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VA officials probe how its hospital treated blind Las Vegas veteran

Keith Rogers

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April 2, 2016

The House Veterans Affairs Committee and local VA officials are probing allegations that staff at the VA Medical Center in North Las Vegas mistreated a blind veteran who was writhing in pain while she waited six hours for emergency care at the center on Oct. 22.

The long wait compounded by frustration with incomplete radiology orders and alleged rude treatment increased 78-year-old Sandi Niccum’s frustration to the point that she would pound her walking cane on the hospital floor.

“Several times she would just beat it on the floor and say, ‘Please somebody help me.’ But they didn’t. Nobody cared,” said Niccum’s friend, Dee Redwine, who was with her through the ordeal.

The Navy veteran, described by her aide, Shirley Newsham, as a “brittle diabetic,” had been a volunteer for the VA’s Visually Impairment Services Team for at least eight years. She died Nov. 15 at a local hospice.

Before she died, Niccum asked Redwine to write a chronology of the VA experience and submit it to the Review-Journal.

“She said, ‘This is wrong. We’re going to have to put this together and turn in a report so this won’t happen to someone else.’ She said it many times,” Redwine said Monday.

Allegations in the chronology drew criticism from members of Congress who oversee the VA, including House Veterans Affairs Committee Chairman Rep. Jeff Miller, R-Fla., and committee member Rep. Dina Titus, D-Nev.

They also prompted a review by a panel at the VA Southern Nevada Healthcare System, which runs the $1 billion medical center. It opened in August 2012.

‘DISTURBING ALLEGATIONS’

Miller said in a statement Tuesday that his committee “is investigating these disturbing allegations, and we will be asking VA to provide copies of all applicable surveillance camera footage so we can examine the sequence of events in detail.”

“All veterans seeking care at VA hospitals deserve to be treated with utmost respect and compassion. Should that ever fail to happen, VA must hold those responsible accountable,” Miller said.

Titus said in a statement that she was “appalled to learn of the shocking mistreatment of a veteran who had given so much to our country and community.”

“Our VA hospital should be the gold standard in both caring for patients and customer service,” Titus said. “I am eager to learn the results of the hospital’s working group and the actions they plan to take to ensure no other veteran suffers from a similar experience.”

Local VA spokesman David Martinez said VA Southern Nevada Healthcare System officials are reviewing Niccum’s chronology.

“While patient privacy laws prohibit us from commenting specifically on her care at the VA, there are issues brought up in her journal that would be unacceptable for any of our veterans to experience,” Martinez wrote in an email. “To that end, VA Las Vegas leadership has convened a team of both clinical and administrative leadership to review every aspect presented with the sole intent to determine what actually took place and to take corrective action where needed.”

Martinez said the review will focus not only on the clinical aspect “but also the criticality of how customer service is delivered. We are absolutely vested in providing care to our veterans that is reflective of their service to our nation.”

‘HORRIBLE EXPERIENCE’ DESCRIBED

Newsham said the VA’s customer service reputation was tarnished when she took Niccum to the center’s emergency room late last summer and they experienced a four-hour wait before she was admitted.

“It was just a horrible experience,” Newsham said about the five-day span Niccum spent in the hospital while doctors tried to determine whether her colon cancer, which was in remission, had flared up again.

“While she was there, she wanted her aides to stay with her because she did not trust the VA,” Newsham said, explaining that Niccum’s doctor at the VA women’s clinic tried to alleviate her fear by allowing her to bring her own medicine and insulin to her room.

Toward the end of her stay, Newsham said, a security person tried to remove Niccum’s medicine when Newsham wasn’t present. Niccum told her, “ ‘Oh no you’re not. Those are mine. Do not take them. Do not touch my medicines.’ And security at that point said, ‘Well then, we’ll have to escort you out of the hospital.’ So she said, ‘Well fine. Take these tubes out of me. Get my wheelchair and I’m out of here.’ ”

Niccum called Newsham to pick her up, but about 15 minutes later, Newsham learned that a doctor had told the security personnel that Niccum had to stay. She stayed four more days. Before she left, she was given medication for pain and stimulants to increase her appetite because she wasn’t eating.

