Deficiencies in Credentialing, Privileging, and Evaluating a Cardiologist at the Richard L. Roudebush VA Medical Center in Indianapolis, Indiana

The VA Office of Inspector General (OIG) assessed allegations at the Richard L. Roudebush VA Medical Center (facility) that a newly trained interventional cardiologist was hired despite poor training and references. Further allegations claimed that the interventional cardiologist provided poor quality of care to patients and that facility leaders did not respond to staff concerns regarding this provider. The OIG did not substantiate that the interventional cardiologist was hired despite poor training and references, but identified deficiencies in the processes used to credential, privilege, and evaluate performance of the interventional cardiologist. Inexperienced staff used a third-party wage verification form instead of the required verification directly from the school or program director to verify completion of an interventional cardiology fellowship training program. The OIG did not substantiate that the interventional cardiologist provided poor quality of care to patients that resulted in adverse clinical outcomes. Despite staff complaints of clinical concerns related to the interventional cardiologist, none identified instances of adverse clinical outcomes related to poor patient care. The OIG did not substantiate that facility leaders failed to act on staff members’ concerns about the interventional cardiologist’s practice. As a result of multiple concerns shared with facility leaders by cardiology nursing staff, the interventional cardiologist’s cardiac catheterization laboratory privileges were suspended and a factfinding investigation was initiated. The OIG found that actions taken were not done timely. While not an allegation, the OIG determined that the volume of percutaneous coronary intervention (PCI) procedures performed at the facility was not sufficient to maintain interventional cardiologists’ competence and patient safety. Five recommendations were addressed to the Facility Director related to credentialing and privileging, mentoring newly trained interventional cardiologists, focused professional practice evaluations, factfinding investigations, and PCI procedure volume.