Fourteen years ago, an ABCNEWS hidden-camera investigation ignited a firestorm about conditions and competence inside Veterans Administration hospitals.
Recently, there have been new stories of misdiagnosis, disastrous management and deficient care at some of the nation's 162 facilities.
At a hospital near Cleveland, an ABCNEWS hidden-camera investigation found bathrooms filthy with what appeared to be human excrement. Supply cabinets were in disarray, with dirty linens from some patients mixed in with clean supplies, or left in hallways on gurneys.
At a neighboring facility, examining tables had dried blood and medications still on them. In several areas, open bio-hazardous waste cans were spilling over. Primetime obtained internal memos documenting that the equipment used to sterilize surgical instruments had broken down — causing surgical delays and possible infection risks.
With 130,000 young American men and women putting their lives at risk in Iraq today, these conditions are particularly relevant. While current soldiers are treated in military hospitals, when they leave the service and need treatment, many will seek care at Veterans Affairs (as the Veterans Administration is now known) hospitals.
"Once you come back to be a veteran, it's like a black hole, you know — nothing," former Army Sgt. Vannessa Turner told ABCNEWS.
Turner was stricken with a mysterious illness while on duty in Iraq this past year. She retired from the military on medical grounds, and when she reported to a VA hospital for treatment, doctors scheduled her for an appointment six months later.
Not a Point of Pride
Veterans who responded to a survey by the American Legion in 2003 said it took an average of seven months to get a first appointment at a VA hospital. In some hospitals, patients have waited as long as two years.
In 1999, Jack Christensen, a former army sergeant who served in the Korean War, was admitted to the VA hospital in Temple, Texas, with pneumonia, and ended up staying three years.
Christensen's wife, Pat, says the attitude of some of the practical nurses was shocking. Some of the patients were forced to beg for food and water, she says. Instead of helping her husband go to the bathroom, she said, "they would put a towel under his hips and tell him to use the towel."
Pat Christensen said her husband's condition worsened over several months — so badly that at one point he developed horrific bedsores and dangerous infections, and she says his doctors said they would have to amputate his legs.
Pat moved her husband to a private facility, where his infection healed and he underwent extensive physical therapy. She sued the VA, and then used the money to pay for private care for her husband. The VA denied liability but paid a settlement.
Dr. Jonathan Perlin, the deputy undersecretary for health, said the VA system has sophisticated quality control. But when he was shown ABCNEWS' hidden-camera video of hallways and supply closets in disarray, he said, "This is something we're not proud of."
Critics have long charged that the VA system puts patients on a kind of assembly line, passing them from doctor to doctor.
There's also criticism of how the VA uses residents — doctors still training and not certified in their specialties.