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Whistleblowers Allege Human Research Violations At San Diego VA

November 20, 2018 1:37 p.m.

Whistleblowers Allege Human Research Violations At San Diego VA | GUEST: Brad Racino, senior reporter and assistant director, inewsource

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Transcript:

This is a rush transcript created by a contractor for KPBS to improve accessibility for the deaf and hard-of-hearing. Please refer to the media file as the formal record of this interview. Opinions expressed by guests during interviews reflect the guest’s individual views and do not necessarily represent those of KPBS staff, members or its sponsors.

inews source has uncovered allegations of dangerous medical research that was performed on veterans at the San Diego V.A..

Investigative reporter Brad racino spoke to whistleblowers in the case and a congressman who is vowing to take action.

You have to be on the committee the Veterans Committee right now so we would have seen Scott Peters is a San Diego Congressman who also serves on the House Committee on Veterans Affairs.

You see here a lot of horror stories from other VA is like huge cost overruns in Denver messing with the schedule in Phoenix to make yourself look good and we didn't. We don't have as much of that in the VA in San Diego. I think the vets we talked to are pretty happy with it.

I spoke to Peters about a recent federal investigation that urged President Donald Trump and Congress to take a truly critical look into the San Diego V.A. but every once in a while you do hear stories like the one you brought up that's that's a concern. And so the story involves Dr. Samuel ho. He's a former division chief at the San Diego V.A. and professor of medicine at UCSD who conducted research on alcoholic veterans suffering from liver disease as part of a federally funded study host said in a November 11th e-mail that he would respond to questions from a news source.

But he hasn't. Nor did he respond to a follow up e-mail. Hoh resigned from both positions in July to take a job at a university in Dubai. My name is Martina Bock and Mario Mario Choucair and Martina Bucke are another part of the story. The two alleged to government investigators that hope coerced alcoholic VA patients to undergo a liver biopsy so he could obtain grant money and publish scientific articles. They said the biopsies were medically unnecessary and potentially dangerous for this type of patient. One already seriously ill at risk of excessive bleeding due to liver problems and unable to benefit from the long term study.

What was it about the procedure that made you think that like what was dangerous about it or wrong or procedure that need it out and by definition are necessary. The only way to practice you need to do everything that the needed but nothing that you need Choucair is the director of the liver and transplantation clinics at the VA and a professor of medicine at UCSD. The procedure that's another benefit to the individual.

This is the first time he's talked publicly about his role in getting federal authorities to investigate the San Diego V.A. and I have a moral obligation as a citizen to protect a patient.

And I notice that he said he was not the equal choice according to the whistleblowers who told patients the procedure was necessary to diagnose an ailment.

Then the doctor saved some of the tissue for the research project. The procedure involves placing a needle and catheter into a patient's neck guiding it with x rays down to the liver and removing a piece of the organ. The VA research safety board denied whoas initial project proposal for several reasons. In February 2013 Martina Buc chaired that committee at the time she said whoas plan to include pregnant veterans in a study that used x rays was the main reason x rays are a known risk for a developing fetus.

Here's Bob. I called for an internal review. On the basis of. It was an unethical proposition. And.

That's where the problem started. The San Diego VA would not grant an interviewed for this story a statement from director Robert Smith to our news source read in part quote While the bulk of these allegations were not substantiated were problems have been identified. They have been addressed or are being addressed and quote when asked about next steps Congressman Peters told a news source he'll ask by the end of this month for hearings on Capitol Hill news source investigative reporter Brad racino joins me now.

Brad thanks for being here. Thanks for having me. Tell us more about the research project Dr. Ho was conducting at the VA. What was the main focus of the research and why did he need the liver biopsies.

The main focus of the research was to improve the diagnosis of liver inflammation caused by alcoholism. That's me oversimplifying but that's basically what it was. It was a collaborative research effort that was led by someone on the East Coast it involved 11 different universities and hospitals and he needed these biopsies as part of that research. And the whistleblowers alleged that it also netted him some money that it would be each biopsy was worth about 15000 dollars. And because they were so rare it would lend him the opportunity to publish a lot in scientific journals going forward about these biopsies how many biopsies was he able to get.

