Tucson VA Hospital

To: AZ medical board July 3, 2018
From: Robert N. Weismiller
Tel: [protected] Email: [email protected]

Sir/Ma’am,

I am writing to you to complain about a couple doctors at the Tucson VA hospital.

Below is a copy of a Federal Tort Claim I just filed against the government concerning the ill-treatment I received there.

Short version

1. I accuse the Tucson VA Medical Center, Marc O’Cleireachain MD, Cameron Hinkel MD and Josephine Jarlego RN of medical malpractice, failure to diagnose and treat a bile leak following gall bladder removal, inappropriate hospital discharge, Peritonitis, emergency surgery required at second hospital, substandard care, gross negligence, neglect, abuse, continued digestive problems and failure to adequately treat pain.

2. I also accuse above said parties of negligent infliction of lasting emotional stress, to include panic, trauma, sleep loss, distress, anger, isolation, anxiety, fear, humiliation and aggravation of a pre-existing mental condition.

3. I have credible witness’s ready to make statements.

4. Staffing possibly below federal standard… this hospital is notorious for understaffing.

5. HIPPA violations.

6. Numerous violations of Patient’s Rights

7. I was literally tortured and screaming in post-op for 4 days. It was suppose to be an outpatient operation. It was absurd. I was in extreme 10/10+ episodic pain 8-12 hours at a time, but was refused adequate pain medication; I was accused of making it all up and was mistakenly profiled as a “drug seeker”.

8. No tests were done for a possible bile leak.

9. WBC and liver tests were out of range right out of surgery and not within limits at discharge.

10. I was neglected and became extremely dehydrated for several hours.

11. I was bullied, berated, abused and disrespected by my doctors.

12. A particular nurse was especially incompetent.

13. False statements have been made in the record and to me personally.

14. I was discharged on the 4th day and told by my doctor “don’t come back unless you are bleeding”.

15. Fearing for my life, with extreme 10/10 pain, high fever and an infection, I went to the university hospital for 4 more days. Bile leak found. 2 procedures; IR abdominal drain and ERCP/stent installed.

16. I would have died of sepsis if I had not gone to the second hospital. I had no reason to believe the VA would not further neglect and kill me.

17. 6 weeks of pure misery at home alone again without adequate pain control or support from my “trauma team”. Could barely take care of myself. Feared death constantly.

18. Further complications… another ED visit in the middle of the night… further misdiagnosis, another IR drain installed, further nitwitery.

19. Total loss of confidence in second hospital and second surgeon as well. They terrorized me also.

20. Found a private Doctor to remove the biliary stent (ERCP) at a 3rd hospital (private rather than public). Excellent service. Most professional. No bile leak since final procedure, 05/17/18.

21. 2 months extreme pain, suffering, worry and fearing for my life, at the hands of incompetent idiots. Lucky to be alive. My mental health condition for which I am disabled via VA/SSA is seriously aggravated by this incident and I’ve been in therapy since.

22. Estimated medical expenses = $30-50k? (still getting bills)

There’s more…
(see below for a more detailed account)

Detailed version

I hereby accuse the Tucson VA, Marc O’Cleireachain MD, Cameron Hinkel MD, and Josephine Jarlego RN of medical malpractice, failure to diagnose and treat a bile leak following gall bladder removal, inappropriate hospital discharge, Peritonitis, emergency surgery required at second hospital, substandard care, gross negligence, neglect, abuse and failure to adequately treat pain.

For as many bad things as I’m about say, I must absolutely commend the exemplary efforts of nurses Tia Jones and Kevin Walker on the surgical recovery floor. I thank them for their professional service at the VA. They were VERY competent, caring and helpful throughout my stay. They did everything they could for me, in spite of the nitwits they work for and those around them.

I’m neither a lawyer nor a very good writer but I’ll try my best here. I’ve shortened this story down but it’s still long. Please forgive me but it’s necessary.

