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Distance, Delays and Denial: VA's broken transplant system

<p>Tammy Baggett, U.S. Navy Veteran</p>

Tammy Baggett is living off borrowed time. In 2014, the 42-year-old Navy veteran went to Atlanta’s Veterans Affairs hospital after falling ill. After hours of prodding, exams and blood draws, tests revealed she likely had been living with leukemia for years.

“[Doctors] said your only chance at survival would be the bone marrow transplant,” Baggett told 11Alive in July.

Baggett received a transplant, but not from the VA. According to Baggett, the VA told her it would only do the procedure if chemotherapy put her leukemia in total remission for safety reasons.

She never went into total remission and the VA denied her transplant. So, Baggett got another opinion from Emory University Hospital, about two miles away. Emory surgeons agreed to do the transplant.

While the transplant did not eradicate the leukemia, Baggett believes the surgery kept her alive for two years longer than if she had stayed with the VA transplant program.

“I think I would be dead,” said Tammy after a recent chemotherapy appointment. The Atlanta-area single mother is not expected to live through August.

A nation-wide investigation conducted by 11Alive and TEGNA-owned TV stations across the country uncovered Baggett isn’t the only veteran denied by the VA. According to a 2012 Inspector General’s report, three different VA transplant centers denied a Minnesota veteran a liver transplant.

Related: KVUE News/Austin reports on VA transplant program problems

“[I was denied] three times for liver transplant by three different [VA] transplant centers. I was given three different reasons,” wrote the veteran in the report.

The veteran received a transplant from a non-VA hospital after a surgeon determined the veteran was “a good candidate from a surgical point of view.”

Read the Inspector General investigation here

Blowing the Whistle

Jamie McBride is program manager for a VA transplant system in San Antonio, Texas.

After five years working at the VA, he’s putting his job on the line to speak up about the problem. In June, he submitted a compliant to the VA Office of Inspector General outlining other transplant denials.

Nothing happened.

Jamie McBride is program manager for a VA transplant system in San Antonio, Texas. He&#39;s now spaeking up about the transplant issues he sees.

“I've gone through every channel we can and the reason that I'm here speaking about it is because the problems have not been solved,” said McBride.

On multiple occasions, the registered nurse says the VA had the opportunity to pay local transplant centers to perform operations, but still required the veteran to travel thousands of miles to a VA center instead.

“They’re uprooted from their homes. They’re uprooted from the jobs. They uprooted from the families,” said McBride. “It’s an unimaginable burden for these people to be uprooted.”

McBride believes ineffective transplant polices have likely contributed to thousands of veterans’ deaths. “I know deep down we can change this,” said McBride.

Pam Moore believes her husband, John, is one of those veterans. The VA put the Minnesota Army veteran on a liver transplant waiting list in 2012.

After four years on the liver transplant waiting list, veteran John Moore passed away.

While nearby University of Minnesota Medical Center performs liver transplants, the VA wouldn’t pay for it. Instead, it required the 60-year-old to travel hundreds of miles away to Houston’s VA transplant center to wait for a liver. “We had to go to Texas every three months,” said Moore.

After four years on the waiting list, Moore died in February 2015.

“If it would have been done here, I think he would have had it. I think he died unnecessarily. That’s truly what I believe," Moore said.

Map of VA transplant centers

Map showing VA National transplant program

In most cases, the VA will only pay for a veteran’s transplant if they use one of its 13 transplant centers across the country. So, if a veteran lives in another state, they’re required to travel no matter how sick they become.

The VA’s policy could be putting veterans in danger.

According to a 2014 University of Pennsylvania study, it found veterans waiting for liver transplants, who traveled 100 miles for treatment, had a “lower likelihood of receiving a transplant and increased mortality”.

Dr. David Goldberg is the lead author of the study. “They have less access to a lifesaving transplant, which directly correlates to a higher chance of dying from liver disease,” explained Goldberg.

If the VA had approved Baggett’s transplant, she would have been forced to travel to Nashville.

San Antonio Army veteran Aaron Arch, in need of a lung transplant, will soon have to travel 1,200 miles to Madison Wisconsin for his operation.

“If something doesn’t go as well as hoped that would be where my story would end. It’s a long way from home,” said Arch.

In 2014, President Obama signed the Veterans Access, Choice and Accountability Act to address treatment delays at VA hospitals. Its goal is also supposed to help veterans receive care from local healthcare providers if veterans live more than 40 miles from VA hospital facilities.

McBride says the VA’s transplant program has not followed its own rules.

“If the VA is not going to offer the service that they need, then at least allow the veterans the opportunity to go to the community; get the insurances they need, Medicare, Medicaid that sort of thing, and pursue transplant locally,” said McBride.

The VA administrator in charge of the transplant system is Dr. William Gunnar, National Director of Surgery. For nearly a month, the 11Alive Investigators requested an interview with him about the problems we uncovered.

The VA said he was “on leave” and unavailable.

In an email, the agency wrote, “VA’s Transplant Program outcomes compare favorably to all United States Transplant Centers as publicly reported by the Scientific Registry for Transplant Recipients (SRTR).”

While the VA explains it “has the authority to refer a Veteran for transplant care in the community in the case that the VA Transplant Program is not feasibly accessible,” it also admits when that happens, it negatively impacts the efficiency of its transplant program.

Read the full statement from Department of Veterans Affairs

McBride believes the VA is more concerned with keeping its transplant program efficient than doing what’s best for veterans.

“We’re basically trying to sell them on something that we don’t necessarily believe in ourselves,” said McBride.

Continuing coverage: Part two of Distance, Delays and Denial continues Tuesday, with reaction from lawmakers and more examples of VA policies some believe put veterans at risk. Watch the 11Alive Investigators after the Olympic games on Tuesday night.

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