Did the Inspector General use a "virtually impossible" standard to exonerate the VA?

Last month, acting Veterans Affairs Inspector General Richard Griffin issued a report on the wait-list scandal that appeared to let the DVA off the hook for patient deaths, while still castigating the bureaucracy for widespread fraud and abuse. One line in the report stated that the deaths of dozens of veterans could not be conclusively linked to the wait-list fraud that kept them from receiving medical care. Thanks to that statement, the national media reported that the claims of whistleblowers were exaggerated and that the problems weren’t as bad as originally thought.

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The Arizona Republic took a closer look at the standard used by Griffin to reach that conclusion, though, and asked medical experts to analyze it. The standard for linking the deaths to a lack of appropriate care was so high that it was “virtually impossible” to meet it:

But health-care experts say Griffin’s report used a measure that is not consistent with pathology practices because no matter how long a patient waits for care, the underlying “cause” of death will be a medical condition, rather than the delay.

Put simply, people die of pneumonia, heart conditions and bullet wounds — not waiting to see the doctor.

“I think that would be a standard that is very difficult to meet,” said Dr. Gregory Schmunk, chief medical examiner in Polk County, Iowa.

Schmunk, past head of the National Association of Medical Examiners, stressed that he was not speaking in that capacity but from his expertise on mortality.

“Delay of care may not have been the proximate cause of death,” he said, “but the real question is: Did delay of treatment cause the patient to die earlier than necessary?”

Dr. Gregory G. Davis, current head of the association and chief medical examiner in Jefferson County, Ala., also questioned the standard used in the Office of Inspector General report.

“I can’t imagine a circumstance where someone would word it that way,” he said.

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Griffin appeared before the Senate Veterans Committee yesterday and got grilled on his methodology — and his independence:

Sen. Dean Heller, R-New Hampshire, implored Griffin about the report’s findings and whether the VA had edited it.

His questioning hinged on a line in the report that indicated that the delays in care could not be conclusively linked to the deaths. Heller asked whether that line was included in the draft of the report submitted for review to the VA.

“It was reported that a line was inserted,” Heller said. “And if you’re the VA, this is the line you want inserted in that report.”

“There are many versions of a draft report,” Griffin replied. “The majority of the changes in our draft report came about as result of further deliberations by the senior staff of the Inspector General’s Office. No one in VA dictated that sentence go in that report.”

CNN’s Drew Griffin also questioned the standard. He walked through a couple of the cases in which the IG couldn’t link a death to delays in care, and quotes a family member that calls it “BS”:

“Could the report be a cover-up?” Anderson Cooper asked, and he’s not the only one. Both the American Legion and Concerned Veterans for America want an independent investigation of the IG report. What we do know is that the narrative that emerged last week is inaccurate — and that internal investigations won’t improve that situation.

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