Investigation - Burnice Breckenridge and VA Quality of Care

A North Texas family believes a revolving door of doctors and a communication breakdown at a Veteran's Affairs Hospital may have cost their loved one her life.

Burnice Breckenridge was going to the North Texas VA, a facility criticized by vets for delays and the quality of care. Last year, the VA system all over the country was under attack.

The government promised better care, and reports show most centers have improved overall quality. However, one North Texas family believes the vets here are still paying the price.

Burnice was all smiles back in 2011, and she had reason to celebrate: one year had passed since her surgery, and doctors thought she was cancer-free.

"It was never a downer when we went there," her daughter, Dominique Breckenridge, said.  "‘Your vital signs look good, this is improving, this looks good.' So, it was almost an in-and-out thing."

Burnice served two years as a private in the Army back in the 1960s, so she used the North Texas Veteran's Hospital, but in 2010, despite regular exams and tests, a VA doctor delivered some stunning news.

"She said, 'We have dropped the ball,'" said Burnice's husband, Howard. "That was her term. ‘We have dropped the ball. We think she has cancer.'"

Burnice was diagnosed with cervical cancer. She went to UT Southwestern Medical Center for a hysterectomy, then back to the VA for chemotherapy and radiation. 

Life rolled on until one day that no one will ever forget in September 2014.
In a letter she wrote to the VA, Burnice says, the doctor asked "…did I know my cancer had advanced to Stage 4?  All of us were shocked. She began to talk about going into Hospice, a living will.  She went on about how we come here to die. She knows we don't want to hear this, but we'd have to face it."

Dominique remembers the family was just floored.

"She said, ‘Dominique, you could have knocked me down when they said stage four,'" Dominique said. "She said, ‘I had no idea.' I said, ‘You? I know we didn't. We were with you at every visit. If you didn't hear it, we didn't hear it.'"

Burnice died at Methodist Hospital in Plano this past February with her family by her side. 

Howard and Dominique spent weeks pouring over hundreds of pages of medical records. They found many inconsistencies.

In January 2014, VA hospitals noted, "concerns for active disease spread."

In March 2014, it says, "questionable enlarging mass," and "possibility of bone involvement," "complicated case." 

The Breckenridge family says that was 6 to 9 months before anyone sat down with them. On September 3, 2014 it says, "prognosis discussed," and "she and family shocked she's stage IV."

"Looking at all of this, it was an unnecessary death…it was a preventable death," Dominique said.  "Now, reading this, I'm saying I was right."

The family also complains there were delays in treatment, like a five-hour emergency room visit, where they were never seen by a physician, and a revolving door of doctors, which complicated her treatment.

"How many doctors do you estimate you saw?" FOX 4 reporter Becky Oliver asked.

"An infinite amount," Dominique said.  "I don't even… I couldn't even count. Every time we went, we had a new doctor."

A recent North Texas VA employee survey shows the Radiation/Oncology Department getting the lowest scores of more than 100 different departments. It ranked at the very bottom for competency, customer satisfaction and planning and evaluation.

A recent review by the Office of Inspector General gave the Dallas VA two stars in quality, with the lowest scores for patient satisfaction and specialty care wait time.

The North Texas VA declined an on-camera interview with FOX 4, but sent a statement saying, the employee survey "reflected many strengths and opportunities for improvement" and the OIG report "is just one tool the VA has as a measure of care" and improvement is being made.

The VA had no comment on Burnice or her letter, but assured FOX 4 that the VA staff is committed to communicating directly with the family. 

The Breckenridge family says they have not heard a word from the Dallas VA.

While Burnice may be gone, her outrage and pleas for better care at the VA will live on.

"I think we were so dumb about the whole situation," Howard said.  "We were just accepting what they were saying.  We were just accepting it as the truth."    

"It is an uncontrollable feeling that I feel she should still be here," Dominique said.

"All the time I was taking care of my family…this time I couldn't do nothing, just couldn't do nothing," Howard said.  

Burnice's surprise diagnosis of stage four cancer happened months after the delayed care scandal in the VA system became public.

The Radiation/Oncology departments ranking at the very bottom was based on the survey of the VA's own staff.

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