1. On 03/21/18 I had a botched routine gallbladder surgery (bile leak discovered 6 days later, see below) at the Tucson VA. Fearing for my life, with extreme 10/10+ stabbing pains to belly and chest, and told repeatedly by VA staff that there was nothing wrong, I had to go to another hospital for help. I’ve been to emergency rooms screaming a couple times since, had 6 surgeries/procedures, and have been in 3 different hospitals for a total of 10 days. Banner/University Hospital quickly found the bile leak and saved my life. I spent most of the next 6+ weeks at home alone in absolute agony, again without adequate pain medication, fearing for my life and worried I was going to get SEPSIS. I have never experienced extreme long-term pain like that in my life and I’ve never been so absolutely SCARED. I had unspeakable things happen to me in the service that I am disabled for… I’ve been in car wrecks, motorcycle accidents and near plane crashes… but I’ve NEVER been traumatized like this. I was quite literally TORTURED at the hands of the Tucson VA staff. I’ve never screamed so loud and for so long… I’m sure… SINCE I WAS A BABY… If I didn’t have a credible witness I would doubt my memory of these absurd events. Today I have zero confidence in VA health care, and I’ve essentially lost my hard earned benefits because I can never go there again in good faith. I NEVER imagined that something so terrible could happen to me.

2. I spent 4 days on a VA recovery ward with NUMEROUS 8-12 hour bouts of episodic
10/10+ pain, screaming for help, and worrying I was going to die. With no tests for a bile leak done, I was mistakenly profiled as a substance abuser looking for a fix and denied adequate pain medication. O’Cleireachain misdiagnosed me as “having a strong reaction to the Co2 dissipation”. Numerous untruths and omissions were made in the record. Throughout my stay on this ward, Marc O’cleireachain misdiagnosed and mistreated me. He was rude, bullying, condescending and dismissive towards me. He was berating and disrespectful. He was grossly ill informed.
My friend/advocate who witnessed 12 hours of this madness termed it “The Carnival of Incompetence”.

3. A nurse named Tia Jones told me on March 22-23 in the middle of the night “your doctor is under-medicating your pain because you are a substance abuser”. In the record I am repeatedly and INCORRECTLY described as an “alchoholic” and a “poly-substance abuser”. I AM NOT an alcoholic or a substance abuser. They got that from an OLD problem list entry from 1991 when I went to a private rehab. I’ve never had any problems with alchohol or substance abuse for the 25 years since and my VA record clearly indicates that. The Tucson VA privacy officer has since had these items deleted from my problem list because she agreed that this information had catastrophically affected my care. I didn’t want it to happen again.
It seems to me that denying a post surgical patient adequate pain medication is a direct violation of my patient rights. It says in the Patient Bill of Rights that a patient has a right to be adequately medicated for pain. What the HECK? When asked my level of pain on a 10 out of 10 scale I screamed ” 10 out of 10… 110 out of 10…. 1000 out of 10″. Nobody believed me. Jesus, I get it that we have an opioid epidemic but I have nothing to do with that. Why on EARTH was I denied adequate pain medication?? Why was I tortured? Why was I misdiagnosed? The VA has given me no answers…
As well, I also believe that my mental health diagnosis negatively influenced my care… “Bipolar disorder, PTSD, and Anxiety” are all there beside my name also, every time I’m mentioned in the record. Dr. O’Cleireachain stated at one point that I was “creating my pain out of my anxiety disorder”, or in simpler terms MAKING IT UP. Why were these factors allowed to negatively influence my care? This is a typical example of “diagnostic overshadowing” and it is NOT ethical. It indicates to me that this doctor is NOT well trained, ESPECIALLY TO WORK WITH VETERANS, many of whom DO have mental health diagnoses… This man has no business working with us. We deserve much better. My so-called “Doctor” also felt it necessary when I was at about the lowest point, in absolute agony and fearing for my life, to tell me that my PTSD diagnosis is [censored]. He said to me condescendingly “EVERYONE HAS PTSD… MY WIFE’S A PSYCHOLOGIST SO I KNOW”!! He actually said that…
On the 3rd day, during a lull in the pain, I was sitting in a chair resting. O’Cleireachain walked in the room, came up to me with his arms folded, glaring and looking disgusted with me… He got in my space and stood over me like a tough guy… He was like an inch from me, and lectured me further about how I’m making this all up. At some point I’d had enough of him standing that close to me and I stood up and went chest to chest with him and asked him to BACK THE [censored] OFF… He refused and stood me off, glaring at me like he was about to strong-arm me. What a tough guy.
There I was, spewing caustic bile into my guts, and this guy is treating me like this… This is not acceptable.
Ironically, after a little research, I see that Dr. O’Cleireachain has actually had substance abuse problems himself and the New Mexico medical board prohibited him from drinking alcohol or using mind altering substances in early 2017 . I’m NOT happy to know this.

