case r:0e-cv-flflff,0-nBPB-dBli,r Filed 05/04/12 Pase tB ot 24 PaserD #:

B8.ot[n?lhl$1;o

AND q#H*
REGur-ArroN oF pRoFESsroNs
View.Entire
OCCUPATIONS rqCETEAr. Chapter
PRACTICE

rb 458.331 Grounds for disclpllnary acHon; acflon by the board and

{ department.--
(1) The followlng acts constltute grounds for
denial.,of a llcense or dlsclpllnary
action,
inrng, or renewrng a ilcense to pracflce
medrcrne by
esenta*ons, or through an enor of the
the board. Jepirtment o,.
(b) Havrng a ricense or the authorrty to practice
medrcrn
otherwrse acted agarnst, fncrudrng the
denrar of rtcens,n
of any Jurrsdrction, Includrng rb aiencles
or subdtvGtons
acceptance of a physlclan,s rellnqurcnmenf
other settlement,_offered tn resp6nse
of a Il*;;;;
to or In anticlpatto
ad m in istrarive cha rses asa|nst
[rr" pt rcr.r" ; tlili,rii5J,']
agalnst the physlclan's llcense
(c) Belng convicted or f,oun
iebarule'ss oi"-a;ralg3uon, .of
nolo contendere to,
tlch dlrectly retates
t
practfce of medlclne or to
!.
to the
mls
(d) False, decepHve, or
(e) Falllng to report to the r
vfolatlon of thls chapter or r

provider approved pursuanl

wlth InformaHon in accordar
(6).
ng, or advlslng any_unllcensed person
apter or to,a ,1. to pracflce
9l the departr"nt o5 in-u.;;il.
tarutory or tegat outtgatton
iL*a ,pon;.t6;:lr:
(h) Maktng or filtng a report whlch
negllg.enfly tulllng to fllE a r'.port
o
lmpedlng or obstructtng suctr
nilno
or records shall Include orly thosd
physician.

t
a
..r
I

medlcine.
(l) solrc'ng patents, either personaty
or through an agent, through
the use of

Ll
case1:'e-cf,;ffi
9ftiRPP,d,?h,.'?,ft.1#HfJ,{43?,f,,F jHip:,,91,Jiefi?T'"L"J,iTX1J3J
;'
f;i'133ff$ Hil/t;?Hlfl5,1miit' Jr'."trv r'" p r.rdv",lq, ",o u n r,,.0
I
I iil
(m) Faifing.lo
feen loglble, as deRned by department
board, medical rccords that ldentify tf,; frc,i*d
phys
and supervrsrng physrcran by name and proftssronar
t
for renderlngr.orderrng, sup€rvisrng, or brilrng for each dri
procedure and that Justiff the couEe of
trea[ment of the paHent, Includtng, but not
llmlted to, patlent hlstorles; examlnatlon results; test
prescribed, dlspensed, or admlnlstered;
results;-rl*ru, of drugs
hospltallzaflons. ' and- --'
reports of consultagons and
(n) Exerclslng Influence on the patient or
cllent In such a manner as to explolt
patient or cllent for flnanclal gain the
of the llcensee or of a thlrd
;arty, whlch shall
$illl;l't
not be limited to, the promoting oi setlins
or r.rGi soods, appliances,
promoflng
(o) or adverUslng gn.Ay prescripflon fu.rm
of a communlty pharmacy
shall also state *rnis prescriptron r.y
be flued aiany pharmacy
;lltt:^'j,:J!m of
(p) Performing professlonal servlces
whlch have not been duty authorlzed
her resar *p*"nLlile, except by the
3:ff!l["''i1T: ?1,!5fl "r'p.uroud In s. 743.064.
(q) prescrtblng, dtspe
drug, Includlng any a
professlonal pracflce.
that prescrlblng, dlspt
drugs, Includlng all m
lnapproprlate quanflH,
@urse of the physlda
(r) prescriblng, dispen
schedule set forth in c
prescrlbed, dlspensed,
authorlzed to prescrlbr
(s) Belng unable to pri
reason of lllness or usl
materlal or as a result
paragraph, the departl
or the Sbate Surgeon (
the licensee ls unable I
paragraph, the authorl
or physlcal examinaHor
refuses to comply wlth
examlnation may be er
where the licensee resl
ls fifed may not be nan
documents, and the prr
be eniltled to the sumn
ce rfl fl cateholder affecte
easonable Intervals
afrorded an opportunltl be
an resume the competent
practlce or mialone wli
(t) Notwlthtt-;aliig .li ratients'
g5trq(z):
l.-committlng meiicat
great welght t" tf" pr"\ The board shall give
50.,
malpnctlie snatt nol'ue Jng thls paragraph.-la"al.ut
one lnstance, event, ot.
aA.
case t'og-.oftgf;hflRPstDd t4tL2 pase 2o ot 24 pasetD #:
3. Commftttng repe
by the board iorrli ned In s. 455.50. A person
forrnrl
may not be ficensei nalpractlce based on
rfs state to provlde
r.4&H""
services as amedlc heatffiE
Nothrng In thrs paragraph strail
be construed to requrre
incomperent to practtce meaictne
tn o.ueiio ut a]]iiirr
paragraph. A recommended
order Uy.n r-rrr"rrel'etrYq
adrnlnistraflve
the board flndlng a vlolagr of
was found to have commll ee
malpracUcern or nmedlcal r

publlcaflon by the boatd n

l^Ili:hr bY the prevallins

expert mentafl
,91stitr1!e o.-n o n
rnq written consent.

to know that he or she ls n

standards of pracHce and s
but not llmlted to, educaflo
Indudlng anesthettcs, assls
ter personnel, transfer
$( or mulUple prccedures,
hen the llcensee delegaflng
rch person ls not qual-lfled "

evlously entered In
a
ruect subpoena of
the
(y) Conspirlng wlth another

yJ
al
r:?hTffi':iff::,".
pregnancy. unlawfi.rr termrnauon
of
lpflon furms.
rar drug appearrng
on schedure II In chapter gg3 by
the
spensfng, admlnlsterlng,
sup?lfng, selling, or glvlng
rmphetamrne or a scnerureii any
sympathomimetii
of, pursuanr to chaprerigi,-io amine
;,. i"r-;;;.il];;
except

.haracterized by
II1TT.
p dtstracta bil
::y".T
tmpublvity; ry;,
or

?Ti9n or the treatment of

Jalities; or
:ompounds when an
10 approved by
the board
uately the.acilvtfles of
those assistants,
*fl{unnurse
ul technlclans, aavai""j-rl!,.."red
case t:os-cvf€ff31&g dplt.&p.%y6rbs?r,1&&if",rJffiol,^I?,fi1::_,1,T,:l;,",rr:," -'

c'* t[.r dfT ?ilffi :;1l11rol'iilfl ln'

ad mrn rsterr ns, supp rvi ns, sen ins, o,. s rur ns

€ ----
(hh) Improperty -r-
rep
(fl) Falllng to inary orocecrtinn

djgctnilnary acflon set.out In

lor
provtdes health care servi"es in a
fadfity unae..fiafter
licenseO 35

ll,'3"'!liili??i1i,:11l,lqHn'n*ff
0j) Betns tuund o), d;,; i5J#"lapter641,rnwh,chthe
ln, iir-," *tu to have provl
m ed lca I expert op
n on uttu.n.a
i I
il
.;HffffiT,i*flllfffi
il :tH,llT,:. T:l$9 co no bo ra u ns wn tten
,:,#'#r,ffi y,iivi,qi,ffi
(kk) Fatng ro ,=lof
li ll','lrTiijxhbntent
rhe board, r1y4trng,
parasraph (b) hT b_een r
raken igihrt
w*hrn 3o
l.,, rf acron as defined In
",ili;rf;#; ti"po.tr.. medicine riranother

