Miami VA Director Paul M. Russo Responds To Neglect Scandal: "I Stand By Our Staff"

This morning, New Times published the second half of its two-part series on a soldier's tragic death inside the Miami Veterans Affairs hospital. Hell On The Home Front follows Nicholas Cutter's journey from heartbroken teenager to battle-hardened soldier to PTSD-suffering veteran to drug addict.

According to extensive interviews and the VA's own internal reports, lax security at the hospital contributed to Cutter's death. Miami VA Director Paul M. Russo, however, insists that the hospital is not to blame.

"I stand by our staff who worked with Mr. Cutter for nearly nine months to help him battle his personal demons," Russo said. Keep reading for his full statement.

See also: Before Dying From Neglect in Miami, Nick Cutter Survived Iraq

On Tuesday, July 22, New Times published Part 1 of the series. That same day, we contacted the Miami VA for comment on Part 2.

A day later, VA spokesman Shane Suzuki responded by saying he took "great issue with the idea that [Cutter] was neglected."

"Our staff worked with him for nearly 9 months, and while it pales compared to the mourning of his family I am sure, our staff is still affected by his passing as they truly made every effort to help him," Suzuki said. "It is also important to note that his case was reviewed medically by outside professionals and they found no issues with the medical care provided to him."

See also: Iraq vet Nick Cutter went to Miami's VA hospital for help. He left in a body bag

Yesterday, Suzuki sent us a list of Russo's responses to our questions. Here they are, in full:

New Times: In your previous email, you took issue with my use of the word "negligent" to describe the VA's treatment of Nicholas Cutter. However, the OIG report, interviews with VA employees, and other documents make it very clear that Miami VA staff did not properly monitor RRTP patients or inspect them for contraband. In effect, patients were allowed to come and go as they pleased, and could easily time their drug use to avoid failing predictable drug tests. Please describe how this is anything other than negligent care.

Paul M. Russo: The SARRTP is a residential program where patients, under individualized care agreements with their providers, are taught the skills necessary to maintain sobriety after discharge from the program. It is not a locked unit and patients do maintain their ability to apply the lessons they learn in treatment, if they meet the clinical goals they make with their providers. It is important to remember that, as a residential care program, participants can elect to discontinue treatment at any time.

We have addressed the areas that the OIG report listed areas for improvement; however the medical care provided to Mr. Cutter was found to be appropriate after peer review by comparable medical professionals.

Why was Nicholas Cutter's family told that he had choked on a sandwich?

It is uncertain what was exactly stated to the mother by a staff member; however there was a remnant of food in his mouth and the medical resident who responded to the code and pronounced the death also spoke with the mother and documented that there was food in his mouth.  However there is no documentation of his exact communication with her.  The Veteran's treating psychiatrist spoke with the mother and father on the phone and communicated to them that a half-eaten sandwich was near the Veteran however he recommended ordering an autopsy to determine the cause of death.

The Medical Examiner conducted the autopsy in the following weeks, however it is our understanding they unsuccessfully attempted to contact the family numerous times with the results.

Why was Cutter's body "stripped, tagged, and placed inside a white body bag by medical staffers" before Miami Police detectives could properly investigate the death? (According to a Miami PD report.)

When nursing staff discovered the Veteran, they initiated cardiopulmonary resuscitation (CPR) and the cardiac arrest code team was called and advanced resuscitation ensued. After pronouncement, the body was treated as any death in the medical center and the nursing staff secured his belongings in anticipation of the family members' arrival. Upon notification, Miami VA Police secured the scene, notified local authorities and VA OIG Criminal investigators who took jurisdiction over the case upon their arrival.

The OIG report made four recommendations: repair the surveillance cameras, properly staff the RRTP units, implement "consistent and comprehensive" contraband checks, and aggressively monitor patients for drug abuse. What is the status of these recommendations? Have they all been implemented? If so, when? If not, why?

The 5th floor cameras were functional before the release of the OIG report. Prior to that staff were utilized to monitor the hallways to compensate until these cameras were repaired. The surveillance camera system is continuing to be upgraded and expanded.

All other recommendations were implemented soon after the OIG report was published.

When did the Miami VA learn about the broken security cameras on the fifth floor? VA employees have said they notified the hospital of the broken surveillance system as far back as 2010, but they were never repaired.

A 2010 Miami VA vulnerability report did identify that the hospital surveillance system did need to be upgraded and that a monitor was not working. The report is void on specific non-operating cameras. The Director of the hospital at that time was Mary Berrocal and why not addressed is unknown. The 2013 Vulnerability assessment report completed in March 2013 did identify the need to replace non-operable cameras and need for system upgrade. The Director authorized funds in April 2013 to address the upgrade needs. The Miami VA 5th floor surveillance system is currently online. Currently, we are in the midst of a $380,000 surveillance system upgrade that was approved in April of 2013 by the current Miami VAHS Director.

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Michael E. Miller was a staff writer at Miami New Times for five years. His work for New Times won many national awards, including back-to-back-to-back Sigma Delta Chi medallions. He now covers local enterprise for the Washington Post.

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