4. I also suspect that the VA recovery room was understaffed at times and out of adherence with federal standards… My witness brought this to my attention. The logs should be checked. The amount of incompetence and negligence was absurd. The supervising “Dr. Son” mentioned in the record was NEVER present although I begged to see a REAL DOCTOR rather than an intern many times. Dr Hinkel told me “For the purpose of your recover I am your doctor”. I don’t believe this intern was qualified to fit that position. Dr. O’cleireachain showed his face only 2 times in 4 days and only after I BEGGED, but just long enough each time to lecture and berate me and make me feel like a PUSSY for not tolerating pain to his standard.

I’m serious; it was like a horror movie. I asked at one point “WHAT IS THIS, SOME KIND OF CIA/KGB TRAINING PROGRAM? A NAZI CONCENTRATION CAMP??”. They seemed at many times in no way prepared to deal with what I was going through. I was in SO MUCH PAIN. It hurt MUCH more than the gallstones did in the first place and they’d given me MORPHINE for that in the emergency room a couple times.
Doctor Cameron Hinkel and a nurse named Josephine Jarlego were also particularly incompetent. I was sure they were going to kill me. They allowed me to get dangerously dehydrated, threw my liver tests for a loop (see the record), and let me ring my bell screaming HELP for up to an hour at a time without responding. The little amount of urine in my foley catheter bag was the color of root beer. The saline drip rate was set at a mere 220ml/hr. I remember the order being made. I thought that was ridiculously low since I just came out of surgery and was PARCHED… Nurse Jarlego giggled and made fun of me when I was moaning and crying in the hallway trying to walk off the pain. She too thought I was just overreacting to the gas, or faking it to get pain drugs.

My visiting friend and advocate Jon Paul Devore witnessed this particular episode for 10 hours on of Mar 22nd (statement attached). He came when I sent him a MAYDAY text in the early afternoon. For a few hours my friend found himself ordering these people around because they absolutely did not know what they were doing. He demanded fluids and got a couple liters of drinking water in me. But still I was having the violent 10/10 stabbing pains to my stomach and chest. I was dying before their eyes and they were clueless. It was quite some time before they increased the rate of the saline drip.
My stay was prolonged by the liver test problem actually rather than because I was screaming in pain. Both of these Docs were oblivious to the fact that they had nearly dehydrated me to death. Doctor Hinkel admitted to me on day 3 that he had in fact made an error and HE ACTUALLY APOLOGIZED TO ME… how amazing. The record seems to also indicate that my WBC and liver tests were not normal even as i came out of surgery, indicating more likely than not that I was leaking bile from the start. No one seemed to care for a couple of days. They couldn’t be bothered.

5. I begged to no avail for further tests, an ultrasound or a HIDA scan, but was told by all parties that this pain was all NORMAL because of the dissipation of the Co2 gas used in the surgery… and that I was exaggerating; and being dramatic, making it all up and that I’m a “DRUG SEEKER”. Dr. O’Cleireachain even went so far as to accuse me of “PANTOMIMING”!!! You’d think they would have wanted to be sure I didn’t have a bile leak but they were too busy thinking I was a FIEND trying to get pain medication or just over reacting to the Co2 gas. They did not have their eyes on the ball, AT ALL.

6. On the 4th day, during yet another lull in the pain, I was discharged and told by my surgeon Dr. O’Cleireachain, and I quote, “DON’T COME BACK UNLESS YOU ARE BLEEDING”. I’m absolutely SURE this is what he said because I asked him specifically. It was a very important question. It was my last exchange with him before I left. The 10/10 stabbing pains had been episodic and I wanted to know at what point it was going to be bad enough to be taken seriously? He more accurately said “don’t come back unless your INCISIONS open up and you are bleeding

7. Once home and some hours later, with pain again in full swing, I went screaming AGAIN in an ambulance, this time to the University hospital, which was closest. I DID NOT GO BACK TO THE VA BECAUSE I FEARED FOR MY LIFE. After what I experienced there previously, I feared they were not going to take me seriously and were going to let me DIE. I did not think they were going to give me any tests. They were going to continue with this farce, tell me the Co2 was the problem, BERATE ME FURTHER and tell me to go home. They also were not going to stop the pain. I was terrorized, traumatized and in a [censored]load of pain for many days at this point… AND… Dr. O’Cleireachain had told me “DON’T COME BACK UNLESS YOU ARE BLEEDING”… I could NOT go back to the VA… I still cannot believe this happened. IF I’D GONE BACK TO THE VA THEY WOULD HAVE KILLED ME…