Niccum continued to experience pain into October, and Newsham complained “every day” to Niccum’s VA nurse.

“  ‘You need to do something,’ ” Newsham said. “I said, ‘You know we’re here, and even though we’re staying 24-7, we’re not really doing anything for her because she can’t eat. She’s rocking. She’s crying. She’s in pain. She’s begging anybody and Jesus to please help her.’ ”

Redwine said Niccum’s condition deteriorated to the point that she was constantly crying and asking for pain pills.

“For Sandi to cry, that never happened,” Redwine said. “I saw her cry two other times: over the loss of her son and her husband. … But she was in so much pain. That was the purpose of us trying to get back into the hospital, at least get her a pain pill so she could sleep.”

WAITING AND WAITING

Finally, Niccum’s primary care doctor told her to go to the VA hospital for a scan and an X-ray.

According to the chronology, Redwine drove Niccum to the VA Medical Center and was with her on Oct. 22 and again two days later for a follow-up visit.

When they arrived at the radiology department at 3:40 p.m. Oct. 22, they were told there were no doctor’s orders in the computer.

The nurse who prepared Niccum’s insulin syringes was contacted, and she called the VA endocrinologist, who informed the VA employee at the patient window that the orders were being typed up.

“The VA employee hung up the phone, stepped back and slammed the window shut and then came out the other door with his (personal) items and left for the day,” Redwine wrote.

Shortly after 4 p.m., Niccum checked in at the center’s emergency room, following orders from her women’s clinic physician.

“We signed in and the lady said, ‘Go over there and wait.’ And Sandi said, ‘How long?’ And she said, ‘I can’t tell you anything, I don’t know.’ So we did go wait,” Redwine said. “One hour. Two hours. Three hours. Eventually a lady did come out of the triage and took Sandi’s blood pressure and her glucose and the numbers were very low.

“The lady did offer Sandi some orange juice. I asked the lady if I could get a blanket and, here are two chairs, can I lay her down? She’s exhausted. She can’t do this. She’s too weak. And the lady said, ‘No. Absolutely not. You cannot lay her down and there are no beds … available for her back here,’ ” Redwine recalled Monday. “So I went back and told Sandi that, and she was still crying.”

Two other women and three men were in the waiting room, Redwine said.

“We waited and waited. The men that were in the waiting room had been there probably two hours. They left. They said, ‘We’ve had enough. We’re going to a local clinic and get taken care of.’ And then there was only three of us in the waiting room, and we still waited another two or three hours,” she said.

The emergency room doctor finally called for Niccum about 9:30 p.m.

“Sandi was so weak at that point I literally had to hold her head up to talk to the doctor. She was exhausted. She had severe pain, and she just kept crying and saying, ‘All I need is a pain pill. That’s what I came for.’ ”

The doctor told her she couldn’t give her a pain pill because it would interfere with tests that were planned but couldn’t be performed earlier because proper information hadn’t been entered into the computer system.

Niccum “just cried and said, ‘I can’t even sit up. I cannot do the tests at this time of night.’ ”

The doctor told her to go home and return “in the morning at 6:30 and be one of the first ones in line at X-ray. I said, ‘Ma’am, when we have an episode like this, Sandi needs 24 hours to recover with her diabetes and whatever is going on with her body right now,’ ” Redwine said.

FINALLY SHE HAD ENOUGH

Two days later, on Oct. 24, Redwine and Niccum arrived at the medical center’s X-ray facility about 7 a.m. They were told the facility wasn’t open yet and to wait.

“Once we did get in, we were told it was not entered in the computer correctly — ‘We cannot do your tests.’ ”

Redwine said she wheeled Niccum into the hallway outside the small waiting room “and explained to her what was going on. And she just cried and cried. And some wonderful gentleman came by and he said, ‘You know what. Give me a minute.’ And he went in X-ray, and I don’t know what he did, but when he came back, he said, ‘Ms. Niccum, I’m going to take care of you.’ ”

Though the test orders weren’t entered correctly in the computer, this man with a VA employee badge arranged for Niccum to take a partial test and go home.

