Rep. Brad Miller and Dr. Anna Chacko: The Politicalization of Government Health Care

Late in the afternoon of December 4th of 2006, laboratory staff of the Veterans Administration Pittsburgh Health Services (VAPHS) based on an order from Dr. Mona Melhem, the associate chief of clinical services, a few minutes earlier – in less than three hours destroying a unique collection of legionella and other isolates that had been collected by two prominent infectious disease researchers over their nearly three decades of research.

So starts a report by the Science Sub Committee chaired by Congressman Brad Miller of the 13th District of North Carolina into a strand of legionella that was destroyed by the Pittsburgh VA and with it thirty years of research by Dr. Victor Yu and his partner Dr. Janet Stout.

This report and its conclusions began a series of events that climaxed with this news broken on in January by Walter Roche of the Pittsburgh Tribune about the same Pittsburgh VA.

A top Pittsburgh Veterans Affairs physician, who got her job back temporarily after congressional intervention, is about to be terminated from her position as the head of radiology in the Pittsburgh facility.

VA officials have issued a formal notice of termination effective Jan. 25 to Dr. Anna Chacko, who has been on administrative leave from the University Drive facility since October.

What, one might ask, does an investigation into a destroyed strand of legionella have to do with the firing of the chief of radiology at a hospital nearly two years later? In reality, the two probably have little do with each other, except in the mind of Congressman Brad Miller. Because Miller made a connection, the events of one lead directly to the events of the other.

In my opinion, the events that lead to the destruction of this legionella is a classic case of he said/she said. In the summer of 2006, Dr. Vu and the administration of the Pittsburgh VA got into a dispute that turned acrimonious and ugly. The Pittsburgh VA claimed that Dr. Vu was running a private business out of their lab. Dr. Vu claimed that he had been doing this since 2000 and no one had a problem until 2006, when he and hospital administrator, Dr. Mona Melhem, began clashing. The Pittsburgh VA claims that Dr. Vu was fired for insubordination and the lab was being closed because it was inefficient and a “drain on VA resources“.

From there, the VA, at the direction of Dr. Melhem, cleared out what they claimed was biohazardous material that wasn’t marked out of this lab. Dr. Yu, meanwhile, claims that he was making arrangements to move said strands of legionella to another facility when this order was given and he claims the strands of legionella were clearly marked.

After having his life’s work destroyed, Dr. Yu reached out to the Science Committee and the result was this investigation that ended in September of 2008. Whatever the truth is in this situation, it’s clear who the Science Sub Committee felt was at fault, Dr. Mona Melhem and the administration at the Pittsburgh VA. (it should also be noted that these events are now the subject of litigation)

Meanwhile, Dr. Anna Chacko arrived at the same Pittsburgh VA shortly after the investigation concluded. Even though Dr. Melhem was one of those responsible for bringing her over, Dr. Chacko immediately began to attack her competence and integrity. For instance, Dr. Chacko complained to the VA administration that Dr. Melhem was endangering patients by authorizing the use of Thallium in radiological tests. Dr. Chacko felt that Molybdenum should have been used instead. (The VA IG later found those charges to be without merit) Then, in the beginning of 2009, an employee of the Pittsburgh VA slipped in their driveway and was concerned they had broken their wrist breaking their fall. Dr. Melhem approved for the Pittsburgh VA to x ray the employee even though they weren’t a patient of the hospital. Dr. Chacko called the VA whistle blower line and accused Dr. Melhem of “fraud” in this incidents.

Chacko’s complaints became so loud that the Pittsburgh VA convened an administrative investigative board in March. Only by then, much of the radiology department had complained formally to the VA about Chacko’s behavior. As a result, the board convened not to hear testimony about this incident but about Chacko’s behavior. In April, the board recommended that Chacko be removed.

Chacko hired a lawyer and she reached out to Congressman Miller. It appears that Dr. Anna Chacko convinced Congressman Brad Miller that her own ouster was being orchestrated by the same Dr. Mona Melhem. That’s because Congressman Miller wrote exactly that in this letter to General Eric Shinseki.

