Quacks: Two Years as a Patient in a Veteran Affairs Nursing Home

By Fred Dungan

I do not want to convey the impression that Veterans Affairs medical care is hopelessly flawed. However, I am of the opinion that it need to work on its priorities. It is all show and no go, with the emphasis placed on what VIP's see when they tour the hospital or nursing home.

Directors who hire unlicensed physicians should be summarily fired and barred from federal employment.

• Language: English
• Publisher: Fred Dungan
• Release date: Mar 26, 2018
• ISBN: 9781370410569

Book preview

Quacks: Two years as a patient in a Veterans Administration nursing home

Noun: quacks kwaks

1. Charlatans who pretend to have medical expertise.

Verb:

1. The harsh sounds of a duck.

2. To act or do business as a quack.

by Fred Dungan

Buy a paperback copy of Quacks at lulu.com

October 13, 2016

3749 Unit A Myers Street

Riverside, CA 92503

[phone]

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Dedicated to the memory of my parents, Chief Russel Alonzo Dungan, U.S.N. (Retired) and Blanche Marie Dungan, whose selfless, God-fearing, caring natures were not lost on their son. Although you no longer walk this earth, your footsteps remain, suspended by good deeds in the sands of time. May your descendants continue to display these social attributes for innumerable generations to come.

Prologue

There are not many books written about nursing homes. That is because nursing homes are insular institutions. Patients tend to be elderly and few write books. Far too many patients die there. Administrators blame the high death rate on old age. Old age is indeed a factor, but negligence and quackery take a much higher toll.

Few long term patients leave nursing homes alive. Dead people do not complain. Many people assume that their loved ones are being given adequate care and nutritious meals. Having lived in a Veterans Administration nursing home for two years, I know better.

Nursing homes range from small, minimum care facilities where patients are largely warehoused on tranquilizers, social security checks have a way of quickly vanishing, and the nursing staff is underpaid and overworked to secure assisted living units where the patients live much the same way they did at home, activities are organized by experienced social directors, and it is possible to maintain privacy.

I would rate Veterans Administration nursing homes as being in the top third of these facilities. Considering their bloated budget (which the taxpayers pay), there is room for improvement. Families should check out a nursing home before committing a relative to it. Some nursing homes are better than others. I am writing this book in the hope that it may help to improve the quality of veterans healthcare in some small way.

Congress recently passed the Nursing Home Transparency and Improvement Act which requires nursing homes to disclose how good of a job they have been doing. Minimum quality standards will be put into place. Supposedly, negligence and abuse will be reported and a national registry will be established that will help nursing homes in identifying potential workers who have proved abusive and/or negligent at other institutions.

I am providing an example of proven quackery for veterans who may be under the opinion that VA healthcare does not have any overarching problems that result in unwarranted patient deaths. From May 14, 1999, to July 10, 2002, Paul Kornak was hired by the Stratton (New York) VA medical facility to direct research on sick veterans. One study involved injecting experimental cancer drugs into patients that caused a number of needless deaths. It was later discovered that Paul Kornak defrauded two drug firms out of $639,000. He pleaded guilty to the charges. He has been barred from federal employment for life. The VA failed to charge Paul Kornak with murder. Earlier, Kornak had been convicted of mail fraud. Why was this not discovered by a background check?

The following statement was posted by veteran and activist Sue Frasier on December 11, 2005, on an online media outlet called One Voice Veterans Forum:

... We had gripping VA drama playing out here in Albany, New York, that was overshadowed by a sinister news media who did their best to confuse and conceal what was really a straight forward story about murdered veterans at a VA Hospital by a phony...employee who was almost successfully protected by the VA itself.

Former VAMC employee Paul Kornak was given a lousy six year sentence for killing five...that's right...five veterans who were staying at the hospital, and this joke of a mandate was issued by another Army veteran himself, Judge Frederick Scullin. The fact that he gave Paul Kornak a one year per murder sentence really did not come as any surprise to those of us who live here.

...Paul Kornak never finished medical school but somehow managed to get hired with fake medical credentials at the Veterans Administration Medical Center here in Albany, New York. He was placed in the Cancer Care unit and began signing his papers as Dr. Paul Kornak, and represented himself throughout the hospital in this same way. He began falsifying the paperwork of veterans staying in the cancer care clinic and entered the patients into drug treatment clinical trials which they were not eligible to be in. (As Kornak's trial progressed, it also came out that he had falsified the patient records of 65 other veterans, but I digress.)

Two VA pharmacists began to notice the lethal dosing that was being issued to the veterans. They made attempts to intervene and were stopped. The five veterans died....bingity, bangity, boom! The two pharmacists went to the Administrators to report the lethal dosing and were promptly fired from their jobs. Yup -- that's right, they were FIRED!

They went to the FBI to tell their story, and wrote complaints to the Veterans Administration Inspector General. It was only after the pharmacists went out to the news media with other employees that the FBI finally agreed to review the case.

Paul Kornak was taken into federal custody on a 41 count grand jury indictment shortly after that.

The...VAMC Director, Mary Ellen Fache-Piche, even had the stones to grandstand in a phony press conference of sorts with the U.S. Attorney {talking about patient care and justice} to spin the entire story away from themselves. The news media fully cooperated with this pile of crap news conference even though it had been all over the area prior to that that the Administration fired the pharmacists.

