Doctor defends cancer treatment at VA hospital

The doctor at the center of an investigation into medical errors in prostate cancer treatments at the Philadelphia VA Medical Center broke his silence this morning and mounted an aggressive defense of his actions.

At a "field" hearing of the U.S. Senate Veterans Affairs Committee called by Sen. Arlen Specter (D., Pa.), University of Pennsylvania doctor Gary D. Kao defended the quality of the brachytherapy radiation program he said he established and led at the hospital.

"Contrary to the allegations that I was a 'rogue' physician, there were precise standard operating procedures formulated and a system of monitoring and oversight," said Kao, a board-certified radiation oncologist with a Ph.D. in molecular biology. "I always acted in the best interests of my patients in delivering this important treatment. I have never nor would I ever falsify documents, cover up results or act in a matter detrimental to the interests of any patients."

"Given all that I have worked so hard to achieve and my commitment to patient care, I was devastated, personally and professionally, by the false allegations . . . branding me as a 'rogue' doctor," Kao added.

"Never in my career have I falsified any medical records and never have I participated in a cover up," he said.

Kao stopped treating patients at both the VA hospital and Penn least year after concerns were raised that 114 patients might have had improper amounts or placement of tiny radioactive seeds to destroy prostate cancer cells.

The doctor continued his National Institutes of Health-funded research at his Penn laboratory until he took an indefinite leave of absence last week.

In June 2008, soon after learning that there might be a problem, the VA hospital suspended its brachytherapy program and contacted all the affected veterans.

In brachytherapy, physicians permanently implant in a prostate from 80 to 120 tiny metal "seeds" that emit radiation over a 10-month period.

If improperly placed, the seeds can damage nearby organs while delivering less-than-optimal doses of radiation to the prostate.

Ongoing investigations by the VA and the U.S. Nuclear Regulatory Commission, which oversees medical use of radioactive materials, found that 57 of the patients were underdosed.

Another 35 patients got too much radiation to nearby tissues and organs, including 25 whose rectums received potentially dangerous doses.

One of those patients, the Rev. Ricardo Flippin, now of Charleston, W. Va., also testified before Sen. Specter, who was joined by U.S. Rep. John Adler (D., N.J.), the region's only member of the House Veterans Affairs Committee, and U.S. Rep. Chaka Fattah (D., Pa.) in the Third Floor Multipurpose Room at the veterans hospital, 3900 Woodland Ave.

A 68-year-old minister, teacher and Air Force veteran who served in Vietnam, Flippin underwent the procedure at the Philadelphia VA facility in May 2005. Medical records show that his prostate gland received only 67 percent of the prescribed radiation dose.

After the treatment, however, Flippin developed rectal pain, bleeding and digestive problems that became debilitating.

A doctor outside the VA health system diagnosed Flippin's problem as radiation injury to the anal canal. Surgery repaired the damage, but he continues to have problems with bowel control.

His lawyer, Robb Graham of Cinnaminson, has filed a claim against the VA.

Speaking publicly for the first time at the hearing, Kao said, "I am not willing to be the scapegoat for the complex, systematic problems that affected the brachytherapy program."

Although Kao and the Department of Veterans Affairs has been in the spotlight over the suspended program and safety violations, the controversy and investigations have implications for Penn's reputation as well.

The Philadelphia VA hospital is on the edge of the Penn campus, and the agency contracted with Penn physicians, who performed the brachytherapy procedures on veterans.

The facility is also a teaching hospital for Penn medical residents.

While Penn and the Philadelphia VA hospital are under scrutiny due to the problems, Kao remains at the center of the storm. A NRC medical expert "noted that the seed placement in the cases reviewed was quite erratic and not consistent with current medical standards."

Kao, however, was unwilling to accept such statements.

"The malicious allegations against me and the program are so deeply hurtful," Kao declared.