iffri#-T$-t-,*''IH"x*l*tt*rd-certinedspec,a,,st,rrnotquarined
[[T,]5?:ifl
complalnt. 'tfi lllil*Hffi ::ffi."?,",:[,fi iffi.ffi,#*xl,.*,Ju,,.n,
provlslon of thts
chapter or chapter 4s6,
[lRr:fl1T:t ?iv or ani rures adopted
tytng llcensun
t fur llcensure
)V
*{lt="l#ffih$Hknl
!3iil:ffi l,llfl'r'.f,'',Tl'...
n' All costs
assoclateJ *rJi *rptance
wrth orders rssued
tation
(3) In any admln 9r
the physiclan.
revocaron o. ,ri larnst a. p.hysicfan whrch
t' the dlvlslon shafl travi
does not Invorve
greater weighi oJ
i.tion. n. iir"rrr, estatrGh_trr-e ;ilil::."i:,:^=fi,.?rrolllio,,.uo
grounds fur revocatlon
9lqr1.ra *r"'r.,"n evrdence. or irrp.nrion
u,, #il.nr.
(4) The board shat not
retnsta'te the tcense
of a physrcian
:::,i'"0i5";{"fi
the finaf order and
?ij:;1,t.::*n,*rlu'lti{jf ilr,it;:f; iff.,,censetobe
I

'"oriinl.ri*iH:tf, :'r','jlf i'fi''',f ,.ffi :,:iL;#=

Case 1:09-cv-00860-DDD-JDK
any mectfcat docto +112 Page 22 of 24 PagelD #:
malpraciloe based
prospectfve llcensr
order and fs capab
(5) The board shal
cases involvtng spr
and maxlmum flner
or reissuance of a I
malpracHce,'and n
consldered dlstnct
(6) Upon the depar
closed clalm agafns
pracUUoner ofa reg
of a presult noflce i

and determfne lf act

(7) Upon the departr
pursuant.to s. 395.0

reasonable sklll and s

authorlzed to malntal

an annual report subn

of an adverse Incldent

(lo).A probabte cause panel

cc
*r lru ;n**k: #3, ln#f
',jtffi ,t*{d3l;l {trn HAH T *ffi .

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Case 1:09-cv-00860-DDD-JDK Document 183-4 Filed O5l04lL2 Page 23 of 24 PagetD #:

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,/i2/200E 15:{1 FA-X 202 45$ 5225 VA EOUSE LIAISON @ ooz

DepanrurflT oF VETERANS Arrruns

Officr of lhe GeneralCounsel
fileshlngton DG 20420

ir0v 5 Z00s

ln Reolv FleferTo:
The Hononable Mary L. Landdeu M1B: KS
united sEilEe senate
Wa*rlngbn, DC 20510

Dear Senabr Landfieu:

I am pteased b respond to yrur Inqulry on befialf of lour constituent,

Fbyd Hamilbn, lll. Mr. Hamilbn contactd you over his concems abgut
prcvHed b his
\ ntofveterans
)
Mr. Hamilton filed a claim wih the VA O'fficg d Regional Counsel in
Housbn, Texas, on Agll 17, 2008. The FedenlTortQaims Ad (FTCA) pmvides
that the agenoy has 6 nronllrs frqn the date of filing b lnvesdgate a deim, frr
1vffdr a ctaimant may elect b f,le flJit or may await a determinatirn fiom the agency.
We regret hatVA dld rd conrplete the inve*ignEon within the &montfi per{od;
horrpver. the Reglond Counsel is arrcitirg the findlnge d an independent rnedbal
rwiew of the deceeeed vebran's cerc. Afier fiat b received, Regbnal Counsel will
have the inbrmation necessery b condude the lnvestgatbn and reach an
apptopfate decision-

Becar.se ttre administrative prooe$r has taken ntre than 6 npnths, the
Reg'lonal Counsel attomey assigned to the case has $Poken with Mr. Hamifton to
advise him of his option under the FTCA to eitherff,e suit in an appropriab Federal
dlstist court or b aymit a decieion fioni the Regbnal Counsel. Wh€n the Regional
Counsel mEkes flre flnal determination, our offce will advise you furlher.

Thank you br yutr stppolt of our Nalion's veErans and their families.

Sincerely yours,

Acting GeneralCounsel

0;
'J

l,f
rAAna A ?rnv
MARY L LANDRIEU
I OUISIANT\

WASHINGTON, DC 2051 O_I 804

November 25,2008

Secretary James B. Peake

US Department of Veterans Affairs
810 Vermont Avenue NW
Washington,DC2004Az

Dear Secretary Peake;

First, I would like to thank you for your hard work and dedication. your
efforts to improve
the lives of vetcrans and their families are conmendable and quite
praiseworthy. I fully support the
initiatives that positively affect our current, retired, or future military p.rro*"i.

In I
Hamilton '
counsel. li
ral

complaints that veterans are not receiving quutity from tire Alexandria VA Medica, a"",!11fr,,
brings me grave ooncern for the Veterans that live"ur"
in my state and more specifically in Alexandria.
'fhe Regional
Counsel reviewed the specific Tort Claim that Mr. Hamilton submitted
and after seven
months it was dcnied administratively. I have also advised Mr.
Hamilton to file his follow-up claim
with VA General clounsel. I have enclosed the letter that Mr Hamilton
received fuom the Regional
General Counscl.

I appreciate your kind considcratiorr of this request. If you need further information,
please
point
contact the y stafffor this requesi, Bart Klners on, atZ02-224-O094 or
Bafl_Kenerson(@ gov.

With warmest regards, I am

Sincerely,

Jt*',
Marf L. ndrieu

fa.
 *r This information is nots for the patient Record i*

Report of Cont.act DaLe: DEC L2, 2006

Contact Number: 502.O607a7 Date of contact: Nov 24, 2006

PaEienl Name: HAMTLTON, FLOYD .]R PaE.ient. SSN: 437012093
TreaLment Stat.us: Inpat ient LocaLion of Event: ?BNf NORTH
Name of ConEact I Phone of Contact: (318)449-4222
Date Due: NOV 30,2006 Into b.ke! byr cIBs(DI,ataRRY L
Eli-9. SLatus: NSC Source of Contact:Visit

Refer To: REED, HOLIJIS T

Issue Text:
MR HAMrIrToNrs
soN REPORTED To ME THAT oN THE WEENEND oF 24 sEpr.06
THAT HIS IN ICU.HE REI,ATED TTIAT HIs FATHER HAD A BREATHING
FATHER WAS
TUBE THAT WAS ORDERED BY DR ST CYR WHO WAS PATIEMT'S ASSIGNED
PHYSICTAN-HE REI,ATED THAT DR ST CYR }IAD ORDERED THIS SO
TT{AT IF HIS
FATHER wourJD ASPTRATE THAT HE wouLD BE ABrJE To HA'E
ArRwAy .IJEAR.HT'
SON REPORTED THAT DR NBGI,AFTER RETURNING BACK To woRK
AF1TER 4 DAY'
ABSENSE ORDERED THE TI,BE REMovED.soN REI,ATED THAT
HE PLEADED II,ITH DR
NAGI NOT TO REMOVE THE TUBE BIIT TIIAT DR NEGI REI,TOVED THE
?UBE AND SENT
PATIENT OUT OF ICU TO A
RooM oN THE F.URTH FLooR.soN RET"ATBD THAT HB HAD sERrous coNcERNs oF
Hrs FATHER AsPrRATrNG.soN RELATED THAT HE HAs poA To
MAKE uEDrcAr.
DECISIONS FOR I{IS FATHER AND THAT HE REQUESTED MEETTNG
WITH DR NEGI TO
DISCUSS THIS MATTER FURTHER BUT THAT HE WAS NqT AFFORDED
THIS
oPPURTtNrrY.soN RETTATED TIIAT sHoRTr,y AprER pATrEMr wAs
MovED To THE
F.URTH FIJR' THAT HE FoItND Hrs FATHER rN A RooM THAT wAs
A DrsrANcE FRoM
THE NURSING STATION ATID HIS FATHER WAS IN DISTRESS AND NEEDED
suctroN.soN RELATED THAT HE wAs CATJTJED AND TOLD By DR sr cyR TttAT
PATIENT }tAD TO 'BAGGEDN AND TAKEN BACK TO ICU SHORTLY AFTER TI'BE WAS
TAKEN OUT AND PATIENT TAKEN OtI! OF ICU.SON MAINTAINS TFAT PATIEMT HAD
MADE MARK IMPROVEMENT IJNDER TrtE CTRE OF DR ST CYR BUT TURN FOR THE
woRsr WHEN DR NEcr BECAIT{B rNvoLvED rN Hrs CARE. HE REIJATED TBAT HE
FEEIJS THAT DR NEGT IS DIRECTLY RESPONSIBIJE FoR BRAIN
DAMAGE THAT HIs
FATHER Now HAS.PATTENT RELATED THAT HE DrsqtssED Tt{rs
!.{ATIER wrrH MR
PARVIN OF COS OFFICE AND ALSO WITH DR ADMA! WIT'I{ NO
SATISFAqIION AND
NOW IS REQUESTING MEETING WITH DR REED PRIOR TO TAKING MATTER OF
STATION.