Senate Letter 2009-05-19[1][1][1] –

Weeks later, General Shinseki put the word down to the Pittsburgh VA not to remove Chacko and she was reinstated. Her behavior didn’t improve following her reinstatement and things climaxed with the news broken that Dr. Chacko has been terminated. (that’s no small feat because a termination is something that must be disclosed to any medical board and usually means the end of someone’s medical career)

Everyone has a bias. As a conservative, I am likely to reject most if not all government programs. When we allow our biases to cloud our judgment, we become dangerous. Congressman Brad Miller has a bias against the Pittsburgh VA and Dr. Mona Melhem. When Wally Roche interviewed Miller, Miller explained that the hospital was “given to infighting” and in “chaos”.

What is less clear is how much Congressman Brad Miller knew about Dr. Anna Chacko prior to writing this letter. Prior to arriving at the Pittsburgh VA, Dr. Chacko spent fourteen months at St. James Hospital in Butte, Montana. During that time, her name is mentioned in no less than four lawsuits. Chief among them is this lawsuit filed by then radiology manager Kristi George against Chacko and the hospital.

Looking at numbers 12-16 of the complaint, it details how Dr. Anna Chacko started working at St. James, immediately began attacking George’s competence, integrity, and credibility, and then number sixteen reveals that Kristi George returned from vacation. In other words,according to the suit,  Dr. Anna Chacko began attacking Kristi George before they’d even worked together.

Prior to her sixteen months at St. James, Dr. Chacko spent about a year at the Boston University Medical Center until charges of sexual harassment forced her to leave. Prior to that, Dr. Chacko spent about five years at Lahey Clinic in the Boston suburb of Burlington where she was famously carried out of the hospital screaming…

Kiss my big Indian Ass

It’s clear that Congressman Miller thought that the Pittsburgh VA was rotten. (the letter leaves no doubt) It’s further clear that his previous investigation into this VA has lead him to this conclusion. (again, the letter leaves no doubt) How much did he know about Dr. Anna Chacko before concluding that fault lies with the administration? Did he know about George’s lawsuit? Did he know that Chacko, now 64, spent time in Boston, Butte, and Pittsburgh, all since 2006? Did he know about the charges at the BU Medical center or the manner in which she was carried out at Lahey Clinic?

Miller told Roche that he plans no further involvement in these matters. I should hope not. After all, hasn’t he done enough? There’s a dynamic to stories like this. Now that Chacko has been removed, it will likely go away. After all, the problem has been resolved. The problem has NOT been resolved. The problem is Congressman Brad Miller’s judgment, as well as the judgment of General Eric Shinseki. They inserted themselves into a situation of which they didn’t have all the facts. As such, they sided with the individual that was causing the problems. Just because Dr. Chacko has now been removed, doesn’t mean that both these men don’t have a lot to answer for.

For instance, according to this article, Congressman Brad Miller was one of three to send a letter to the Secretary of Navy regarding funding of health studies related to the contaminated drinking water at U.S. Marine Corps Base Camp Lejeune in North Carolina. Given what we know about this situation, is anyone reading this really all that confident that Congressman Miller had a grasp of that situation before writing that letter?

This is about judgment and power. Congressman Brad Miller has a lot of the second and the first is in serious doubt. That’s a very dangerous combination. Dr. Anna Chacko is a manipulator. That’s what she did while serving as head of radiology at Lahey Clinic. It’s what she did in the same post in St. James. In the same way, she manipulated Congressman Brad Miller and made him believe something that was simply not true. As a result, he acted and Dr. Anna Chacko manipulated the situation in her favor.

It’s really as simple as that, and nothing Congressman Brad Miller will say can change that. Nothing that happened between September 2008 and the present had anything to do with the legionella investigation. Whatever Dr. Mona Melhem may, or may not have done in that situation, it doesn’t change how Dr. Anna Chacko behaved upon arriving at the Pittsburgh VA. It doesn’t change that her behavior warranted her removal in April. She would have been removed had Congressman Brad Miller not decided that the internal dynamics of the Pittsburgh VA were his jurisdiction. When he did, he had a duty to everyone to be right. In fact, he was wrong, and he couldn’t have been more wrong. Such a lack of judgment combined with a plethora of power is a dangerous combination. Those in the thirteenth district of North Carolina should heed that come November of 2010.