Before former Chief of Surgery Dinesh Ranjan became a focal point for controversy at the Roseburg Veterans Affairs Medical Center, he worked at the Iron Mountain VA, in Michigan’s rural Upper Peninsula. Independent investigators recently raised concerns about colonoscopies performed by Ranjan and other doctors there, the Iron Mountain Daily News reported last week.
Ranjan stepped down as chief of surgery last month in the wake of allegations of bullying and whistle-blower retaliation. He’s currently working for the VA Northwest Network, helping develop its surgical telehealth program.
Ranjan joined the Roseburg VA in 2014, at a time when hundreds of patients were on wait lists for colonoscopies. The VA asked Ranjan to help reduce the backlog, and by Aug. 21 that year, he had performed 79 colon procedures, including colonoscopies and less invasive procedures called sigmoidoscopies. The VA’s gastroenterologist and another surgeon, Philo Calhoun, voiced concern about Ranjan’s competence. Both later alleged VA managers retaliated against them for blowing the whistle on Ranjan.
After reviewing Ranjan’s performance here and finding he used outdated methods to perform colonoscopies on Roseburg VA patients, the VA’s Office of Inspector General recommended in July 2017 that the 2,000 colonoscopies he performed at Iron Mountain get a second look.
The Iron Mountain newspaper reported the VA reviewed a random sample of those colonoscopies, and subsequently commissioned an independent review by non-VA investigators of 4,117 colonoscopies and other colon procedures performed by multiple doctors at the Iron Mountain VA from 2009 through August 2014. That investigation raised concerns about procedures performed on four veterans by three doctors, including Ranjan. One of those veterans had died, and the cause was related to “colon issues,” a VA official told the Iron Mountain Daily. It appears Ranjan was not the doctor who treated the patient who died, since that doctor was said to be no longer working for the VA.
The full report on the Iron Mountain colonoscopies has not been released by the VA, which cited health care privacy laws, according to the Iron Mountain paper.
In the earlier July 2017 report on the Roseburg VA, which was released to the public, the Inspector General found Ranjan used outdated practices like burning polyps, a procedure that increases the risk of colon perforation. It said investigators found no evidence colonoscopies had been performed unsafely at the Roseburg VA. No complications or missed cancers were discovered in the VA’s review of Ranjan’s work here. However, it found deficiencies in documentation on Ranjan’s cases that led it to change its rules nationwide about what records VA doctors around the country need to create when they perform colonoscopies.
After reporting his concerns about Ranjan in 2014, Calhoun was barred from performing surgeries, given a poor performance review and blocked from seeking employment at another VA. Calhoun was later vindicated by the U.S. Office of Special Counsel, which found he had been retaliated against for whistle-blowing. Calhoun was reassigned to the Portland VA, and has since retired.
The Roseburg VA placed the gastroenterologist who had reported on Ranjan on administrative leave and removed her property from her office, according to the Inspector General’s July report. She has hired legal representation and filed a whistle-blower claim, the report said. She had ordered some of Ranjan’s patients to receive repeat colonoscopies, but VA managers canceled some scheduled repeats, the report said.
VA doctor Steven Blum said the Iron Mountain study illustrates the importance of the Roseburg doctors raising their concerns about Ranjan.
“The recent admission by the Iron Mountain VA that patients were injured and died proves that the actions of whistle-blowers in Roseburg have literally saved lives,” Blum said.
He said managers who allegedly covered up the problems delayed “much needed care” for the patients, and that the injuries and deaths of veterans “should not go unpunished.”
The VA issued a statement Wednesday morning confirming “there have been several reviews” by the Inspector General and the regional network about colonoscopies conducted at Roseburg.
“These reviews did not substantiate Dr. Ranjan performed colonoscopies unsafely, but found that he practiced in an outdated manner. Dr. Ranjan performed 79 cases at the Roseburg (VA) between April and August 2014, and each were independently reviewed. He received additional training and supervision, but has not performed any colonoscopies at Roseburg since August 2014,” it said.
The VA said if patients have any questions about care they should contact patient advocates Wendy Thatcher and Barrett Smith, who are available weekdays at 541-440-1000, ext. 41206, or drop by the office in Building One on the Roseburg campus.