MARION – Steve Beauford was born and raised in America’s Great Northwest. Like a lot of people, he ended up in the mountains of Western North Carolina by a sort of happy chance. At least it started out happy.
Rewind to 1973: Steve, a young draftee, had expressed a desire to be assigned to the Army Medical Corps for training as a nurse. By what he calls pure luck, he not only was granted his requested branch assignment but was sent for training to NATO headquarters in Brussels. He served for four years as an emergency room nurse and wanted to make nursing his career when he finished active duty. But he fell victim to the disconnect between military training and civilian reality; his army experience and credentials counted for nothing in the private sector without a formal nursing degree, which he had neither time nor money to pursue. Long story short: he ended up in the U.S. Forest Service where, being an outdoor type, he spent the next 30 years.
He might be there yet, he says, except that he developed high blood pressure – in fact he had two minor strokes – and a chronically painful shoulder and knee. The Forest Service persuaded him to take early retirement and Social Security awarded him total disability status.
“They said ‘You’ll never have to work again,’” Steve recalls. “I said well okay, then. I had my retirement income, my disability, and I was a veteran, so I could get whatever needed to be fixed done through the VA. I knew about this area through the Forest Service and thought it would be a good place to retire. I used to love to hike.”
By the time the Beaufords moved to Marion in 2009, Steve was experiencing constant pain in his right knee. He was examined by a physicians’ associate at the Oteen VA medical center who advised a total knee replacement. Steve began pre-op physical training at the Center and VA staff doctors performed his surgery in January of 2010. During follow-up physical training he began experiencing pain around his brand-new artificial knee. A re-examination and a review of the records indicated that one or more nerves in Steve’s knee had been cut in order to complete the surgery, but there was a possibility that they had not been cauterized – hence the continuing pain and swelling. Under the stress of continuous pain, Steve says he told the VA surgeon – only partly in jest – “Just cut it off.” He says the surgeon replied, completely seriously, “Let’s not explore that option … yet.”
Maybe, Steve thought, it was time for a second opinion. Fine, he was told, just show up at a VA hospital in another town and tell them what you want. “I knew that wasn’t right,” Steve says. “You need a referral for a second opinion, and I had the feeling I wasn’t going to get one from Oteen. I wondered if they didn’t want it in their records that I asked for one.”
Meanwhile, Steve went back to physical therapy. His new therapist opined that the initial therapy he had received had been too strenuous and could be partly to blame for the inflammation. After two more months, the pain was still acute, so VA doctors tried a nerve block, which gave Steve “massive headaches and nausea” … so they abandoned the blocks and put Steve on high-dose Hydrocodone, which gave him some relief.
Nevertheless, Steve felt he had received negligent treatment, so he consulted a local attorney specializing in medical malpractice. He was told that the nerves severed during the operation were not vital ones – that in fact they were sometimes used in surgery to repair other nerves – and therefore any suit he might try to bring would probably be a weak one. He quoted the attorney as saying, “There’s just not enough in it for me.”
Not long afterwards the toe business started.
A painful bone spur had developed on Steve’s left great toe and he went back to the VA Hospital to have the toe bone fused by means of a surgical screw. The procedure, done in September of 2011, seemed successful and the stitches were removed. Then, a couple of weeks later, the toe became inflamed, swollen and hot. The hospital pronounced the wound infected and put Steve on antibiotics. The infection worsened, was diagnosed as staph, and Steve spent three months taking the powerful antibiotic Augmentin.
One day, Steve says, his daughter, who was changing his bandage, noticed a dark object she first thought was a splinter at the wound site. She removed it and held it up. “That’s a suture,” she said. “They left it in.” Steve says he put the suture in a Ziplok bag and took it with him to Dr. John Lucey, the VA orthopedic surgeon who had done the procedure.
According to Steve, Lucey’s nurse, Barbara Hough, said “Oh, my Lord” when she saw the suture, but the surgeon said, “It happens.” Steve says that when he read the report of his visit later, he found Lucey had indicated the suture was “spat out” during the examination. At that point Steve, working through a VA patient advocate, filled out a change of record form, seeking to show that the suture was recovered by his daughter at home, not by the doctor in his office. Late last August, he says, he received a letter from VA Hospital Director Cynthia Breyfogle stating that Lucey had reviewed the record and found it “accurate in its current form;” Steve’s request for telling his side of the story was denied.
Stonewalled by the VA and blown off by an attorney, Steve sought assistance through the office of Sen. Kay Hagan. Late last summer Hagan’s Constituent Services Representative, Adeline Noger, inquired of the VA Hospital as to why Steve’s request to correct the record regarding the infection and the left-behind suture had been denied. In September Noger reported back to Steve that Breyfogle said she had never signed a letter of denial to Steve Beauford of Marion, North Carolina.
Could a boilerplate letter with a computer-generated signature have somehow been accidentally triggered and found its way into the Beaufords’ mailbox? In a phone conversation this week Steve’s wife, Susan, told the Tribune she had the letter in front of her, that it did not appear to have come from a template, and that the signature was real. “You can run your hand across the back and feel where it’s pressed down on the paper,” she said. “Somebody actually signed this.”
There followed a series of e-mail exchanges between the Beaufords and Noger, who said she was attempting to follow up on the VA’s reply but so far had not heard back from them. “The last time we e-mailed Sen. Hagan’s office was the week before Christmas, Susan Beauford says. “Everything has been dead quiet since then.”
So Steve Beauford sits, and takes his Hydrocodone and slow release morphine and waits. It isn’t like he’s going anywhere.
Next: Steve Beauford’s caregivers tell their side of the story.
Ed. Note: Time and space constraints for this issue prevented the Tribune from including interviews or comments from the medical and administrative sources mentioned in this story as part of a single installment. In the interest of fair, accurate and complete reporting, we will be contacting these individuals and offering them full opportunity to respond. Our findings will appear in a second installment.