MANCHESTER, N.H. — Veterans Affairs Secretary David Shulkin has removed two top officials at New Hampshire's only veterans hospital and has ordered a review of the facility starting Monday amid allegations of "dangerously substandard care."

The Boston Globe reported that 11 physicians and medical employees alleged the Manchester VA Medical Center was endangering patients. They described a fly-infested operating room; surgical instruments that weren't always sterilized; and patients whose conditions were ignored or weren't treated properly.

The Office of the Special Counsel, a federal whistle-blower agency, found "substantial likelihood" the allegations were true and ordered an investigation, which began in January. Shulkin also said the VA Office of the Medical Inspector and the VA Office of Accountability and Whistleblower Protection were starting a "top-to-bottom review" of the hospital, beginning Monday.

Following the newspaper report Sunday, Shulkin removed hospital Director Danielle Ocker and Chief of Staff James Schlosser. A VA spokesman told the newspaper the two would be assigned other duties in the interim.

"We will stop at nothing short of delivering the best care for our veterans," said Republican Gov. Chris Sununu, who said he called Shulkin on Sunday morning.

Rep. Annie Kuster, a member of the U.S. House Veterans' Affairs Committee, and Sen. Jeanne Shaheen, a member of the Senate Armed Services Committee — both Democrats — met with VA doctors last year about their allegations and brought the concerns to the VA's Office of Special Counsel and the Office of the Inspector General for further investigation. Kuster said she was "deeply concerned."

"I appreciate the seriousness with which Secretary Shulkin is taking this matter," Kuster said in a statement.

The Globe reported in a recent interview, Ocker and Schlosser acknowledged significant cuts in services, such as the elimination of cataract surgery, and administrative problems, such as ordering a $1 million nuclear medicine camera but never installing it because it was too big for the examination room. As a result, the hospital stopped offering nuclear stress tests for heart disease risk and bone scans that can detect tumors this year.

But Ocker and Schlosser said they were surprised that so many medical staff members reported the problems to federal investigators. They said the hospital was addressing the shortcomings and patient safety hasn't been compromised.

Much of the Globe's report focused on accounts from Dr. William "Ed" Kois, head of Manchester VA's spinal cord clinic, who compiled a list of at least 80 patients at the hospital over five years suffering from advanced and potentially crippling nerve compression in the neck, and using canes, wheelchairs and walkers, instead of getting surgery. He said the condition is easy to diagnose and treat with surgery before it progresses too far.

"It's like if you suddenly saw cases of syphilis — a disease that has long been curable with penicillin," Kois said.

New Hampshire is one of a few states without a full-service VA hospital. The Manchester center provides urgent care, primary care, ambulatory surgery, mental health treatment and other services, but it contracts with Concord Hospital and others for more elaborate surgery and inpatient care. Members of New Hampshire's congressional delegation have lobbied for the hospital to become full-service going back at least a decade.

Dave Kenney, chairman of the State Veterans Advisory Committee, which brings together numerous veterans organizations to advise New Hampshire's Legislature about veterans affairs, said he hopes the investigation results in significant change.

"They need to put their money where their mouth is," he said. "They need to put the resources in to get it done and fix it."

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