Reeolution:
r pRovrDED A COpy OF THrS REPORT TO QM
4ID TO DR REED.

l3
 DEPARTMENT OF VETERANS AFFAIRS
Medlcal Center
Alexandrir, Louislana 7f 30C9004

In Reply Refer To:

March 13,2007
50a11

Mr. Floyd Hamilton, Jr.

6512 JoYce
Alexandria, [A

Re: Floyd Hamilton, Sr.

Dear Mr. Hamilton,

service chiefs also
I have spent the last two months with your dad's record and our
reviewed the record.
hospitallzed in a private
To summ anze,your father was seriously ill in July.wfren he was
behavioral problems
facility. Aside tffi ftis .tiokg, he had severe cerLbral atrophy, and
at home.
he had carotid artery
He came to us briefly and then went on to VA Houston where
At thattirn" n" n.a a right hemiplegia. He was contused and some of his
=Lig"t
u"n?ri'or"l problems caused alterations in his treatment plans.
been here since
After he finished his surgery he came back to Atexandria and he has
re.spiratory arrest whigh
that time. prior to the weekend oi*norn he had episodes of
w'rth each episode his
resufted in his imrnediate intubation due to absent respirations-
neurotogic function decreased.
indicated and his
His extubation and transter to 7cs were appropriate and medicafly
a respiratory anest this
management on 7CS was also appropriate.' Hi Oia not sustain
subsequently required
time but he was retumed to the f CL t6r closer monitoring- He
reintubation.
was in even a year ago'
Mr. Hamilton will not going to go home in the condition he
his care has been
However, across the three hospitals he has been in since July'
appropriate.

Sincerely, ,/,4
t'24-/
T.
HOLLIS
11-
REED; MD
1* 1'-1c-'
tr
rur 15 F t' f- X'J 1'/
.-$ nfrt,r1x,r'fu
"{t
\tl
 ocT-aFzata I4t45
I P.1A
DEPARTMENT OF VETERANS AFFAIRS
Office of Regional Gounsel

00

APR 2 4 20ffi
PaEickA, Keen
Gencrrl Attornsy
51 0 Easi Stoner Avenue

tvlodical CeatelDirector (5 0100) Shrevopott, LA 71 I 01-4295

Depafiffnt of Vt terans Aeirs (310) 42+€le6 (ole)

AJexaudria VA h,l:rdical Ceutcr (31 s) 424€19e (Fax)

Post Offic6Bor 69004

Emall: petrlck.keen@va.gov
Atorauarie krrdiq'iana 71306-9004

Re: ^ddminisnative
Tort Claimof Floydlduiltoq Ir. (2093)

Dear Ms Wakfur:

Enclosed is a slai,m from Floyd Hamiltotr, III, son ard ppmoml represtntative of Floyd Hamitto4 Jr,
(2093). The ciaiu rllegos negligeuce by VA Healfr Care hoviders fTICP') s alHdauLs 4 the
Alarandria VA llledical Center. Thr agEregato damegos alleged are per*oral injury in a fiihre to
provide fte reaiir od standad of c4rc, failue to hEat and frilure to diaguose the ccdition of Floyd
Ilamilton, Ir, in premafiuely removing him from vetrtildor zupport and moving hiil fio'rrt ICU to a Dou-
aqrte unit, Tliu rrfficc will inyestigafe the claim and work with yor aad yorr stafthrurghout the
iffnestigdiou.

Wo rcquire cogial of any peer revie$'s tbat have examined thc a[eged nogligenco of perconal tdury. h
addition to theoe iuaforials, pleasc foruard ary board of inveutigdion results. Ifthers has b€€n an official
inquiry telating tr the alleged negligence, please ftrward a copy of your reaponse.

To assisl our iarc'stigation, pleasc have yorr staffprepare ONE paginoted copy ofthe entiro medical,
adrninistrative, iud (rlcctronic records of the vetcran/claimant, as wcll as TWO (2) CPRS CDs o'f the
medical rscord i:lcasc inforrn this office if portioru of ttrc vsteran's records arc located at anotler VA
lhciliry, If so, ;lltasc seclrre copios of those rccords, as wcll, In addition. please havo your stnffprovidu
one copy of tho filllowing:

(a) AUr trilms rude from January 2004 fudugb curd dao on disk The disk ie to inolude all
Mldlirosuhs, CT ecan $sults, EKG and EEO rorults, eto.;
O) So,,luester any blmks, slidcs aEd prosthesis, etc., assooiated wih the Bgdicsl rGcords;
(c) Naurt of all HCP or dardants involwd in the neafrnont of the veterrn/ctairnaat relatod to the
al}rged negligence. Please hdioate the currcnt duty stdns and addr€fs of these individuals.

General Afornq

Encloqurffi (a/i)

cc: Medi$ilfiegalAfiBirs(sZElllML)
Mediqrl,Cefier Chief of Staff (5 0z I l)

2093.10r

t5
i9c
rep, lu, ll.l|.)u l/:rurHl ru,'1 4Lv L t

DEFARTME NT OF VETERANS AFFAI Rg

Alcxandria YA Dledical Gentcr
249C thnvrpott HQhway 7l-North
Post Office Box G9004
Alerand ria, Louiaiana 71 3009004

September 5, 2008
/ l ,i
4,,rr'' rl
The Honorable Rodney Alexander ":
U.S. House sf ReprcsenhtiveE , l;2 t- i:' " i9 Ll - GA:O i

1412 Centre Court, Suite 402 I

Alexandn'a, Louisiana 7'l 301

Dear Congreseman Alexander

Thank you br yoJr conespondence on behatf of Mr. Joe Grcen, Eteatthe Officer for the Coalllim
Againqt Mqdisa!_Mjglra-a_lrnent d Vetgans, regardlng hls request fs aosistancs h investigating the
medical traaBnent dveterans at the AlElrandrla VA Medlcal Csnter.

In his letter, Mr. Green sserts ttrat the Glasgou Coma Scda (GCS) is used to'determina the need
for placing e pstient on brething srpport.' tn f;act, GCS ls a neurologbal scele n'hich alms to give a
rdiable, objective vrey of recordlng thc conscious statc of a person, fu initial as well as conttnuing
aeseeement. GCS wae lniflally ue€d to essecs lewl of coltsclousness afur head iniury, and the scale
ls now used b)t frst ai.d, EDIS and doctors as being applcable b all aarc medical and fauma
palicntr. In frospitata it b alao us€d h cfnwric patlent monibrhg, ln for instanca, intensi\re care. GCS
is not r.rsed for determiniry the need br breathing support

qnv rHgcsF @efu tn*-Hdilt rEvleLs-Qf.

