Joint Hearing of the Committee on Homeland Security and Governmental Affairs of the U.S. Senate and the Committee on Veterans’ Affairs of the U.S. House of Representatives at 1:00 p.m. CDT.
Witness Testimony of Barry Coates, Veteran
My name is Barry Lynn Coates and due to the inadequate and lack of follow up care I received through the VA system, I stand before you terminally ill today. I joined the Army in February of 1991 anxious to serve my country. Near the end of basic training an injury to my back derailed those plans and I was discharged around the first of May that same year.
After a five year fight to obtain service connection status for my injury and the treatment and pain management required as a result of it, I finally became eligible for medical treatment through the VA system. That was the start of the long, painful, emotional, and unnecessary journey that brings me to you.
On November 22, 2010 severe abdominal pain sent me to Carolina Pines Regional Medical Center in Hartsville SC, where a spinal CT showed that my lungs were clear and my liver were normal however, there was blood seen in the stool so a follow-up was recommended and consideration of a colonoscopy was suggested. That follow-up recommendation was completed at the Rock Hill Clinic with Dr. Anuradha Verma on January 20, 2011. No rectal exam was done, I was basically told to continue taking my medications previously prescribed and to come back if things did not improve or things got worse.
Due to increased pain and constipation, on February 25, 2011 I requested to be seen by a doctor or to be referred to a GI Specialist. I saw Dr. Verma again on March 3, 2011 because of increased pain and rectal bleeding. I reminded her of the suggestion made by the ER doctor that a colonoscopy might be needed. I was sent home with hemorrhoidal suppositories and the promise that a colonoscopy might be done at some point. I was not seen until May of 2011 and the results were the same.
I had relocated in October 2010 but had to continued to be seen at the Rock Hill, SC Clinic due to the back log at the Florence, SC Clinic. I was first seen by Dr. Eric Naumann at the Florence Clinic in June 2011. He started by putting me on 100 mg of the stool softener “Docusate” in order to counteract the constipation caused by narcotics necessary to treat the ongoing back pain to my previous injury. He also expressed dismay that this had not be done previously. Most importantly, he agreed that a colonoscopy needed to be done.
However my first GI consult did not occur until August 2011 with Dr. Sylvia Kim. I informed Dr. Kim of the ongoing pain, constipation, and bloody stools that I had been dealing with for over a year only to repeatedly have it dismissed as hemorrhoids. I was simply told to return in two months, still no referral for colonoscopy despite my request. In a conversation with Andy Pigge, Rn at the Florence Clinic, I made it known that my requests were being ignored and I felt it was jeopardizing my health.
On September 1, 2011 after ample time on the Docusate I sent Dr. Naumann a message via my healthyvet.com informing him that I was still bleeding every bowel movement and still experiencing pain. As of September 15, 2011 I began having trouble urinating in addition to the other problems and only found some relief sitting in warm water. Dr. Naumann was informed of these new symptoms at this time. He stated that I may need to see a surgeon and may need to be considered for a colonoscopy. Dr. Naumann requested for the second time a colonoscopy October 4, 2011.
I saw Dr. Kim October 12, 2011 and told her that the pain was now constant as well as the rectal bleeding and that my stools have become smaller and bright red in color. I was finally scheduled to have a colonoscopy consultation in April of 2012, which would be approximately a year and a half after the beginning of this journey.
Tired of living in constant pain and knowing that my problems were bigger than hemorrhoids, I persistently called on the chance that there might be an earlier opening or cancellation. I was able to secure an opening for consultation appointment for November 30, 2011 and finally had the colonoscopy done December 9, 2011. The procedure was done at the Fort Jackson Hospital by Dr. Steedman Sarbah which found that I had a 5.5 mm nodule located six to eight centimeters from the anal verge with almost total luminal obstruction. I was diagnosed with stage four colon rectal cancer. Further tests revealed metastatic nodules on the right lung in the upper lobe along with liver lesions. It was stated that because of the post proximity of the nodules to anal verge a proper rectal exam would have easily found it and prompted treatment sooner.
I saw Dr. Kim days later on the 14 of December 2012 and expressed to her sentiments of the doctor that performed the colonoscopy along with my own that a doctor should take time to listen to her patients as they know their bodies and can often sense when something is wrong. After “supposedly” not being able to feel the tumor during prior exam after seeing the images she was suddenly able to locate it easily.
I had surgery on December 16, 2012 for a post diverting loop colostomy and started chemotherapy in January of 2012 followed by 26 radiation treatments. The tumor was removed July 22, 2012 with a total anal recession. I have since had to endure a permanent colostomy which requires multiple bag changes per day along with catherization several times daily because of the bladder nerves being severed in order to remove the tumor. I am totally and permanently impotent as well as incontinent. The extensive chemotherapy has resulted in permanent neuropathy in both my hands and feet causing constant discomfort and pain.
A follow up exam on April 2, 2014 has shown even further spreading of cancer with new lesions on my liver, multiple new lesions on both lungs, plus growth of the existing lesions and a referral for a MRI as the doctor fears it may have spread to my brain. Another round of Chemotherapy would have been started immediately but was postponed so I would be able to come and speak to all of you.
It is likely too late for me, the gross negligence of my ongoing problems and crippling back log epidemic of the VA medical system has not only handed me a death sentence but ruined the quality of my life I have for the meantime. I am not here today for me, I am here to speak for those to come so that they might be spared the pain I have already endured and know that I have yet to face.
My situation is made even more unnecessary knowing that a 1.2 million dollar grant was given to the Dorn VA Center to reduce backlog and improve care and treatment of veterans only to learn that the money was misallocated by diverting it to other uses instead of using it for the intended purpose. Only 1/3 of those funds were used properly.
Men and women across this country volunteer every day to serve in the armed forces. The fact that our military stays well-manned and strong solely on the willingness of those volunteers to risk to lives for the protection of the nation as a whole is truly awe-inspiring. Other nations have to force service in order to maintain a strong military. The very least this country should do is to ensure that those volunteers are taken care of after they have made sacrifices to take care of our country. I am not a unique case in the VA health care system as 19 others have already died and 60 more are in the same terminal status I am here because proper care was not given exams were not performed properly, and diagnostic tests were either postponed or not done at all.
In the civilian world, these doctors would face malpractice suits and medical review boards. As the saying goes “heads would roll.” In the VA system oversight is not as clear cut and complaints are often either lost or covered up by bureaucracy. So I ask you today, how many more vets will be allowed to suffer and die before someone is held accountable?
Thank you for your time,