“I went and got the car and loaded Sandi again. She was still crying in pain. We’re driving home on the freeway and Sandi’s phone rings. It was the Veterans (Affairs) hospital. They did not identify themselves. ‘You need to come back right away. This is an emergency. You have cancer.’ I pulled off the highway, and I just let her cry.”

Then Niccum’s endocrinologist called to tell her that he didn’t believe she had cancer. He told her to go to St. Rose Dominican Hospital, Redwine said, “and so we did. … We went to St. Rose, and they took her right away. They were wonderful.”

The St. Rose staff told her there was a large mass on her right side that they thought was a tumor. She also had a medical issue with a ruptured abscess in her colon. They decided not to operate, however, because of her history of congestive heart failure.

Even on the last day of Niccum’s life, Redwine asked a doctor at Nathan Adelson Hospice to “tell this lady the exact diagnosis that is on paper. Please don’t say, ‘I think this is what’s wrong,’ because every doctor had said that to Sandi. I said she needs to know.”

Redwine said that to the end of her life Niccum feared that, because of diabetes, she would go into a coma and die.

Her blindness stemmed from diabetes developed during her fifth year of active duty with the Navy Medical Corps as a medic for the Marine Corps at Parris Island, S.C. She was honorably discharged in 1958. She lost vision in one eye in 1983 and the other eye three years later.

Suffering from septic shock from the ruptured abscess in her colon, she died in her sleep about 2 a.m. on Nov. 15. The exact cause of death was unknown, Redwine said.

Niccum’s ashes will be buried at the Southern Nevada Veterans Memorial Cemetery in Boulder City at 10 a.m. on Dec. 12 with full military honors.

Donations can be made in her name to the Blinded Veterans Association, P.O. Box 46272, Las Vegas, NV 89114.

Contact reporter Keith Rogers at krogers@reviewjournal.com or 702-383-0308.

Sandra Niccum Veteran Volunteer background:

Sandra is a U.S. Navy Veteran who served 1953 to 1958, as a Medic. She is 100% service connected disabled Veteran and totally blind. Even with her disabilities Sandra has volunteered for many years for the Veterans.

She has been with the DAV local chapter as president, vice president, secretary and treasurer. She has volunteered at the Lions club, helped with the local chapter set-up and served on their Board of Directors. Sandra volunteered for the National Council for the Blind Veterans and was also on their Board of Directors. She was President of the National local chapter of Navy Women Veterans for 7 years. Currently she is the Director of Southern Nevada regional BVA.

Her volunteering did not end there; she has volunteered at the V.A. since 1998 and has been awarded the Presidential Lifetime Achievement Award, for her VA service to Veterans.

She has such compassion for the Veterans. Imagine doing all of the above as a blind woman Veteran. A remarkable Woman, who’s later in life career has been outstanding.

A few medical facts, which the VA has on record, she is blind, she is an insulin user diabetic, has a pace maker has congestive heart failure, and had colon cancer, but in remission.

With the above in mind, the information below is a list of events that took place at the V.A. hospital in her time of need. Her treatment was deployable and inexcusable.

1. Approximately 3 PM on 10-22-13 (Tues.) Sandra Niccum, a 100 % service connected disabled Veteran was instructed by her VA primary care doctor and advised to go to the VA Hospital for a scan and chest x-ray. She was having severe stomach pain. This had been happening for the last few weeks. The pain was on going and she had been crying twenty four seven.

2. We arrived about 3:40 PM at the VA Hospital at the X-ray/radiology dept., as directed. The VA employee at the desk said there are no orders in the computer from your VA doctor to perform these tests. Sandra’s VA home nurse was called. The nurse called the VA endocrinologist and he said the orders were being typed up as they spoke. The VA employee hung up the phone stepped back and slammed the window shut and then came out the other door, with his personnel items and left for the day.

How could he have such little regard for this Women Veteran in so much pain? As a V.A. employee, that was unacceptable treatment.

Sandra was in so much pain and just sat and cried. Two VA women employees then came from the back area of the x-ray dept. and told Sandra her VA primary Care doctor said she was to go to the ER dept and sign in.