-
Copi* of medfcal reoords art availabb and
lnd sign a release of inbrmetion funn.

The Ale)€ndria VAMC ls not aurers of arry ratumlng wlarant beirq freitant to seek care at our
facility. ln Ect in recent Focr.p Group meetings with Operetion EnduJing Frcedom (OEF) and
OpcriUon lmqi Freedom (OlF) veterans, the facillty recefued very positive r€€_qon6* concerning
sdrvices provided. The Atexandria VA[4C has algnlicanUy enhanced its rnental health aervlces in
response to the Globaf War on Tsrorisrn. New Ssvices includc the Hlotrinqltlggrems: OEF/OIF,
tttehtat Health Intensfue case Management Post Traumatlc str€es Disoder (ffsD) clini;al Team,
Suicide Prewntion, Primary Gare in Menbl Heallh, Local Rcovery Cmrdinator, Traumalic Brain
Injury Clinic and a Polylraurna Support Olnical Tearn. In addition, Ale,raldria VAMC works closefi
-Aayn+.tonea
witn Army Community Hospibl at Fort Pollt, loubbna and the Louisiana National Guard
to oureach to vebrans needlng VA services.

The Alexandria VA lt/edical Center is accredited by the Joint Commission. As part of the federal
gwernrnenfr sccond largest agency, the Aloendria VAMC is subject to multiple, rigorous sib visits
evary year thst exsmine all .xipects of the facility's operatlons.

lf Mr. Grean has any addilional concems aboul the quality of medical treatment at the Alexandria VA
Medicaf Center, ha may contact llr. Jay DeWorfr, Mrninistnetiv€ AssHant to the Dlrector, at (318)
473-001 0, sxtension 2010.

MedirnlCenbr Director
Congesional 0fi1

llo
 ErHlEfT a3
September 7,ZOW

I received a call from Rebecca on August 31,

2009 at about 930 a.m. on my cell phone asking fo"r
minutes
for the critical care meeting. I elplained to her that I didn't
have any minutes and that all I had was the
folderthat Dr- Negi had glven me from the meetng whlctr I didn't attend.
I told Rebecca that no
minutes were done because Dr. Negi dropped off the folder before
she left to go on vacation and didn,t
explain anything to me on what or how she wanted the minutes
to be done and that I couldn,t
understand her notes. I also explained to Rebecca that this was
my first ume to do minutes and that I
had no clue as to what order or template l'm suppose to foltowing
because the task was given to me
with no explanauon as to how to do iL Rebecca asked did I at least attempt
to do anything with the
crltical information- | told her yes, I typed up the date, time, place,
employees present, etc- she said ok
And we hung up after that- Rebecca then called me back about
30 minutes later asking me for my user
id and my password to log on to my computer to get the info
that I put for the criucal meeung. I
explained to her tha! that was illegal and that I wasn't giving her
my informauon. she then preceded to
say well Dr. Ne$ wanted your Informadon so she can do the
minutes hercelf. t o<plained to Rebecca
that this was inapproprlate for her to call me asking me for my personal
information for Dr. Negi and
that I was at home witlr my slck ctrild and that they can just get the
folder that Dr. Negi put on my desk
and go from there with it Rebecca dalmed that she looked fior
lt and that she couldn,t find the fotder. I
then gave her instrucdons as to where to look,on my desk and
told her the color of the folder. Rebecca
said well Dr' Negi is upset and need the critical care infiormauon.
I told Rebecca once again that l,m at
home wlth my slck ctrlld whom had the flu and that rlras
least of tmportance to me atthe time and to
Bet
the folder off my desli Rebecca told me I HAD to come in and get
the folder and give it to Dr. Negi. I
told her hat I will speak ftt Dr. Rivera about this and then we hung
up. I uled calllng Dr. Rivera ln his
clinic but at the time he was with a patient I then got my sick
son out the bed and came up here to the
vA to get the critcal care fiolder and give lt to Rebecca.
The fiolder wils on top of my desk.when I came in
there' As I was walking over to Rebecca's office with my son, Dr. Negi
raralked in with an attitude saying
hey you, were is my cridcal care Informauon I gave y(xr.
I explained to her that my name is l,Keisha
and
not hey yeq. I then handed
, : ,. l
you and 4ot to ask anyqqe I
She mok the folder and wal
people from' I picked
up my son and left the vA and went home to call Dr. Rivera
again. I finally got in
toudt with him and oplained to him what Rebecca had done
with calling me for my log in name and
password and telling me I HAD to come
up her and glve the folder to Dr. Negl and also what Dr. Negi had
said' He told me that he was going to take care of it upon
my retum to work the nort weelg I asked Dr.
Rlvera did he speak to the both of them and
he staEd he did. I asked him whatwas the outcome
and he
said that Rebecca didn't say very muctt, and that
Dr. Negi, 'welr you know honr she if she basically
laughed- ltold him ok and I went and typed up
this note to keep in my remrds.

"/ft4^- Ru-r.^- #ry^--

 ,4rfn4't I

A TlmeWarner ComPanY

t?

-to, oll
//)
z- /"' t/
-> /e '6lu't
ll /)f rttI'tc
fao ur 1rl -/

A Tlm&an.l
Conpanv
From: McBryde, Robin M. (ALX)
Sent: Tuesday, September 29,2009 11:35 AM
To: VHAALX ALL
Subject: lf you are ever contacted by the media...

Remember that only the Public Affairs Officer (PAO) and the Medical Center Director will initiate
contacts with the media or respond to inquiries from the media. \A/hen media representatives contact
medical center employees other than the PAO and the Medical Center Director, they will be referred
courteously and promptly to one or the other. lf immediate referral is not feasible, the emptoyee will
take the calle/s name and number and assure the caller that someone will return the call shortly.

Remember: Should you ever be contacted by the media, refer them to Tammie Arnold, PAO
(extension 206'l) or Barbara Watkins, Medical Center Director (extension 2205). Please call Ms.
Arnold should you have any questions.

Tavwvtttt ArwoLd
PublicAffairc fficer
VA MedicalCenter
Alexandria, Louisiana
(31 8) 466-2061 (office)
(318) 623-4316 (cell)
(318) 483-5029 (fax)
tammie.amold@va.oov

lq
 ETIIPTOYEE

February 17,2010 In Reply Refer To: 502/00

Cfem6nt F. X..Canofl, phys 15,

Step g, physician
Medicaf Seruice
VA Medicaf Center Afexandria
Pineville, LA 71360

RE: Discharge _Abeyance Agreement

Molation

2' fn the agreement, it states thatyou

will not engage in any further inappropriate
fi ll#J.'!ffi :E:'itr'$,"S
re tated 6ifi;h ;'g ;;;'i6"m*iil;'l ; yo u r p rop osed
"-'

I I have thoroughly reviewed

I have no choice uut-to-reinJt"t"
the information provided to me. Based
on the above,
n" actionioJil#rg'" you from your position of

aa
 Paga 2 ot Z

Physician, in Medicalservice, vAMqAlexandria, pineville,

service, effective Fridav. Februarv 26.20i0. -'
LA and from Federal

4. In accordance with the Abeyal.ceAgreement.- you

- ' signed on May 21, 200g, you
have waived alf rights to appealthis Oiscna-rge.

5' You will be placed on paid administrative absence until

the effective date of your
discharge. You must vacate VAMC Alexandria *rpu. immediaterv. VAnrc Abxandria
Pofice will escort you to your office andlor locker to retrieve your
m fersonat items. you
erty and clear any indebteiness, prior to the release
31
Fc
wiit ue unable toiersonally clear'the fiacility Dr. Jose,
this is done.

