Allegations prompt investigation at Naval Hospital

The allegations of a civilian psychiatrist fired while working at the Deployment Health Center of Camp Lejeune’s Naval Hospital, have prompted an onsite quality assurance investigation, Navy official said.

Deborah Kallgren, public affairs officer for Navy Medicine East which oversees the Naval Hospital and Camp Lejeune-area clinics, said a multi-disciplinary team of clinical professionals from the command conducted a review at the hospital between Dec. 7 and 11.

The review, she said, included verbal interviews with several dozen personnel, including hospital leadership and former colleagues of Dr. Kernan Manion, the psychiatrist fired from the hospital in early September.

Manion, a Hampstead resident, spent seven months under contract at the hospital, employed by an organization called Spectrum Healthcare Resources. In his time there, he said he witnessed a number of troops under his care exhibiting signs of severe post-traumatic stress disorder who were not immediately identified for psychiatric care, overworked therapists and physicians breaking down in his office, and Marines who posed a threat to themselves and others unsupervised on base.

“I had a guy lose it in my office, slammed his fist into my table, standing up full force, and then stormed out of my office,” Manion said. “He has identified that he is suicidal, homicidal and alcohol-addicted.”

Manion said it took a quarter of an hour for military police to arrive. Following the incident, he raised one of the first of a number of his complaints to his superiors, about enforcement of the policies on patient violence.

On top of concerns Manion had about patient care, he said his work conditions were unacceptable, as the Deployment Health Center was located in eight large trailers for two years while a $5 million renovation of the building that now houses the center was completed.

Among his grievances were paper-thin walls and “cheesy and shoddy” construction that cause the trailer to shake with howitzer fire from a nearby artillery range, plus an infestation of mites that afflicted doctor and patients.

Following other incidents, including one in which Manion was warned by two Marines that a Marine they knew was going to “lose it,” he began to send his memos higher up the chain of command, elevating them to the hospital’s director of mental health, medical director and director of branch clinics.

Finally near the end of April, Manion sent a lengthy letter, one that he said took 40 hours to write, to the hospital’s Commanding Officer, Capt. Gerard Cox.

Two weeks later, he received an e-mail from Cox telling him that his concerns had been heard and that changes were in progress, Manion said. But in June, he received a notice from his contracting company advising him to “cease and desist” correspondence with the government.

Officials from the Naval Hospital would not comment on the circumstances of Manion’s firing, because it was a decision made by no one at the hospital. The contractor has released no specifics about the incident.

Before he left, Manion wrote letters complaining about the quality of patient care to the inspector general of the Navy and other officials including President Barack Obama.

Rep. Walter Jones, whose Third District constituency includes Camp Lejeune, became involved after Manion reached out to him with his complaints about the hospital.

Catherine Fodor, Jones’ press secretary, said the congressman had written a letter to Defense Secretary Robert Gates, bringing the matter to his attention.

“Based on the number of cases that have reached (Jones’) desk, it’s fairly convincing that there are serious problems that need to be dealt with,” Fodor said. She said the office had received no response to the letter to date and was waiting to allow the investigation to play out.

Kallgren said Navy Medicine East is taking the allegations seriously.

“(We) want to be able to look at the information that was gathered in these interviews and the information gathered by Dr. Manion to have a complete report,” said Kallgren.

Last week’s review, she said, also involved access to all the documents that Manion had given to the Inspector General.

Cox said that he believed Manion’s memos had been treated with due diligence.

“I think what’s fair to say is that we took his concerns seriously and addressed them at each step along the way,” he said. “We did our best to satisfy his concerns.”

A confluence of events, Cox said, had contributed to the conditions that Manion complained of, including the renovation of the Deployment Health Center, into which the trailer-housed offices were relocated shortly after he left; an influx of troops requiring mental health care due to ongoing combat; and a growth initiative that brought more than 10,000 additional active-duty Marines to Eastern North Carolina.

“One of the areas in which we’ve experienced the biggest and most obvious demand is for mental health services,” Cox said.

In order to meet a demand for care that now outpaces physician availability, Cox said the hospital was rapidly hiring personnel.

“We’ve got the funding to contract with up to 55 additional staff members in Deployment Health and Mental Health, and we’re trying to fill those positions,” he said.

Cox said the hospital receives 26,000 referrals per year for mental health care.

Kallgren said that the review, now completed, would be combined with the information gathered by Manion to produce a complete report. Since the results could contain clinical information, she said she didn’t know if the report would be made public, although an executive summary may be released following analysis.

On Friday, Cox said in a statement, “Caring for Camp Lejeune's wounded warriors and their families is both our most important mission and our sacred privilege.  We are proud of the excellent quality and ready availability of mental health care at Naval Hospital Camp Lejeune. The community can rest assured that Marines and sailors at Camp Lejeune who risk their lives in the service of our nation receive top-quality health care when they return from the combat theater.”

Contact Hope Hodge at 910-219-8453 or hhodge@freedomenc.com.