September 4, 2010, 03:30:00PM. By Heidi Turner

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Philadelphia, PA: Soldiers returning from duty often have to turn to VA hospitals for help with serious health problems. Yet some receive a lower standard of care and are left filing lawsuits alleging veteran medical malpractice.

One lawsuit reportedly filed against the Philadelphia VA Medical Center, Dr. Gary Kao, and the University of Pennsylvania alleges that the defendants erred when providing radiation therapy. The plaintiffs, five Iraq war veterans, say approximately 100 veterans are believed to have received improper radiation therapy from the defendants.

According to the lawsuit, patients underwent brachytherapy to treat their cancer. Brachytherapy involves the use of radioactive metal seeds that are placed inside the prostate via needles. Those seeds create radiation that is meant to attack and contain cancerous cells.

Reports indicate that Dr. Kao was investigated by the US Nuclear Regulatory Commission (NRC), which found that of 114 patients treated in six years, only 16 procedures were done correctly. Incorrect procedures involved the use of weak radiation doses, overdoses in other areas of the body and seeds being inserted in the patient's bladder or rectum rather than the prostate. A report from the NRC found that Dr. Kao and others in his unit continued performing the procedure even after a device to measure the radiation in patients broke down, which prevented them from ensuring the work was performed properly.

Furthermore, the NRC found that staff in the cancer unit altered medical records so it would appear that the errors were part of the patient's treatment plan. The New York Times reported on 6/21/09 that in one case, Dr. Kao implanted 40 seeds in a patient's bladder by mistake and rewrote the surgical plan to make the mistake disappear. The patient underwent a second implant, which also failed, but the error was allegedly never reported.

One of the defendants, Barry Lackro, says his cancer has returned and is incurable. Other veterans underwent repeat implants or surgery to lessen damage caused by incorrectly performed procedures.

In 2008, Dr. Kao was reportedly removed from his position at the hospital.

According to the New York Times, Dr. Kao spoke before a Congressional panel and said that he "could have done better" with some implants but overall his patients received effective treatment. He further said that he always acted in the best interests of his patients. Furthermore, Dr. Kao said that implanting seeds outside the prostate was a recognized risk of the procedure.

As of the date of publication of the Times article, Dr. Kao had faced no medical malpractice lawsuits.

The Times reports that the Veterans Affairs radiation safety committee knew about some problems with the Philadelphia VA hospital prostate unit but did not act decisively on those issues. In March 2010, the NRC hit the Philadelphia VA Medical Center with more than $227,000 in fines.

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