9 Any-questions regarding the above may be directed to Bill Cutrer,

in Human Resources Management
UER Speciafist
service, ai ertension 22s4.
Sincerely,

I have received the originaf and one copy of this document.

Signature Date

&3
 case 1:09-ov-00860-DDD-JDK Document55 Filed 0g/15/10 page
1 of 3

LINITED STATES DISTRICT COIJRT

WESTERN DISTRICT OF LOUISIANA
AIEXANDRIA DIVISION

FLOYD HAMILTON, M CIWL ACTION NO. 09-0860

VERSUS JUDGE DRELL

SHIVANI NEGI, ET AL MAGISTRATE JUDGE KIRK

DEFENDANTS' RESPONSE TO

Now INTO COURT, through undersigned counsel, come defendants, Shivani Negi,
Hollis
Ree4 and Barbara Watkins, who file this, their response to plaintitps
Motion to Add Discovery
(Doc. 48) for the following reasons:

1' On August 18, 2010, Floyd Hamilton filed a Motion to Add Discovery.
Attached to
plaintiffls motion is a letter dated september 13, 2003 from the Florida
Medical Board which
appears to be minutes of a proceeding involving Dr. Shivani Negi before the Florida Board
of
Medicine' From that document it appears the Board denied licensure and permitted
Dr. Negi
fourteen (14) days to withdraw her application.

2' Defendants have no objection to plaintif,Ps use of this document

atfralon the basis of
untimeliness, i.e. that it was obtained after the discovery cut-off. However,
defendants respectfully

submit that it is premature to make a determination as to whether this

document will be admissible

as evidence at trial- First, it is assumed that the Dr. Negi referenced in the minutes is
the same Dr.

Negi involve'd in this case (discoveryhas alreadyrevealed a Dr. Shivani Negi within the VA system

in Chicago who is not the snme Dr. Negi herein). Second, defendants
object to the admissibility of

e,L|
 Case 1:09-cv-00860-DDD-JDK Document 55 Filed 09/15/10 Page 2 of 3

the docr:ment as it is ingomplete and taken out of context of the proceeding. Thfu{ the document

makes reference to numerous appaxent Florida Board of Medicine regulations and that said

regulations are not reproduced or explained in the document. Fourth, defendants challenge the

admissibitityof those minutes based onrdevance. Fifft, defendants challenge the admissibility of

the minutes upon authenticity grounds as the document is not certified. And last$ Magistrate Judge

Kirk has previously stated on August 24,20L0 that the document would not bp permissible in

support of any claim of 'brongful hiring" by the VA as such a claim is not in the complaint.

3. In addition, defendants submit that a determination on the admissibility of the

aforementioned document is premature. Although the discovery deadlines in the Scheduling Order

have expired, it is evident from the postr.re sfrhis case, as well as Magistrate Kirk's order on August

24,20l0,that discoverylgmains open. It also appears that the issue of discoverywill be revisited

by this Cotut at the November22,2010 hearing.

WHEREFORE, for the foregoing reasons, defendants respectfrrlly submit that plaintifPs

Motion to Add Discovery shouldbe denied as premature.

Respectfully submitted,

STEPHANIE A. FINLEY
UNITED STATES ATTORNEY

s/John A. Broadwell

JOHN A. BROADWELL, No. 1733

Assistant United States Attomey
300 Fannin Steet, Suite 3201
Shreveport, Louisiana 7 1 l0l -3068
(318) 676-3610 ll Fax (318) 676-3642 s

a5
UASC 1 :U9-CV.UUE6O.DDD.JDK
36 of s6 pasetD #:
JuIy 19, 2017 incident !ls.
VAIVIC E& cr_c
Dr. Negi abues of patient, stafi, D.r. John
S"m*

iy HH*T l"* j33gJ#. f, aft u an adminishativety ordq"d,

1,5f,i5ff ff HL*:ffi :*l5ylklyr:yd,,r"r_h.r*;i;ffi
pq 1d,h''sl. r i"qd;;ffi
F'***#lgg*
'vftich qp_ry:gi1
codes the EIU MD aftEnits. We nsw bad n in houqa hoqpitatist *a
-*J;tff.
eJtog-t
' hoqtrbl floors was Do longunecessary. Iinquired about codes stthe C[,C
was bld wo still rcqpmdcd tbffe.
hrnsing h. .),rd
' Otr thc evecing of 071901l, a code was callod fur the VAI.{C
mrsino hn ,,,.. r nmr r^
.H*) A^ -J--* L--l - r . r !
mnnd fte pmiem. '|a-Ihc pdied
-Jg --t-- br$ was minimnlly bn
had apulse
hnd jnst rcceived a nedicdion,
bag vcdildion unas used by mc
rypeariqg h shbilize, brt in no
Mort rhnn 5 minfrs afrEr'I
ry
Dr. N.d -"de ho ul
oftbp simaioa sboimdiety ordered me to ntum
Iesrrc lhc ET{t for Crc codes-
t
tre Ett

I rEfirtrdb thc ETU, cl

the paied was bchg mfled inft
p,s 'nding on the ETU dom fot
r
a.tivity. Chestcompnessioil! wErE hgrn"
Noer@diffibdim
ftII20 bei"i uriible b
minrrteq
could tht nunes- Einally, I reon

b thepdied,s.chcst v,odcr
shc
tbptirnt CI.C pbnician andl
compressions. Uftile Iums doin
you're dorngfrcmtoo slow.
Do
reply u'as, hd you wuuld hoq

{,

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 IEP1Rt".-Tttr
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 RtrsRt"OF ggiltHRgteo pasetD #;

DefincanoHtos.ErDcs,

: lfllGoFtEIHAll IW or pill **ot*or*t--

A['O.RES6 OFI'EIERAil TEtEpHonEto.or@
i
.lt
FID 4n{010, sa.2510 :

TYEoFcDllrlcf tffiad
reHt=l€m.@
(31S)473{0tqun

iffior@
I'
i

BHEFSIATHE}TTffi lq 4R{010. aa .

a8
 p7

Case 1:09-cv-00860-DDD-JDK Docunrenr 261-3 Filed OBi 13/13 Page L of 6 PagelD #: 44LO

UNITED STATES DISTIUCT COURT

WESTERN DJSTRICT OF LOUISIANA
.A.IEXAN DITI A DII/I S ION

FLOYD I-li\1.{lL'1'ON, tll NUMBEIT 09-CV-0850

VEIISUS JUDGE DIiELI,

SI{IVANI NIJGI, ETAL IVIAG]STRATE JUDGE I(IRK

.tlE CL.rLIt-,\'f I O N Otr' .l [N NI F]IiR L. D I! S C H EN ]rS

I, Jennifer L. Deschene.s, Ceclare the tbllowing to be a true and conect stetemelt cf facts:

1) I ul the Deputy Executive l)irector of Discipline for the Board of Medicine (Board) in

the Departrnurt of Health h'ofe.qsions (DHP) for the Commonwealth of Virglnia. The

Boa;'d is in cluuge of licensing and regulating allopathic physicians (in addition to

osteopa"lrir,: physicians. podiatrists, ctrir.cpr.actoru, p.hSrsicizur assistants, urd o0rcr alllccl

ltealih proibssionals) in the Comrnonrveal0r of Virginia. As thc Depury Execurive

Director, I anr in cha-rge of overseeing tlie disciplinary process for alt Board licensces, I

have been ilre Board's Deputy for seven (T) years.

2) Due to the nature cf my ollicial duties, I am pcrsonally familiar with rl:e investigalive

troccss, prrobalrlc cause :evierv. anC ihe adjuJicaiion process that rakes place r1,hen a

Iiccn;'ec has a cornplait',t filcd against hinr,fter,

3) I',ly official duties incltrde but are nol limired to the follorving:

1. l.'{anaging the iiscipline sccticn of the Board to ensure tjmcl5, case r:solutjc,n.

