Soon after officials closed a poor-quality prostate cancer program at the Philadelphia VA Medical Center in mid-2008, the entire facility was accredited by the Joint Commission, the main group that assures quality at the nation's hospitals.
During a hearing yesterday of the Senate Committee on Veterans Affairs, several senators wondered how the group could have given its imprimatur given that circumstance.
"We need to pull back and take a look at this," responded Robert Wise, vice president of standards and survey methods for the Joint Commission.
The senators also wanted to know if such mistakes were occurring at VA hospitals more than at facilities in the private sector, and whether still more errors in the hospital system would emerge.
"What worries me is what else has happened," said Sen. Richard Burr (R., N.C.).
Much of the 21/2-hour hearing focused on findings that other VA hospitals had improperly sterilized their equipment, putting more than 200 veterans at risk for HIV and hepatitis B infections after colonoscopies and other screening tests.
But the senators' concerns also encompassed recent revelations that a doctor at the Philadelphia VA Medical Center botched 92 out of 114 prostate cancer radiation treatments, in some cases causing grave injury by placing radioactive pellets in other organs.
"This is an unacceptable way to treat our veterans," said Burr, who called the hearing along with Daniel Akaka (D., Hawaii), the committee's chairman.
Akaka and Burr directed most questions about the Philadelphia VA to Gerald M. Cross, the VA's acting undersecretary for health.
Akaka asked Cross whether the VA had any proof of the competence of the doctor who conducted the radiation procedures, Gary Kao, a University of Pennsylvania radiation oncologist who was contracted out to the VA. Akaka suggested that Penn did not consider Kao qualified to do those procedures on its own patients.
"We haven't looked into that specific allegation," said Cross, "but that doesn't excuse our lack of oversight."
Cross noted that the Philadelphia VA had just earned good marks from several external expert panels, including the American College of Radiation Oncologists and the Joint Commission.
More details may surface Monday at a field hearing in Philadelphia called by Sen. Arlen Specter (D., Pa.).
Specter made a brief appearance at the hearing to ask Cross if he would testify.
Cross said he had planned to attend a wedding, but added, "I'll skip it if I have to."