability or capacity to deliver needed care in-house. In doing so, we work collaboratively with VA to ensure its facilities are maximized.
With regard to the services needed by the Veteran, we scheduled care in the community at the request of VA, only to find the secondary authorization request for the surgery the community provider scheduled with the Veteran needed further detail prior to VA approving that procedure. We understand the very challenging situation this disconnect created for this Veteran and, therefore, once we were notified of the situation, we immediately worked with the Veteran, VA and the provider to reschedule surgery at a mutually agreeable date. We have made sure that all required approvals are in place to help ensure a successful outcome for this Veteran, and have assured him that all parties have been working together to prevent a similar situation from occurring for another Veteran in the future.
We are pleased the Veteran is getting his care and wish him the best today as he receives the care that he has so rightfully earned and deserves, and will support VA and the Veteran in any way they see fit.
"I think it was an unfortunate incident what happened but unfortunately what we have are rules and regulations that people have to abide by and that's not only to protect the provider but that's also to protect the veteran," Ramey told us. He said improvements will be made within the next year when the VA consolidates its community care programs.
"Instead of them having to work with a third party provider to get their care, they will work directly with the VA," according to Ramey.
As for John Latham, "I just want to make sure that it doesn't happen to another veteran."
A doctor who recently retired from the VA Emergency Department says John's case illustrates systemic problems with veteran healthcare. We'll bring you his first-hand perspective as our investigation continues in the second part of this story on Monday at 11 P.M.