GOVERI'IMENT
EXHIBIT
4
 p.8

case 1 09-Cv-00860-DDD-JDK Document zor-3 Fited oB/13/13 page

2 of 6 pagetD #: 441,L

2' workiDg with the Execuiive Director to irnplement newly

passed or revised laurs

anri reguladons rogarding the Mect:cal Practice Act. the

Dr.ug Cc.rtrol Aci, ancl ih:,

Board's Standards of professional Con,Juct.

3' Ensuring quality case Cecisions by the complcte revie.z of facls

aud application of

larv 6116 regulatior to all cases, and that all p;oceedirrgs arc run:n accordance rvith
admini_straiive larv and d,.re process,

4' Coarclitrating witir DIll"s Adnrinisuaijuc Plor.:cydir:gs Divisiorr, rhe Oft:sc oithe

Attomcy Ceneral and privale altcrncys io faciliure ile ci:spositrgn lf cases.

5' overseeing esteblished proccsses for compliancc casc resolution for the
Br:ard ro

unsure licensce compliance with Board c.rders or referral

for fiuther

i nv asri gu tiorv'proceedi ngs i n cases of roncornpl i an cc.

4) 'l'he slatcnler-ts that follorv

erc baserl or) my revierv of BoanilDl{p oLjlcial files anc1

reuolds' my own personal k:'torvlctlge., ancl lhe intbrn:atjtln

I acquirecJ while prerfo:ming
my official duties,

5) on Jar:uary 23,2a12,I receir''ecl a lettcr cared January lg,zll2ttom Lcruisiena

congressman charles w, Bou.stany, Jr., M.D, which includecl a letter s_:rd ,,several

packels of int-ormation'' linm N{r. Paui Labbe (a

Lcruisiana constil,uent of Bogstany,s).
'Ihc: infornation proviclcd
in Lflbbe's l:tter anJ atta,Jlunurl'6 (the .,Labbc compluln1,,)

included allegations of unetbical coruluct by multiple

individueJs and entjfies, Onll, one
individual named in 1he malcrials was identified as a liccnsee <rf thc Board (Shiv.ani
Negi,
lvl'D')' Tbcj Labbe complaint alteged that Dr. Negi cornmitted licensure
ftaud iu that she

Pui'Portedly 'lieC to rhe Virginia Mcclical Boar-d by not filling out quesrion 7 rvhich

specifically asked tvhether she ita.j cver besn cleniu.tl iiccnsurr:.compcrcilcy

examirralion
 p9

case L:09-cv-00860-DDD-JDK Docunrent 26i-3 Filed 0g/13/L3 page

3 of 6 pagetD #: 4472

by any licensing authorir-y." 'rhE Lo,:'oe conrplaint

claimec rrrat Dr. Iriegi hac been clcuied
licensure by thu Florida Board of Medicine
fFrorida Board,), and so shourd ha.ve
disclosed the allegcd denial to virginia. In support of this allegaticn, the Labbe
complaint enclosed documents thar included u..notjce
of intent lo deny,, ordcr entered on

october i3,2003 by thc Florica Board's Executivc

)ircctor, Larr_v- Mcpherson, Jr.
I rerriewcd the Elorida Board's "norice of irrtent ro de ny"
and cetermined it rvas not a

staffcontacted lv1s.

clrandra Prjne at the Florida Boarcl on o: round Januay,2j,

:012, Ir!s. prine confirmcd
that Dr. \egi had wilhdrarvrr her application and as a result, hacl not
been deniec

licersure' I captured this information in uhanclwritten notation

rnade on an email u,ith

lvls' Prine 's contacl informalior (see attoched email

from Jennie Wood to Jemifer

Desclrenes, dare.Ianuary 23,2012). i then for,*,arded p.rj iuronnation garhered by Board

staff (i'e'. thc l.abbc complnirtt a:rd the conruct i:rforrrai:on
for lv{s. prine) :o thc DHp
Enforeement Divisicn unc! asked theo, to investigatc
the matter (see attached

Iv{enrorandu:n rlsts.l Ja:tuary E,20l2from Jeru'rifer I-. Dcsc}encs to pat Kaufma').

7) oa or around lvtarch l,zoTz,EnForcoment returned its complcted

invastlgati\€ report to
the Boarrd

Accordingly. the llofird lbund rr:ar Dr, Ncgi was rrot obligared
to
repon hor "witbdrawd" lo thc Boanl, an,J so
shc did noi corunit "licensure fi.aud,,as

3'l
 p10

Case 1:09-cv-00860-DDD-JDK Docunrerrl 26I-3 Filed 08/13/L3 Page 4 of 6 PagelD H: 44t3

clairne<i L.r the Labbe complaint. The Board closed the case on Di. Negi on lvlarch 2,

2112.

Deputy Erecutive Director, Disciptine

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 IN THE UNITED STATES COURT OF APPEALS
FOR THE FIFTH CIRCUIT
United States Court of Appeals
Fifth Circuit
No. 14-30328 FILED
December 17,2014

F'LOYD HAMILTON, Lyle W. Cayce

III,
Clerk
plaintiff-Appellant,
v.
SHIVANI NEGI; HOLLIS REED; BARBARA WATKINS;
UNITED STATES OF AMERICA,

Defendants-Appellees.

Appeal from the United States District Court

Western District of Louisiana
USDC No. 1:09-CV-S60

Before srEwART, chief Judge, and BARKSDALE and GRAVES, circuit

Judges.
PER CURIAM:*
Plaintiff-Appellant Floyd Hamilton, III, ("Floyd"), brought suit against
Defendants'Appellees, Shivani Negi, Hollis Reed, Barbara Watkins, and the
United States (collectively, "Defendants-Appellees"), und.er the Federal Tort
Claims Act ("FTCA") asserting medical malpractice and other related claims.
The district court rendered judgment in favor of Defendants-Appellees and
dismissed Floyd's claims with prejudice. We affirm.

.
Pursuant to 5rg Cm. R. 47.5, the court has determined that this opinion should not
be published and is not precedent except under the limited circumstances set forth in 5TH
cm. R. 47.5.4.

3U
 M. r+-soszs

Militar*, r,^r-^ r.
-
veteran Floyd
eighties *n*u Hamilton
n' was a Fatient , Jr. (Mr.Hamil

ji,;Mil,Tfi,{# in his
("vAMc) at the was
,t'" ;:r":}|. l;:"""''

;tr?r{ilil1111
and suffered fr.,r-, n.-r' r - -"- vruYlU' lvlr' Hamilton v
- wa.q o r.^^-- --"'
*"fl"{lHl* :,j:H#,1*.r#I*
*:
hi s,.ry .,

emergency room
in JuIy 2006, and shortly
Houston vAMc where thereafter, was transferred
he underwent a reft to the
recovering from surgery'
carotid endarterectomy. while
Mr' Hamilton developed
more health complications
and was transferred back
to the Alexandrr"
*a. Dr. Mark St. cyr, a board-
certified internist and vAMc
hospitarist, began treating
Mr. Ham'ton on
september 1' 2006' and acknowledged
at trial that his prognosis at that
time
was poor' Dr' st' cyr discussed this
issue with Floyd who insisted that
Mr.
Hamilton remain at full code statusr and receive
every means of support.
During the first three weeks of September 2006, Dr.
St. Cyr treated Mr.
Hamilton for a variety of health problems including multiple cardiac arrests,
respiratory distress, pneumonia, heart and blood pressure problems, agitation,
and lack of responsiveness. During this period, Mr. Hamilton v;as intubated,
transferred to the intensive care unit ("ICU"), placed on a ventilator, and.
treated with intravenous antibiotics and fluids. Floyd was informed of these
events but he reiterated his desire that Mr. Hamilton remain at full code
status.

