The majority of the 23 deaths were gastrointestinal cancer patients. All 76 cases were spread out over 27 VA hospitals, with resulting deaths at 13 of those facilities. Out of these facilities, the one with the worst record was the Williams Jennings Bryan Dorn Veterans Hospital in Columbia, SC. The hospital had 20 confirmed cases of delays as well as six deaths.
The VA claims that the delays were caused by their overwhelmed computer systems. As part of their review, they are dedicated to finding ways to improve their systems to ensure that no additional veterans are harmed.
In October 2013, a report was issued by the VA Office of Inspector General. John Daigh, the VA's Assistant Inspector General for health care, said he thought that these delays occurred because the VA failed to “focus on its core mission to deliver quality health care.”
A hearing was held on April 9th, 2014 by the House Committee on Veterans’ Affairs to address this issue. In addition to the 23 deaths reported by the VA, the Committee also “reviewed at least eighteen preventable deaths that occurred because of mismanagement, improper infection control practices, and a host of other maladies plaguing the VA health care system nationwide.”
Jeff Miller, the Chairman of the House Veterans Affairs Committee, hotly called for the VA to hold themselves properly accountable for these incidences. “We all recognize that no medical system is infallible, no matter how high the quality standards might be. But . . . it concerns me that VA’s briefing Monday and testimony today include very few details about what, if any, specific actions have been taken to ensure accountability for the 23 veterans who lost their lives and the many more who were harmed because they didn’t get the care they needed in a timely manner.”