3. A blonde VA women employee checked Sandra in approximately. 4:05 PM in the V.A. ER Dept. and told Sandra she did not know how long she it would be , to have a seat. Two male Veterans, at about 6:45 PM said they were going to quick care because they had been waiting for two hours for care. Sandra was triaged after a few hours, they checked her blood sugar and Blood Pressure and was told her sugar level was 65 and was then offered some orange juice. Sandra was still crying with the pain and was freezing cold. She was offered a blanket. She needed to lie down; she had been sitting in the wheel chair for 4-5 hours by this time. There was one double chair and I asked if Sandra could lie down in that chair and I was told NO and they also told me there were no beds available either. Since Sandra is a brittle diabetic, she was very weak, in pain and crying continually and ER did nothing to help her. There were never more then 6-9 Veterans waiting for care from 4:15 till 9:30 PM. It appeared the staff were to busy chatting with each other to help the Veterans waiting. (I have some pictures of this). This again is unacceptable treatment, how can V.A. employees be so uncaring

4. We next went to the V.A. Pharmacy, it was now after 10 PM, and the employee there said he was busy with someone upstairs. After Sandra sat there for 45 minutes Security came by to check on why she was still there. He then called someone for help in this dept. and by 11PM she got her pain prescription filled. What can be said about this wait, it is unknown who was upstairs but for Sandra to get pain pills , when you see the pain she is in, a lack of caring to help her as fast as you can. Security had to step in to help!

5. We were home by 11:20 PM; we were at the V.A. Hosp from 3:40 to after 11 PM. Sandra was so weak, and in so much pain but she had to have something to eat due to her diabetics. She got her pain pills down and they helped. She was still cold and exhausted and very stressed out. We later found out she developed open wounds on her bottom from sitting so long in her chair, which became severely infected.

6. Wed. 10-23-13 Sandra could not get out of bed and slept most of the day. No one called from the V.A. to check on her.

7. On Thursday 10-24-13 we had been told by the physician to come for an X-ray between 6am - 7:30 so we arrived for the X-ray about 6:40 AM only to find out they did not open till 7:30 AM We were told to take a number and wait, Sandra was so cold and needed to lay down. For the first time a V.A. Employee … stopped by us and asked if he could assist us. He went back to the x-ray dept. and came back and said the orders written by the doctor were not complete but he would work on it and be right back. He came back in a short time and got Sandra .and did the tests. We were told that was all and we left.

8. We were driving home and Sandra received a phone call from the V.A. saying she needed to return to the VA Hosp. because she had cancer and needed immediate surgery. Sandra was trying to absorb what they just told her.

Who ever made this phone call to her was very inconsiderate and a disgrace to what the V.A. stands for. What Sandra has gone through for the last 3 days with the V.A. is all disgraceful and should not be tolerated. Heads need to roll. Veterans need to be treated with dignity and respect and not like Sandra has been treated. Sandra called her VA nurse and the VA endocrinologist to find out what was going on… Her endocrinologist returned her call and told her he did not thing she had cancer and to immediately go to St. Rose Hosp.

9. On Thursday 10-24 she was admitted to St. Rose Hosp. in Henderson. They found a large mass on the right side of her abdomen, a ruptured abscess on her colon and is under the care of a cardiologist, infection disease doctor, an endocrinologist and a primary care doctor. She is very sick and has lost 30-40 lbs. Nothing has been said about cancer. There appears to be a problem that Medicare and the V.A. can not agree on? St Rose is sending Sandra home 10-30 Wed. with an IV of antibiotics and they do not think she could survive surgery.

10. 10-31-13 to 11-3-13 Sandra is bed ridden, very very weak, and sleeps all the time.

11. On 11-3 Sandra is home and upon having her vitals checked they could not find a good pulse rate, the Paramedics were called. She was taken to Mountain View Hosp. Sandra has taken a turn for the worse… Doctors now think her colon cancer has returned. Sandy is to be transferred to Silver Hills Nursing Home 11-8-13. From Silver Hills back to Mountain View Hospital and then to Nathan Adeleson Hospice. Sandra passed away November 15th.

SOURCE: Dee Redwine

http://www.reviewjournal.com/news/va-officials-probe-how-its-hospital-treated-blind-las-vegas-veteran