OIG conducted an inspection to assess the merit of allegations from an anonymous complainant regarding the Surgical Service at the Fayetteville VA Medical Center, Fayetteville, NC.
We substantiated that some patients were not properly evaluated prior to surgery; However, we could not substantiate that inadequate preoperative evaluations caused an increase in surgical complications. We substantiated that patient deaths that occurred within 30 days of surgery were not reviewed as required, and that peer reviews were not conducted as required. We substantiated that a gynecological procedure was stopped after surgery had begun because of a lack of instruments, and there were ongoing problems with obtaining and maintaining surgical supplies and instruments. We substantiated that a surgical technician was placed in charge of the surgery schedule; however, this action was appropriate. We did not substantiate that staff were bypassed in the scheduling process or that surgeons had to perform cases without adequate assistance. We substantiated that surgical technician positions that were not being actively recruited and that having different service alignments for the surgical technician positions led to confusion. We did not substantiate that complication rates of surgical residents exceeded 30 percent. We did not substantiate that the Chief of Surgery awarded a contract or that the contract was not offered to other bidders. We found that the facility’s surgical post-operative clinic did not have the same nurse staffing pattern as other outpatient clinics. We recommended that recommendations from previous reviews, if any, be implemented; that preoperative patients are adequately evaluated; that peer reviews are completed in accordance with VHA policy; that necessary surgical supplies, equipment, and instruments are available; that the organizational structure for surgical technicians be evaluated, and that the surgical outpatient clinic have the same nurse staffing as other outpatient clinics.