I "Full
code status" means that the patient will continue to receive all resuscitative
measures should an end-of-life situation occur.
2
35
 No. 14-30328
on Friday, september 22, 2006, Dr. st. cyr saw Mr.
Hamilton and
determined that his long'term prognosis was
still poor. During that visit, he
observed lack of responsiveness and a Glasgow
Coma scale (,,Glasgow,,) score
of 3'2 Dr' st' cyr elected not to extubate Mr. Hamilton
at this time due to his
low Glasgow score and because he believed Mr.
Hamilton would be unable to
breathe on his own' Dr. st. cyr noted his reasons
for keeping Mr. Hamilton
intubated but did not leave orders instructing subsequent
physicians to keep
Mr' Hamilton intubated. He also noted at this time that
another discussion
should take place with Floyd about putting Mr.
Hamilton on DNF,, 1.e., d.o not
resuscitate, status.g
Dr. shivani Negi, an internist at the VAMC, was an
on-cail physician
covering the ICU during the weekend of September
28, 2006. She first
examined Mr' Hamilton on Saturday, September 28, and testifred that
she
reviewed his medical chart and conducted. a clinical
examination, which
showed stable vitals and no signs of active infection. She
observed that he had
been breathing on continuous positive airway pressure for
three days and was
"tolerating [it] well," which told her that he could breathe
on his own and was
stable enough for extubation.
Dr' Negi called Floyd to discuss the extubation and he stated that
he
wanted "everything done" and reiterated. his desire that Mr. Hamilton
remain
at full code status. Dr. N"gt then d.etermined that the family's consent
was not
required in order to extubate Mr. Hamilton and that neither his low
Glasgow
score nor Dr' St. Cyr's notes preclud.ed extubation. Later that morning, Mr.
Hamiiton was extubated.

2 Glasgow Coma
Scale measures a patient's level of consciousness and. is
based on a
nurse or physician's subjective assessment. Patients with
a score of B-8 are usually said to
be in a comatose state.
3 Floyd had power
of attorney for Mr. Hamilton.
3

3b
 No. 14-30328
Following the extubation, Mr. Hamilton remained. in the
ICU where he
received one-on'one supervision for approximately 24 hours. Dr.
Negi saw Mr.
Hamilton again on the morning of Sunday, September 24, and noted that
he
was "doing well" but was not "waking up." She testified that she considered
Mr' Hamilton's neurological status, examined his vital signs and secretions
levels, and looked for other signs of continued infection, including fever,
but
that he showed no signs of active infection upon examination. Dr. Negi then
concluded that Mr. Hamilton was stable enough to be moved out of the
ICU
and for his antibiotic coverage to be discontinued.
Mr. Hamilton was transferred. out of the ICU to a room on the fourth
floor where one-on-one supervision was not available. Dr. Negi issued. detailed
transfer orders pertaining to Mr. Hamilton's care upon transfer. That night,
Mr. Hamilton was seen by Dr. Rakiya Akwa, another on-call physician, who
observed that his condition was worsening and restarted him on antibiotics.
He noted that if Mr. Hamilton's condition continued to deteriorate, he should
be transferred back to the ICU, however, he remained stable overnight.
On Monday, September 25, 2006, Dr. St. Cyr resumed treatment of Mr.
Hamilton. He determined that Mr. Hamilton's condition had worsened. since
his previous visit and transferred him back to the ICU. He also ordered that
Mr. Hamilton be reintubated and placed. on a ventilaior.
Mr. Hamilton's remaining years at the VAMC were complicated by
pneumonia, sepsis, a recurrent pneumothorax that required. chest tube
placement, difficulty breathing and the continued. need for ventilator support,
urinary tract infections, gastrointestinal bleeding requiring transfusions,
renal failure, ventricular tachycardia, hypotension, and skin breakdowns.
Despite repeated conversations between Floyd and VAMC personnel, Mr.
Hamilton was never moved. to a community nursing home or long-term acute
care facility. He remained at the VANIC where he received long-term
4
31
 supportiv€ care rrn*ir , *o ' 74-30328
until he was pronounced
2oog. *, dead after cardiac,
utopsy reveared
"'""t that he had burous
adenocarcinorna
of the rung. empnu."lil";::",:].,]:
After Mr. Hamilton,s
death, Floyd
the F?cA against filed
Dr. Nregi, Dr.
United States.
See 2g U.S.C.
HorrisReed,;:HH.;::;H::#
S 2e\t, et se'tq. Floyd
breached the standard argued that Dr.
of ."". o;";; Negi
(1) extubating ;;end of septemr
Mr. Ham'ton, (2) discontinuing
his antibiotics,
him out of the intensive
care unit, anci (4)
;;;H:T'T
consent prior to doing
fa'ing to obiain Froyd,s
these things' Additionalry, informed
Floyd alreged that Dr.
obtained her medical license Negi
through fraud.a
After a Dauberl hearing
and three-day bench triar,
ruled in favor of Defendants
the district court
and dismissed Floyd,s claims
with prejudice. In
its reasons for judgment, the district
court concluded that the expert
testimony
and evidence in the record' supported
that Dr. Negi's medical d.ecisions-to
have Mr' Hamilton extubated, discontinue
his antibiotics, and to transfer him
out of the ICU--did not fall below the applicable standard
of care.
Additionally, the expert testimony and VAMC guidelines supported
Dr. Negi,s
decision to do these things without obtaining Floyd.'s prior informed consent.
Because it found that Dr'. Nugr did not breach the standard of care and
lr

No. 14-30828
II.
Proceedin g pro se on appeal, Floyd challenges
the district court,s
judgment that Dr. Negi did
not breach the applicable stand.ard of care
when
she extubated Mr' Hamilton, discontinued
his antibiotic coverage, an4
transferred him out of the ICU. Floyd
also argues that the district court erred
in failing to find that Dr. Negi obtained her
medical licenseb through fraud.6
IIr.
Following a bench trial, this court reviews
a district court,s factual
frndings for clear error and its conclusions
of law de novo. trrench u. Allstate
Indem. co., GB7 F.Bd s7r, ET7 (bth cir. 20rr) (citation
omitted).
After considering the parties' arguments as
briefed on appeal, and after
reviewing the record, the applicable law, and
the district court,s judgment and
reasoninS' w€ AFFIRM the district court's judgment
and adopt its analysis in
full.

5 we agree ion to pretermit discussion of Floyd,s claim

llir"T;ilX1'r"rTl gh fraud in tight of its finding that Dr. Negi

nguage in his statement of the issues in his

nit unethical acts to protect Dr. Negi and VA
ssue is had Dr. Negi commit similar acts of

31
 July 14,2015

Mr. Phillip Tenell, Dishict Attorney

Rapides Parish
P. O. Box 1472
Alexandria, Louisiana 7 1309'1 47 2

Dear Mr. Terrell, District Attorney:

I, Floyd Hamilton III, would like to take this time out to thank you for your services that you
have provided in support of my case Floyd Hamilton, III versus Shivani N"gt, et al., and all other
veterans that have been affected by Dr. Shivani Negr. Words cannot express our gratitude. I

Recently, I spoke with the Attonrey General Office conceming this case. The Attorney General
offrce along with his staffis willing to step forward and investigate this matter.

