THE OSCAR G. JOHNSON VA Medical Center in Iron Mountain. (Theresa Proudfit/Daily News photo)

IRON MOUNTAIN – A third-party review of thousands of colon examinations done at the Oscar G. Johnson VA Medical Center from early 2009 through August 2014 identified potential concerns about treatment of four veterans, one of whom is now deceased, a VA spokesman said.

All four veterans or their family members were contacted and notified, said Terrence L. Hayes of the Department of Veterans Affairs’s Media Relations Division in Washington.

“The four cases involved three physicians, two of whom no longer work at VA and another who still works at VA but is no longer treating patients,” Hayes said in response to an inquiry from The Daily News.

“One of the four affected veterans is deceased, and the cause was related to colon issues,” Hayes said. “Upon completion of the review, senior leadership at Iron Mountain VAMC contacted the veteran’s family to express condolences and provide full disclosure. We also would like to take this opportunity to extend our sincere apologies to the family.

“This is not the standard of care we provide to veterans and their family members who entrust us with their health care,” Hayes said. “The doctor involved in this veteran’s care no longer works for VA.”

The review was prompted by concerns that a physician performed colonoscopies in “an outdated manner” at the Iron Mountain VA and other sites. That surgeon performed some 2,000 colonoscopies at Iron Mountain before transferring in 2014 to a VA facility in Roseburg, Ore., according to the Department of Veterans Affairs.

The issue came to light when staff at the VA Roseburg Healthcare System claimed in the summer of 2014 that colonoscopies were being performed unsafely at their facility. The VA’s Office of Healthcare Inspections looked into it but did not substantiate the charge.

The agency did, however, question the methods used by the former Iron Mountain VA physician — who is still employed by the VA. The review at Roseburg was initiated in October 2014 and work was completed in November 2016.

In studying the surgeon’s cases at Roseburg, inspectors found his documentation often did not include data such as polyp size or quality of bowel preparation. They also found he fulgurated, or burnt, polyps, a practice that has fallen out of favor.

In addition, he made recommendations for surveillance colonoscopies without waiting for pathology results, the report said.

Meanwhile, the VA did a random review of colonoscopies performed by the surgeon in question during his tenure at Iron Mountain. That internal quality review, conducted by a Clinical Executive Response Team, was completed in July 2017.

The VA then commissioned an additional independent, outside review that covered 4,117 colonoscopy or sigmoidoscopy cases at the Iron Mountain VA from early 2009 through August 2014, Hayes said.

The second review is complete, Hayes said, but it contains personal medical information that is prevented from release under health care privacy laws.

The complaints at Roseburg drew the attention of a U.S. Senate committee after a doctor said he suffered retaliation for blowing the whistle on allegedly unsafe colonoscopies.

When the Iron Mountain VA was contacted by The Daily News in fall 2015 about the Roseburg whistle-blower incident, officials said they had not been made aware of any quality of care concerns regarding colonoscopies at Iron Mountain. Later, the Iron Mountain VA was notified by the Inspector General about the need to re-evaluate its colonoscopy cases.

The doctor whose practices led to the review is now assisting in the development of the VA Northwest Network’s surgical telehealth program. He recently stepped down as chief of surgery at Roseburg.

Colonoscopies provide both a visual diagnosis of the colon and the opportunity for biopsy or removal of suspected colorectal cancer lesions. A sigmoidoscopy is similar to a colonoscopy, but is a partial exam that only covers the left side of the colon.

Colorectal cancer is the second-leading cause of cancer deaths for men and women in the U.S.