Two-Year-Old Report of Alleged Patient Abuse in Murfreesboro VA Released

By Walter F. Roche Jr.


More than two years after it was completed, a report has been issued on an investigation of alleged patient abuse at the Alvin C. York veterans facility in Murfreesboro.
The abbreviated report from the Inspector General for the Veterans Administration was one of dozens previously kept secret that were finally released recently following widespread complaints from members of congress.
According to the two-page report, an anonymous complaint was filed charging that a patient at the Murfreesboro community living center was given a doughnut coated with hot sauce.
The hot doughnut was in apparent retaliation for the patient resisting efforts to give him a shower after he had soiled himself.
The IG interviewed a nurse who told them she had witnessed the event. She said she realized the doughnut was doused with hot pepper sauce when she began picking it up after the patient spat it out.
"Nurse A denied the allegation," the report states, adding that "there is no evidence to support the allegation of patient abuse."
The report states that no other staffer interviewed could corroborate the allegation.
The complainant also had charged that following the hot sauce incident the patient refused to leave his bed and, as a result, developed deep vein thrombosis.
The IG report also cited a lack of evidence to support that allegation.
The incident occurred in June of 2012 and the report was completed on March 5, 2013.
Other reports previously kept secret included a complaint that the persons assigned to detect evidence of the legionella bacteria at the Pittsburgh VA were not qualified.
According to the one-page report, the investigation was quickly closed after a Pittsburgh VA official assured the IG that the staff were qualified.
Subsequently a major fatal outbreak of legionaires disease was reported at the the Pittsburgh VA facilities.  Some 22 patients were sickened and six died in 2011 and 2012. Just this week yet another legionella death was reported at the Pittsburgh VA.
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