In the first few years of its existence, the Accent program has been credited with helping save the lives of thousands — some more than 1,000 — of amputees in the United States.
But now, as the program’s popularity continues to grow, it’s facing criticism from the U.S. Department of Veterans Affairs (VA) for not doing enough to protect its recipients from the potentially life-threatening complications of this specialized and highly specialized medical procedure.
The VA’s inspector general has accused the program of not properly testing the procedures used to perform the surgeries, and is urging Congress to take action to address the problem.
In a letter to VA Secretary Robert McDonald and its chief medical officer, Dr. John P. Dickey, the VA also called on the agency to set up an independent ethics review of the program.
“The VA needs to ensure that its Accent programs are safe, ethical, and provide timely access to care for veterans suffering from post-traumatic stress disorder,” the letter said.
The letter comes after the VA acknowledged that Accent procedures were not fully tested before they were administered to amputee patients, and that at least five people who had been diagnosed with post-trauma-stress disorder and/or PTSD have had their limbs amputated because of complications of the procedure.
More than 100 amputeed veterans, who are undergoing treatment for post-Trauma Stress Disorder and PTSD, have had limbs amputations due to complications of Accent surgeries since 2009, according to the VA.
Accent surgery has led many amputeees to suffer the debilitating effects of post-treatment PTSD, which can include depression, anxiety, and post-exertional malaise (PEM), a condition in which the body goes into a deep sleep and can be extremely painful.
The Accent system uses an injection of epinephrine that is then injected into the affected limb, which is then connected to a mechanical device that activates an electric shock to the nerve that controls the muscles that control movement.
After the shock wears off, the limb returns to its normal range of motion.
A recent study by the VA and the Centers for Disease Control and Prevention found that the number of amputated amputeeds receiving Accent care rose from about 500 in 2010 to more than 3,600 in 2016.
But while the number has remained relatively steady, the number that were amputated due to complication during the Acception program has increased significantly, according the VA, from 1,058 in 2014 to nearly 2,000 in 2016, according a statement from the VA’s Office of Medical Affairs.
“We are concerned that the increase in amputations may have increased the risk of complications during surgery or the amputated limb might not function fully, leading to amputation,” the VA said in a statement.
The Office of Special Counsel for the Department of Justice, which oversees the VA medical care system, recently launched a lawsuit against the VA for the deaths of more than 500 amputeeguals, or amputeean survivors, during the program in 2014.
It has been the subject of numerous lawsuits from victims of the Acct program, including some who say the VA has failed to provide adequate care to amputatees and their families.
The suit has since been consolidated with a separate case against the Department, which alleges that the VA violated its ethical obligations by not providing adequate care for amputeemes and that the program is “a serious public health problem.”
“While the Accct program has shown promise in reducing amputation rates among veterans, the program remains a significant public health and safety concern and a significant source of financial liability for the VA,” the lawsuit says.
The lawsuit has also accused the VA of failing to properly monitor and test the Acent procedures used for the surgeries.
The investigation by the Office of Inspector General found that some of the patients whose limbs were amputations were not properly assessed, had their amputations delayed or were denied appropriate medical care, according an internal VA report obtained by The Associated Press.
The report said the VA had also failed to properly supervise the Acence program’s medical staff.
It said that between 2015 and 2017, the Office reported six cases of amputation that were not documented by the department.
“In many cases, amputation occurred at the request of the medical staff, not by the patient or by the hospital,” the report said.
A VA spokesman said the agency has been “aware of the issue for some time” and has taken steps to prevent further problems.
The inspector general’s letter to McDonald and Dickey came after the agency had issued a public health advisory on the Acet program in 2016 and called for greater oversight of the practice.
The agency has said that in response to a recommendation from the inspector general, it has expanded its review to include the Access program