Systemic Failures and Preventable Tragedies at the Tomah VA Medical Center

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By Ron Johnson (ed)
Year: 2016
Pages: 376
Binding Paperback
ISBN 978-1-4578-6447-6

Product Code: 1457864479

Description

The report of an investigation of the systemic failures across the executive branch that led to preventable tragedies of the Veterans Affairs Medical Center in Tomah, WI (Tomah VAMC) -- the veteran deaths, abuse of authority, and whistleblower retaliation. The Tomah VAMC became known as äóìCandy Landäó for its easy access to prescription medications. Allegations of drug diversion, opiod over-prescription, retaliation, and mismanagement festered. As a result, veterans died. Contents of this report: The scope of the investigation; missed opportunities to prevent the tragedies at Tomah; The Veterans Affairs Office of Inspector Generaläó»s (VA OIGäó»s) health care inspection of the Tomah VAMC; whistleblower retaliation and a culture of fear at the Tomah VAMC; attempts at stonewalling the investigation; increased accountability since the investigation; recommendations. Figures. This is a print on demand report.

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