G.V. "Sonny" Montgomery Veterans Affairs Medical Center in Jackson, Mississippi barred one of its doctors from seeing patients years ago but continues to pay him a $339,177 annual salary.
The Jackson VA fired neurosurgeon Dr. Mohamed Eleraky in August 2016 following questions about his treatment of five anonymous patients, but he's back on staff today.
Eleraky and the VA are in ongoing litigation, in which Eleraky's attorney subpoenaed the medical records of a patient we'll call John, who agreed to be interviewed but not identified by name.
In 2013, Eleraky performed a spinal fusion on John.
"Things did not turn out well for me at all," John told the Clarion Ledger.
The veteran first got an infection, then the VA sent him to the University of Mississippi Medical Center "for them to redo something that had went wrong," John said.
"I couldn't move my head. I couldn't turn my head to the side very far ... For the longest, I couldn't lift my arms over my shoulder," John said. "I seem to be slowly getting better but there's some problems I'm still having."
He's just now regaining feeling in his right hand, his dominant hand, four years later.
John, who is in his 60s, said he couldn't recall what doctors told him went wrong in surgery, nor does he know if Eleraky is at fault for the adverse events he experienced.
Eleraky returned to work at the medical center in April after the VA Disciplinary Appeals Board found local officials did not prove their claims that Eleraky failed to properly assess patients or failed to follow surgical rules.
Still, "(Eleraky) is not in a patient care position, nor will he ever be until it is clear he has the requisite skills to practice neurosurgery," Jackson VA Director David Walker said in a statement.
After weeks of inquiry by the Clarion Ledger, the U.S. Department of Veteran Affairs provided a statement saying if local officials do not believe Eleraky can resume surgical duties, he should be transferred to a nonsurgical clinical position with a lower salary.
If medical center leaders believe he cannot provide patient care altogether, the statement continued, he should be terminated or given an administrative, non-clinical position with corresponding pay.
This situation isn't necessarily unique. In February 2016, the Clarion Ledger found VA medical centers across the country, including in Mississippi, dole out millions in paid administrative leave for doctors with questionable track records.
Retired Maj. Gen. Erik Hearon, former assistant adjutant general and commander of the Mississippi Air National Guard, told the Clarion Ledger then that veterans are hurt by this because they can't see these surgeons and taxpayers are hurt because they have to pay for veterans to receive care elsewhere.
VA officials are continuing to explore whether they can pursue other disciplinary actions against Eleraky.
In 2015, the doctor filed a complaint in federal court against the medical center, alleging the discipline he's received — an initial suspension of his operating privileges in 2013 and a second suspension of his entire clinical privileges in 2014 — was improper.
It's clear the VA doesn't want Eleraky as a doctor on its medical staff, treating patients, but officials won't say exactly what happened in the operating room to warrant multiple disciplinary actions or why the medical center was "forced to reinstate him" earlier this year.
After repeated requests, a VA spokesperson said ongoing litigation prevents the center from providing the justification for Eleraky's termination, other than "reason having to do with clinical care."
The VA has paid Eleraky more than $1 million over the course of 3½ years, during which he has not performed any surgeries. For three of those years, he didn't even see patients, relegated instead to "sitting in his office with no job responsibilities," according to the lawsuit.
The VA first suspended Eleraky's operating privileges in July 2013, less than two years after he was hired as a neurosurgeon to the center's medical staff. Eleraky claims in his lawsuit that officials did not explain the reason for his suspension, nor did he receive a fair disciplinary hearing.
Eleraky's attorney, Whitman Johnson III, said the initial suspension arose out of an alleged surgical complication that is "actually a common outcome for this type of procedure."
Eleraky remained on staff for almost a year until the VA suspended him from seeing patients altogether in April 2014.
"Dr. Eleraky's privileges remained suspended with no results or action taken for over 2 years. During that time, he was relegated to sitting in his office with no job responsibilities, effectively stigmatizing him," reads Eleraky's amended complaint, filed Nov. 6.
