Psychologist Blows Whistle on New Orleans VA Procedures

A New Orleans psychologist was at the center of a CBS News investigative report that
aired last month finding that the New Orleans VA may not have been diagnosing enough veterans so that they could be treated adequately for traumatic brain injury (TBI), the signature wound of the Afghanistan and Iraq wars.

CBS investigative reporter Jim Axelrod broke the story, “Whistleblower says veteran
affairs dramatically under diagnosed traumatic brain injuries.” Louisiana
psychologist Dr. Frederic Sautter was key to the report.

Go to CBS online for the full report.

Axelrod reported on the heartbreaking story of Army Sergeant Daniel Murphy
who served five decorated combat tours in Afghanistan and Iraq. Murphy
specialized in detonating explosives and was honorably discharged in According to the
report, Murphy suffered both physically and psychologically. “He had the classic symptoms of posttraumatic stress disorder –insomnia, anxiety, and a feeling that the
enemy was lurking around every corner,“ said Axelrod.

According to the CBS report, VA sources confirmed that Murphy screened positive for
traumatic brain injury (TBI) in 2017. However, he did not receive a final TBI diagnosis or treatment. Two months later he took his own life at 32 years old.

The report notes that suicide is twice as high in veterans with TBI than in those with PTSD only.

Cases like Sergeant Murphy’s haunted Dr. Sautter, said Axelrod. Dr. Sautter retired recently from the VA, but until that time he headed up the family mental health program at Southeast Louisiana Veterans Health Care System in New Orleans. Dr. Sautter saw hundreds of vets coming home from the Iraq and Afghanistan conflicts and began to become suspicious that they were not being properly assessed for TBI, said the CBS reporter.

Sautter told Axelrod that many of his patients, who were suffering from PTSD, appeared to also be presenting symptoms of traumatic brain injury. However, they had not been diagnosed or treated for the injury and this was a concern to him. So, Sautter set out to try and understand what was happening and he did his own research into the numbers.

According to Axelrod’s investigation, the VA protocol requires that all Iraq and Afghanistan veterans are screened for TBI and a positive screen then leads to further evaluation. Reporting on internal documents from the VA, Axelrod noted that most vets who receive a positive screen are ultimately diagnosed with TBI.

CBS found that 60% to 80% of patients who are positive on the screening, across all the VA hospitals, are ultimately diagnosed and receive treatment for TBI.

However, Dr. Sautter found that at the New Orleans VA this number was only 18%.

According to the report, Dr. Sautter brought his results and list of the veterans who had slipped through the cracks to colleagues at the Pain Management & Rehabilitation (PM&R) division at the VA. A nurse at the division, Priscilla Peltier, told CBS that “There was absolutely no treatment being provided to them.”

In October 2017, Peltier presented a plan to her boss, the chief of PM&R, Dr. Robert Mipro, for contacting the veterans on the list. Peltier told CBS that Dr. Mipro responded that the list was not their concern and to “lose the list.”

Dr. Sautter insisted that the VA to investigate his concerns first through the Inspector General and then through the Office of Special Counsel.

CBS said the Office of Special Counsel ordered an investigation by the VA Medical Inspector and produced a report in March 2019. CBS said that the report was not made public but confirmed the New Orleans relatively low TBI diagnosis.

However CBS then contacted a VA spokes person who said the Medical Inspector’s report had used “bad data” and that the TBI diagnosis rates in New Orleans were in line with the national average.

Dr. Sautter is not optimistic about changes at the VA. “No one on staff will convince VA to change their practice and take responsibility,” he explained to the Times last week.

“Their focus is on their image and maintaining good numbers. The current PM&R staff is quite good. The issue is prior patients not receiving evaluations need to be contacted and assessed,” he said.

“I am now retired from VA and have a private practice. There have not been negative consequences for me except the anxiety of the experience and disappointment at the total denial by the institution and alienation from the institution,” he said.

Dr. Sautter was the Manager of a Family Mental Health Program at a VA Med Center for many years, and treated hundreds of couples and individuals. He is an expert in traumatic stress and relationship problems and has treated hundreds of combat veterans to help them overcome a variety of stress problems, providing compassionate evidence-informed care to individuals that have had to endure immense emotional pain, according to Psychology Today’s provider information.

Asked how it was to work with CBS News, he said, “CBS was very professional, vetted everything with attorneys, and put a great deal of effort into it. They were impressive.”

Has he experienced retaliation? “I feel like I did the right thing and veterans have communicated appreciation,” he said. “The reaction of the institution was total denial. I would never encourage anyone to do it unless they were in the later stages of career and could accept leaving the institution (VA). The nurse who complained was retaliated against but I never felt like anyone was going to try to intimidate me.”

His thoughts for other psychologists? “If important protocols are not enacted it is
your duty to report it. Do not expect gratitude from anyone at the institution but it is very satisfying knowing that you stood up for what you believe in,” he said.

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