Thread by @AnnieWaldman

NEW: About one month ago, we received an anonymous tip:

"PLEASE look into what happened at the Robert J Dole VA…hundreds of local military heroes had their legs mutilated…and nobody has been held accountable."

And so I started to dig….a thread:
propublica.org/article/medtro…

Back in 2017, a whistleblower lawsuit made some disturbing claims:

VA hospital workers in Kansas allegedly received kickbacks from a medical device company, whose sales reps then “groomed and trained” doctors to excessively use their devices in patients, putting them at risk.

These were devices used to treat a common medical condition: clogged leg vessels (also known as peripheral artery disease), which impacts more than 6 million Americans over the age of 40.

It turns out the whistleblower wasn't the only one concerned about the excessive use of medical devices in veteran patients at the hospital, according to court records.

Around the same time, the director of the Wichita VA also investigated these procedures, and found a number of failings:
* Evidence-based medicine was not followed in most cases.
* Procedures were over-aggressive.
* A total disregard for best practices.

While it's not uncommon to deploy several devices in a procedure, a medical expert on the investigation team found that doctors at the VA sometimes used 15+ at a time -- one used 33 -- deviating from the standard of care.

Just a few weeks ago, text messages were unsealed in the whistleblower case that brought up new questions about the influence of medical device company reps in these procedures at the Wichita VA.

The use of these devices at the Wichita VA raised alarm bells among hospital leadership. Internal emails show that amputation rates increased sixfold in the same timeframe as the procedures in question.

In 2018, the director of the VA facility turned over his findings to the criminal division of the U.S. Department of Veterans Affairs Office of Inspector General. He also shut down interventional radiology procedures at the facility.

OIG federal agents also looked into the allegations of kickbacks at the hospital and found that, during this time, the medical device company reported that they paid for hundreds of meals for hospital workers, possibly violating VA ethics rules:

The VA OIG would not confirm or deny whether it was continuing to investigate kickbacks at the facility. No criminal charges have been filed.

The medical device company, Medtronic, declined to respond to my questions, citing the ongoing lawsuit but said: “These allegations are false and Medtronic is defending against these claims in court." Sales reps didn't respond to our questions or declined to comment.

The medical group that had a contract with the VA for vascular interventions did not respond to my requests for comment, nor did the doctors named in the suit.

I reached out to the VA, which said they are "conducting an extensive review of patient care" at the Kansas hospital, "including the number of devices used on patients – to make sure that Veterans were not harmed by any procedures."

The VA did not specifically respond to my questions about the increase in amputations, but said they have not found any "quality of care issues" so far. The review will take several months.

Important to note that it's unclear if the VA has reached out to individual patients whose records were reviewed. I reached out to more than half a dozen veteran community groups in the Wichita area, and none told me that they had heard of the investigation.

We're continuing to report on this. Do you know more about the procedures at the Dole VA in Wichita? Were you or was someone you know a patient who had one of these procedures? We want to hear from you: DM or email at [e-mail].

We're also going to be looking into the booming business around peripheral artery disease across the country, fill out our form if you have a story to share (or contact me or @mayatmiller): propublica.org/getinvolved/pe…

Also a shout out to our excellent partner on this story, The Wichita Eagle: subscribe.kansas.com/beinformed

And ProPublica is always interested in your story ideas and tips, a reminder of how to contact us:
propublica.org/getinvolved/se…