8. I spent 6 days in the University hospital. I arrived with a fever and an abdominal infection. I was treated with antibiotics. I had 2 procedures done finally, one to install an abdominal drain to extract the spewed bile, and another to put a stent in my common bile duct so the leaking cystic stump could heal itself shut. They said it was amazing that I didn’t have Sepsis. I spent the first 44 hours in the emergency room, in a cold “cell”, doped up on Fentanyl, listening to the schizophrenic next door yelling and smearing her [censored] all over the walls and windows. Really… more horror movie material.

9. Although the food there was better, the care at this teaching hospital was equally incompetent and as scary as the VA. You don’t get to talk to a real doctor and are left at the mercy of more know-nothing interns… They give you half answers and conflicting opinions. Few of them know what they are doing. After 4 days they pushed me out the door with very scant and contradictory instructions especially in terms of self-care. I had an abdominal drain and I had no idea where it went, what it actually did or how to take care of it. I knew nothing about changing bandages that you need 3 hands to accomplish. I knew nothing about sterile practice. I had nobody at home to take care of me. Nobody from my “trauma team” at the hospital would call me back when blood started flowing out of the drain, or when I had more bouts with pain. If it hadn’t have been for YOUTUBE I’d be dead. All they would say was to go back to the ED if I wanted to… which I DID NOT after my grueling experience the first time. I didn’t want to go back if I didn’t have to. I feared for my life that I would get an infection waiting again there for 2 days. I just wanted a little phone triage but they don’t offer that there…

I don’t live in this city. I’d come from overseas to try to help my ailing parents just a couple months before. I was alone, terrified, pissed off at these doctors and worried seriously about dying. I suffered in more horrible pain from 2 misplaced drains for 5 weeks staying in an RV, while I waited to get the stent out. I went to the emergency room again in agony once more. I spent 14 excruciating hours there in the middle of the night on April 2. I got misdiagnosed with opiate induced constipation by more nitwit interns and was sent home to suffer alone some more. 4 weeks later when they pulled the drains it became apparent then that THEY were the cause of the pain.

10. Rather than give me even a lick of assurance, the UMC surgeon refused to meet me in person and chose instead to terrorize me FURTHER over the phone with worst case scenarios and scenes of deepening complications. It was clear that he either didn’t know how to fix me, or that he was trying to get me to go back to the VA so his friend O’Cleareachain could save some face. (it became apparent in the second hospital that local gastro docs of course all know and cover each others asses). This was not the first time I was prodded to go back to the VA. An intern named Ashley Northcut told me the 3rd day “Ok, you’re ready to go back to the VA”. O’Cleireachain encouraged me twice to come back to the VA, once at our post-op appointment and another time when I ran into him at the University hospital. He was so nice to me, all professional and smiling and acting like none of what I’ve stated here had happened or maybe hoping that I’d forgotten all these details in the haze of the pain and the Hydrocodone. “You’re always welcome back at the VA, you know!!” he said like 4 times.

Scared [censored]less and bewildered I decided the second guy was NOT the guy to get me out of the woods. I did not trust him to manage any further possible complications.

11. I was so scared and desperate at that point that I actually went back to the VA and asked if THEY could take the stent out. It was absurd but I felt I had no choice. I felt they had more skin in the game. I wanted somebody to tell me they knew what the heck they were doing. It was a horrible position to be in. I was scared to death to even go to the VA hospital, but the stent needed to come out before it malfunctioned and caused problems. Without help I was going to die. I wanted someone to tell me they knew what the heck they were doing and to give me some confidence. O’Cleireachain seemed eager to wipe some egg off his face and was anxious to take me back. With hesitation I agreed.

12. BUT… luckily at the last minute I found a very reputable private Doctor with many years of experience and a “5 star” WebMD.com rating to remove the stent on short notice. He did it on 5/17/18 at Tucson Medical Center, a private hospital. He had complete confidence and absolutely knew what he was doing. He was MOST assuring and in no way a nitwit. The difference in this case between a private and a public doctor was shocking. I gladly cancelled the appointments at the VA and at the University.