According to the office of medical inspector report there were 28 patients that underwent this what's called a trans jugular liver biopsy.

So in all 28 patients and the whistleblowers say Dr. Who convinced the patients to undergo the liver biopsies by telling them it was necessary for diagnosis purposes. But how did Dr. Ho justify performing the biopsies to the V.A.. Was this a routine procedure.

So whenever you do this kind of research you have to go through what's called an IRP which is an institutional review board. And their main purpose is to protect human research subjects. Dr. Ho went through this process and told the IAB that this procedure was what's called standard of care which really just boils down to it's best practice. This is what other doctors are doing to diagnose ailments and this particular patient cohort. So that's what he said was that this is what's pretty much this is what everybody's doing.

And so you mentioned that Dr. Ho convinced everyone that this was a standard of care wasn't in fact. Is that true.

So it depends who you ask. But basically the Office of Medical Inspector to determine whether this was standard of care when asked another researcher or a professor at UCSD it turns out that guy was really conflicted because he had issued reports with Dr. Samuel Ho and these reports were concerning the biopsies that were under question. So he was relatively conflicted out. The Office of Special Counsel found a problem with that but also found that the VA had never performed this surgery before on this patient cohort. So they asked the question of if this was standard of care if this was best practice then what were they doing for all the years before this.

And so that hasn't really been resolved and that's why the OAC asked the Congress and president to look further into this and the whistleblowers in your story initially filed complaints with the San Diego V.A..

How did those complaints end up in the hands of federal investigators.

Well they filed complaints to upper management at both the VA and UCSD because those two institutions are so intertwined. Back in 2013 and they continue to follow up with allegations to upper management. And according to the whistleblowers nothing happened over those years. It was 2013 2014 2015 and into 2016 when they finally got fed up that nothing was happening they lodged complaints with the Office of Special Counsel which is in D.C. and handles whistleblower complaints at different federal agencies around the country.

And I understand that whistleblowers say they've also been retaliated against.

What have they experienced so Martina Buck who is one of the whistleblowers in this story. She was let go from the V.A.. Their reasoning was that she was causing a disturbance within the VA VA that she was acting out. And then at UCSD they let her go a few months later because she wasn't bringing in grants. She alleges that all this was because of what she did that she. She blew the whistle on upper management and a on a doctor. Mario Choucair who's the other whistleblower in this case told me that he has been retaliated against as well constant harassment by Dr. Ho and others in management at the V.A. and UCSD.

Now what does all this mean for the thousands of veterans who get their health care through the San Diego VA which has one of the largest research programs and the national V.A. network.

I would say that this means that if you are either at the VA or anywhere you go if you were asked to participate in a research experiment ask questions. Know what it's about. Get a second opinion. These can be relatively dangerous there are mechanisms put in place to safeguard patients. But as we see in this case in this what allegedly happened it can be dangerous so if anything comes up with research get a second opinion ask a lot of questions.

Federal investigators sent a letter to President Trump and Congressman Scott Peters is now involved what Peter said about what may come next.

So I sat down with him a couple of weeks ago and talked about this he says Well Peter sits on the House Committee on Veterans Affairs so he is very involved in overseeing the local VA. He told me that he will ask for hearings on Capitol Hill and expects them to take place in early 2019.

And you all are looking for other people who may have been involved in this research right.

Yes yes. We're asking anyone if they've had any involvement in Dr. Samuel whoas research know anybody that has or just have different information about this story or this series and they can reach out to us at a special e-mail we set up V.A.. I knew SourceForge that's a at I and E W S O U R C O R G.

All right and I've been speaking with Brad racino New Source investigative reporter. Brent thanks so much for joining us. Thanks for having me. I knew source is an independently funded nonprofit partner of KPBS.