Help for injured veterans could vanish
Dr. Robert Van Boven, LOCAL CONTRIBUTOR
Monday, December 08, 2008
There is new bureaucratic bumbling to address the mismanagement and waste at the new traumatic brain injury research program at Central Texas Veterans Health Care System. The system has spent nearly $2.5 million in more than two years on salaries, supplies and MRI scanner time — and not a single veteran has been studied or benefited from the expenditures.
Rather than holding managers accountable for serious transgressions, including literal suppression of, and inaction to, disclosures of fraud, waste, and invalid human research, according to Tim Shea, a regional director of the Veterans Integrated Service Network , the Veterans Administration is considering the closure of one of a few centers in the nation dedicated to testing new imaging and treatments for brain injury.
It appears that the VA is contemplating to "throw the baby out and leave the bath water." Traumatic brain injury and post-traumatic stress disorder are often connected. Estimates are that about 40,000 returning troops suffer brain injuries and 300,000 are afflicted with post trauma stress. A recent Institute of Medicine report concluded that evidence is inadequate for nearly all treatments for PTSD and that no effective treatments are proven for mild to moderate TBI.
On Thursday, the Institute of Medicine also released a report that forebodes the frightening long-term consequences of brain injury for those who risked their lives for us in battle, including dementia, depression and socio-economic decline . We as a nation are in desperate need of answers and effective solutions. The Brain Imaging and Recovery Laboratory held an open house on Jan. 17, 2007, to announce war on this affliction.
This sorely needed scientific initiative has been subsequently blindly thwarted by a culture of insulated bureaucrats without vision. The chief of staff of the Central Texas VA System admitted he "only had the fuzziest notion of what it (the BIRL) was." Nonetheless, he authorized funding of scientifically invalid work despite knowledge of allegations of fraudulent billing, admitting to his knowledge and inaction "that the consultant could be padding his hours, and a bunch of things."
Despite more than $200,000 of resources, the VA Office of the Inspector General found that after seven months of "research," the investigator did not collect and record data. It concluded that such blatant omission of a basic principle of scientific methods "could interfere with the ability of the study to contribute to generalizeable knowledge, which is the definition of research."
The OIG then held its punch and — incredibly — claimed that, though it did not study scientific merit — the essential element to justify research funding — that the research funding was appropriate in exchange for administrative duties. This conclusion was made in the face of five outside, expert reviews all panning the research and the lack of original research experience or qualifications by the administrator/clinician. Shea failed to hold management accountable for inaction and suppression of disclosures and instead has discussed closing the BIRL outright, thereby "burying" the mistakes and misconduct.
The great promise of diagnostic and treatment breakthroughs to be born here in Texas for combat victims and civilians alike may also quietly fade away as well. This is a grave disservice to our wounded heroes and the 1.5 million children and adult civilians who sustain brain injuries every year.
Van Boven is a physician-scientist specializing in mechanisms of recovery after injury to the brain and nervous system.
Monday, December 8, 2008
Help for injured veterans could vanish