13. I will never be the same after this ordeal. I’m sure it’s taken 10 years off my life. I’m TERRIFIED. I can’t sleep. I lay awake in bed every night with my heart pounding, playing this all out in my head, OVER AND OVER. I’m never going to forget this for as long as I live. I am livid and feel unduly victimized by these NITWITS. Good LORD… This did NOT have to happen. I will NEVER forget being TORTURED. That is NOT acceptable. I will never forget the experience of being in extreme pain for that long. I will never forgive them for unduly withholding pain medication.
I will never forgive them for failing to diagnose me when they could have done do so easily with some simple tests.

If Doctor O’Cleireachain had just admitted he made a mistake and apologized to me, I would not be filing this claim. But instead Dr. O’cleireachain has insisted on making bold-faced lies and seeking to cover his ass. He has made false statements to me and he has falsified the record. He says he told me at discharge to “return if my pain returned”. He says this in the record too. THIS IS A BOLDFACED LIE… HE TOLD ME TO “COME BACK WHEN YOU ARE BLEEDING”. I believe that Dr. Hinkel was present when he said this. “Marc O’Cleireachain, M.D. bullied me, disrespected me, humiliated me, MISDIAGNOSED ME and ALMOST KILLED ME.. When I later tried to talk to him about it in early April, he ran me over and told me none of that happened, like I was making it up. He gas lighted me. He said he did not deny me adequate pain meds because he thought I was a substance abuser, but instead “because there was no Fentanyl or morphine in the stores”. What? How could this possibly be? He also made up the ridiculous notion that my bile leak did NOT start until AFTER I was discharged. This is simply not true. The record was written to minimize the horrible experience I had those four days. My experience was much more difficult than they recorded, and I was certainly leaking bile from the beginning. The tests indicate that likelihood and the symptoms had been the same for 6 days by the time I went screaming to the second hospital.

The record also says that my pain always responded to narcotics. THIS IS NOT TRUE. Why else did I have several 8-10 hour bouts of extreme pain??

For Christ’s sake, come on people. The VA needs to be better than this. Veterans deserve MORE. How many Veterans have to suffer at the hands of these quack second-rate doctors at the VA before something changes?

13.5. In early April I was told by the VA privacy officer Donna Wilson that the VA and University doctors might have violated my HIPA privacy rights… It turns out that these people are all colleagues. Gastro Docs all know each other, went to school together, and do shifts at both hospitals… They go to conferences together. I NEVER gave my permission for them to talk about me. The University hospital cannot produce a document I signed giving my permission. I realize there is perhaps an implied consent for pertinent information but not for casual conversation or to cover each others asses. It’s become clear from conversations with them all that they had talked quite a bit. The university docs wrote in the record that I’d had a “normal course” at the VA… WHAT?? I’d told them quite loudly exactly what had happened at the VA. THIS IS NOT ACCEPTABLE AND I’D LIKE IT LOOKED INTO.

14. As for pain and suffering, I have no idea what to ask for here monetarily. I have no experience in this realm. I’m guessing at the number. What I’ve claimed is a quarter million dollars, approximately $4000/day for pain and suffering for 60 days… IT’S NOT ENOUGH. If somebody offered me $4000/day to be tortured and in pain, worried and afraid for 2 months I WOULD SAY NO… and so would anybody else… No amount of money is EVER going to make this right.

Please tell me what the government would offer in such a case??

As for damages other than pain and suffering, I estimate I will owe between $5-10, 000 dollars in co-pays for the non-VA care I received. I’ll have a more accurate number in a month or two.

Hopefully I don’t start leaking bile again or have any further complications. According to O’Cleireachain the titanium clips he used on my cystic duct have all fallen off… so… they are floating around in my guts… there have been complications connected to these clips. O’cleireachain just shrugged when I asked him about them. I was told by the second surgeon that once you’ve leaked you are always at risk. The 3rd surgeon says I’ll be fine. Good GOD… Only time will tell.

15. I am disabled and do not work. I have no loss of wages.

16. And finally, to be very clear again:

I DESPERATELY FEARED FOR MY LIFE AT THE HANDS OF THE TUCSON VA AND HAD NO CHOICE BUT TO SEEK ANOTHER PROVIDER.

Had I not, I WOULD NOW BE DEAD…

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