Review of Alleged Waste of Funds at VHA's Madison VA Medical Center

The Office of Inspector General received an allegation regarding the potential waste of funds at the Madison VA Medical Center (VAMC), located in Madison, WI. The complainant alleged that the facility had purchased a laser lead extractor in 2012 for about $1 million and never used it. The complainant also alleged that the facility spent approximately $125,000 on a robot to distribute supplies that could not operate autonomously within the hospital and installed a patient lift for about $2,500, despite staff stating that they did not need it and would not use it. We substantiated the allegation that the Cardiology department did not use the laser lead extractor. We found that the facility did not purchase but leased this device at a cost of about $100,000. Even though the laser lead extractor had been on hand for nearly two and a half years, the Cardiology department was unable to use it because of operating room space utilization and staffing issues. Instead, the Cardiology department sent veterans to non-VA facilities to have the procedures performed. We determined that the VAMC officials involved in the decision to lease the device did not ensure the lease of the laser lead extractor was the most cost-effective approach for extracting pacemaker and defibrillator leads. We found that the facility purchased two robots for nearly $313,000. We substantiated the allegation that the VAMC could not use the robots effectively because, when planning the acquisition, the logistics department did not consider whether the robots could operate effectively within the facility. As a result, the two robots have not been used in about 2 years. We concluded that the VAMC could have better used the roughly $410,000 it spent to lease the laser lead extractor and purchase the robots. We did not substantiate the allegation regarding the patient lift. The facility installed the lift in response to an encounter with a double amputee bariatric patient and a Safe Patient Handling Program guidance. We found that the lift provides a benefit to employees and ensures the safety of patients when they need to be moved. We recommended the Veterans Integrated Service Network (VISN) 12 Acting Director ensure Madison VAMC management complies with facility policy requiring sufficient justification supporting equipment acquisition requests. We also recommended the VISN 12 Acting Director conduct an analysis to ensure VISN facilities are effectively utilizing any laser lead extractors. The VISN 12 Acting Director concurred with our recommendations and provided plans for corrective action. We will monitor planned actions and follow up on their implementation.