The two fired pharmacists were eventually hired back into their jobs, but only after a considerable legal expense to do so.

Paul Kornak pleaded guilty to the indictment. In exchange for that, the government gave him a lousy one year per murder of a veteran, a total of 71 months. He is in his fifties now, and he will be 60 or so when he is released.

The families had to take out second mortgages on their houses to pay for lawyer bills in a civil action against Kornak. No word has ever been in the press about the results of the civil action.

Perhaps the biggest tragedy of all is that not one single veterans' organization was at the string of hearings to give support to the family members. No DAV, no VFW, and no American Legion. On the day of the sentencing, one of the widows did the TV news interviews entirely alone by herself. There was not an organizational hat anywhere to be found next to her.

...Paul Kornak had an accomplice, a Dr. George Holland, who was fired from the VAMC at the same time that Paul Kornak was, but managed to flee the area and relocate somewhere in the state of Georgia, and is continuing to practice medicine...

If this story isn't your wake-up call that we are all in extreme danger inside of this system, then I don't know what is.

Considering Mr. Kornak's easily obtainable record of fraud, he could not have passed even a cursory scrutiny of his resume. In 1993 in Harrisburg, Pennsylvania, Judge William W. Caldwell of United States District Court sentenced Mr. Kornak to a $2,500 fine and three years of probation for forging his credentials to obtain a medical license...Mr. Kornak's history of fraud began with the falsification of a college transcript, and lie followed lie until he lost a medical license in Iowa, was denied one in New Jersey and was arrested in Pennsylvania.

Six years after Judge Caldwell's pronouncement, Mr. Kornak answered an advertisement for a research assistant position at the Albany veterans hospital's research institute.

Mr. Kornak told Dr. Hrushesky that he had lost his medical license because he could not document a year of medical school in Poland, according to the journal. Mr. Kornak gave us a resume with an M.D. on it and a lot of gaps, Dr. Hrushesky told the media. We decided to give him a chance.

Unfortunately, the patients that Kornak used for guinea pigs in his macabre drug experimentation never stood a chance.

Research violations were a way of life at Stratton for 10 years, said Jeffrey Fudin, a pharmacist at the hospital. Stratton officials turned a blind eye to unethical cancer research practices and punished those who spoke out against them. The whole Kornak episode could have been prevented.

According to Paul Kornak's lawyer, E. Stewart Jones, there was a clear systems failure, permitting a research culture where rules weren't followed, protocols weren't applied and supervision was nonexistent.

It was also a culture whose descent into criminality forced the Department of Veterans Affairs nationwide to reckon with what an internal memorandum in 2003 described as systemic weaknesses in the human research protections program, especially in studies funded by industry.

Excluding simple chart reviews, about 80 percent of the department's human research is financed by industry. The private sector pumps considerable cash into the system. In Albany, it accounted for $500,000 of the $1.15 million in research funding in 2004.

In January 2003, the VA abolished its independent research safety watchdog office, the Office for Research Compliance and Assessment (ORCA). The Bureau of National Affairs reported that the move has puzzled Capitol Hill observers, some of whom have suggested an act of Congress to restore an independently functioning office. Obviously, despite being a public agency charged with transparency, the VA does not tolerate criticism and whistleblowers.

On March 25, 1999, Terence Monmaney, a medical writer for the Los Angeles Times wrote that a patient at the West Los Angeles Veterans Affairs Medical Center told doctors twice that he did not want to be a guinea pig. Nonetheless, they kept him on an operating table with an electrophysiology probe inserted in his heart for an extra 45 minutes to collect research data.

An inspection at a Veterans Affairs nursing home in Philadelphia in 2008 turned up conditions placing veterans at imminent risk of harm, including one patient whose leg had to be amputated after maggots were seen falling from his foot.

The multiple deficiencies at the facility, part of the VA Medical Center, were included in a 16-page report released to the Pittsburgh Tribune-Review in response to a federal Freedom of Information Act request.

The report by the Wisconsin-based Long Term Care Institute concluded that the facility, whose bed count has been cut from 240 to 120, failed to provide a sanitary and safe environment for their residents.

There was a significant failure to promote and protect their residents' rights to autonomy and to be treated with respect and dignity, the report concludes.

VA administrators, in response to the study, issued a corrective action plan, updated on June 29, which includes the hiring of consultants, additional staff, remedial training, and retraining programs for staff. A great many changes have been instituted at the (nursing home) over the past year to improve the quality of care and quality of life for our veterans, VA spokesman Dale Warman wrote in an e-mail response to questions.

Citing significant issues with resident grooming, housekeeping and pest control, inspectors observed dried blood and tube feeding on the floors.

Re-educate staff on dignity, respect and privacy, the action plan dictated.

Three months before the report was issued, a mute and disabled Vietnam veteran, David Allen, 56, died from choking on solid food, even though he was supposed to be on a soft-food diet. His death was not mentioned in the report, but triggered an internal investigation. In a written statement about the choking incident, the VA said the contracts of two agency nurses were terminated. Other staff members were given additional training on swallowing difficulties "as