Johnson claims in the lawsuit the VA "intentionally held Dr. Eleraky in limbo by progressively expanding and extending his 'temporary' suspensions with no apparent intent to reach a decision in the hope that he eventually resigns on his own."
The VA eventually fired him in August 2016 after Eleraky complained to VA headquarters about his inability to resolve the suspension.
During this time, Eleraky's hospital privileges expired, so he's awaiting direction from the VA on taking a skills assessment so he can regain privileges that allow him to conduct surgery.
Veteran Affairs Secretary David Shulkin has instructed the VA to perform a review to see if there are doctors across the system being paid clinical salaries while not performing clinical duties.
Though Eleraky's suspension was based on his care of five patients, an October letter from Johnson to VA Human Resource representative Wilmino Sainbert, reveals the VA attempted to use additional patient stories in the case against him.
Emails to a personal address listed for Eleraky went unanswered.
Counsel for the Jackson VA, Assistant U.S. Attorney Angela Williams, also would not comment.
Eleraky claims in his complaint he was inappropriately disciplined for "his initial refusal to amend certain patient records until ordered to do so, his ethnicity and any related speech pattern issues, and in retaliation for his filing of an EEOC (Equal Employment Opportunity Commission) complaint."
Eleraky, 52, is originally from Egypt, where he received his medical degree from Tanta University in 1988. He received his master in general surgery in 1993 and his doctor of philosophy in neurosurgery in 1999 from the University of Arizona.
Before arriving at the Jackson VA, Eleraky completed a complex spine surgery fellowship at University of California at Davis and three years of neuro-oncology training at the H. Lee Moffitt Cancer Center & Research Institute in Florida.
Eleraky is not a licensed doctor in the state of Mississippi, but in Florida. The Florida Health Department has no record of complaints or discipline against Eleraky.
VA medical centers do not require doctors to be licensed in the state in which they are employed. Because Eleraky is not licensed in Mississippi, the Mississippi State Board of Medical Licensure has no jurisdiction to investigate Eleraky.
In July, the U.S. Department of Veteran Affairs began publishing a list of employee terminations, demotions and suspensions in an effort to increase transparency.
"Veterans and taxpayers have a right to know what we're doing to hold our employees accountable and make our personnel actions transparent," Shulkin said in written statement.
Below is the full statement from U.S. Department of Veteran Affairs Press Secretary Curt Cashour:
In April, VA was forced to reinstate Dr. Mohamed Eleraky, whom we had fired in August of 2016.
Dr. Eleraky is not presently in a surgical position, but (Veteran Affairs) Secretary (David) Shulkin has made clear that any VA doctors who were hired for clinical positions are required to practice in a clinical position caring for patients.
If the medical center leadership does not feel Dr. Eleraky is able to resume surgical duties, we will ensure he is moved to caring for patients in a clinical, non-surgical capacity, and adjust his salary downward to reflect his new role.
If medical center leaders do not believe Dr. Eleraky is qualified to treat patients altogether, then he should be removed from VA employment or transferred to a VA administrative position with an administrative/non-clinical care salary.
Also, we are exploring whether additional grounds exist to pursue other disciplinary actions for Dr. Eleraky with a new set of facts.
Finally, Secretary Shulkin has directed VA to conduct a top-to-bottom review to determine whether there are other doctors in the VA system who were hired for clinical positions and are not performing clinical duties while receiving salaries of practicing physicians, so that those cases, if any, will be handled in the same way as we are now proceeding with Dr. Eleraky.
As part of this review, we are examining whether new policy or legislative changes are necessary to allow VA to remove unqualified physicians from clinical care responsibilities and/or employment within the VA system.
We are committed to holding employees accountable if they fail to do their jobs or live up to VA's values, and we will never allow disciplinary red tape to jeopardize patient safety.