I am, therefore, requesting that you submit tb Attomey General Buddy Caldwell in
a letter
pursuit of an investigation so that we can move tbrward with this case.
.

lfnant you in advance for your valuable time.

r Sincerely,

YO
 ow
f,,q
tI
Flrdrc af.ftsurisiuns
DEPARTMENT OF IUSTICE
P.O. BOX 94005
BATON ROUGE
7080+9005
Jeues D. "BuDoY' C,rlowru.
A1TORNEY GENEMT

November 17,2015

Mr. Floyd Harnilton, III

6512 Joyce Steet
Alexandriq Lo-uisiana 7 1302
i.

Dear Mr. Hamilton:

This letter is to confirrr that we are in receipt of your complaint regarding the teatrnent
by a physician at the Veterans' Administation Hgspital. We will certain make an ipquiry into
this grievance and determine the appropriate action- -j

We will keep you informed as we get any information.

a'

Sincerely,

JAMES D. "BUDDY' CALDWELL

ATTORNEY GENERAL

. ,..'1 r I .;.::r fi.: j'

ii

J6 {l
 i.l
State of Louisiana
DEPARTMENT OF JUSTICE
OFFICE OF THE ATTORNEY GENERAL
P.0. Box 94005
BATON ROUGE
70804-9005

Jefflandry
Attorney General

July 13, 2016

Mr. Floyd Hamilton,lll

6512 Joyce Street
Afexandria, IA7L3O2

Dear Mr. Hamilton,

Thank you for contacting the Louisiana Department of Justice. We are in receipt of your February 17th
and July 1lth letters.

After a thorough review of the federal investigation, all provided documents of your civil litigation, and
the investigatory findings of multiple divisions within the LADOJ - our office has determined there is no
viable path for criminal prosecution.

While this may not be the reply for which you were wishin& we hope our efforts have been helpful to
you.

Director, Louisiana Bureau of Investigation

IJA
 215t2019 Locals criticize VA system at hearing

Locals criticize vA system at hearing

u.S- House Health Subcommittee holds vA health care

hearing at pineville city Hall.
By Steven Maxwelll posted: Mon 10:20 pM, Jun 20,2016
| Updated: Mon 10:36 pM, Jun 20,2016
PINEVILLE' La' (ltALB) - For the past few years, the
vA healthcare system has been under fire for providing
many have said is "inadequate healthcare."
what

on Monday, the issue hit center stage in cenla as Rep. Ralph Abraham
held a u.s. House Health subcommittee
hearing at Pineville city Hall as a chance to hear both sides
of the story when it comes to VA healthcare in cenla.
Abraham along with Rep. Dan Benishek, R-Michigan, and
Rep. John Fleming, R-Louisiana, heard pages
testimony from local veterans who have had issues with VA healthcare.
of

"lt's the scariest thing I ever didi said Gordon Rydel

an opetousas man who testified at the hearing. ,,1
loaded him
up in a car and drove four hours to M.D. Anderson.,,

Ryder is one of many who testified about having problems

with the Alexandria VA hospital.
form of rymphoma. According to Gordon's testimony,
in
a vA, Gerrit's chemo treatment was fairing
and wourd
e than a week with no approvarfrom the VA
to transfer;
rgency room, where they admitted him.
"lt's a time factor," said Ryder' "lf we could've got
to M.D. Anderson back earlier in octobel November
had a lot of strength and he was stiil in good where he still
shape they courd,ve herped him.,,
Ryder's was one of five testimonies heard at
the hearing. Following that, VA representatives got
to testify, their
answers didn't sit wellwith the subcommittee.
Ll3
https://www.kalb,com/contenvnews/Locars+riticize-VA-system-at-rrearing_3g3725291.htm1
1t2
 2t5t2019 Congressmen criticize'broken' VA system

Congressmen criticize 'broken' VA system

Jelf Mstthews' jmatthews@tbetowntalk,com, (318) 487-6380 Published 7:21 p.m. CT June 20, 2016 | Updated 7:21 p.m. CT June 20, 2016

/ssues regarding local veterans health care discus sed in oversight hearing

Gordon Ryder waited as long as he could for the Veterans Health Administration to refer his critically ill son to
MD Anderson Cancer Center.

After nearly two weeks, he did the only thing that made sense to him he put his son in the car and they
showed up at the doors of the hospital in Houston unannounced.
-

"Trying to get this approval was like pulling teeth," said Ryder, an Air Force veteran. "lf I had waited, we would
(Photo: Melinda
d I n e zJm m a di n e z@lh
have never got there."
Ma e t o)

Ryder told this story to a Congressional subcommittee Monday in Pineville. Members of the House Committee
on Veterans'Affairs Subcommittee on Health were in town for an oversight hearing concerning issues with the Alexandria VA Health Care System.

Ryde/s son, a Navy veteran, died in March. Ryder wonders if getting to MD Anderson sooner could have saved him.

"lt's harder than it should be," Ryder told committee members. "You give them a DVD and they shove it in a cassette player. One side is speaking
English, the other side is speaking German. There's no continuity..

"The VA system is broken," said Rep. Ralph Abraham, R-Alto. "There are some successes, but stories like the ones we heard today far overshadow
those. Unfortunately, it's not just here in Alexandria, it's all over the nation.,'

lssues discussed Monday included not only access to care for veterans, but also poor customer service, a high tumover rate of directors
in the Alexandria
system and a lack of consequences for employees who do not perform.

qq
Enjoy 3 free articles
Buy Photo
nIrPsT/www.lnelownlalK.com/slory/news/zul bi ub/zulcongressmen{nUctze-DroKen-va-system/6b1J /c1U/
 Floyd Hamilton, lll
6512 Joyce Street
Alexand ria, Louisiana 7 1302

February 5,2019

Congressman Ralph Abraham

417 Cannon House Office Building

Washington, DC 20515

RE: Alexandria-Pineville Vetera n Administration Medica I Center (VAMC)

Contact lnformation: vboles1000@gmail.com; 407-490-2457 cell

Dear Congressman Ralph Abraham:

This letter is written to call your attention to the travesty on-going at Alexandria-Pineville Veteran
Administration Medical Center.

Jan 2004, this facility hired Shivani Negi, MD., knowing that she had inadequate credentials for
practicing medicine. She was not required to complete the credentialing process, VETPRO, put in place
to screen applicants; nor was information concerning her rejection for a medical license by the Florida
Medical Board considered; nor was the incomplete application for the Virginia license addressed prior to
her hiring- detoils avoiloble upon request.

During Shivani Negi's tenure at Alexandria-Pineville VAMC, dozens of veterans and their families have
been adversely affected. Many veterans have died, others have been denied medications and others
have sought medical attention elsewhere to avoid her caustic and aggressive behavior.

May 20, 2009, my World War ll, bronze-star recipient father died at the Alexandria-Pineville VAMC after
2 tlzyears in an iatrogenic brain injury coma cause by Shivani Negi. My father withered away in the
VAMC, as opposed to an alternative facility, because the VAMC covered-up for Shivani Negi during legal
action against her.

Spring 2017, Rep Ralph Abraham had a hearing at Pineville Councilman Chambers looking at several
issues at the Alexandria-Pineville VAMC, but failed to address the most prominent problem of hiring
incompetent medical personnel, especially Shivani Negi, who is not the only unqualified physician hired
by the facility .

Page 1 of 2

r{y
The actions of Senators Durbin and Obama of lllinois in 2007 represents the thorough investigation
necessary for the Alexandria-Pineville VAMC to stop the cover up of that facility's continued deviation
from national Veteran Administration policies and procedures.

The case of Darla Marshall vs United States of America (Docket # 08-805JPG) under Federal Tort Claims
Act 28 USC 2671 et seq. set forth that the actions of Veterans Administrations Medical Center that allow
non-credentialed medical personnelto injury and/or killveterans implicates the United States
government complicity to such crimes.

It is imperative that actions be taken to establish competent medical staffing at Alexandria-Pineville

VAMC, removing all who do not meet VETPRO and national VAMC standards of medical care. Families of
mistreated, maligned and killed veterans must be compensated for their suffering and their losses. I feel
that l, Floyd Hamilton, lll, should be awarded damagesforthe suffering and death of myfather, post-
traumatic stress syndrome experienced by me as I continue to console my 88 year-old mother following
the tortuous loss of her life partner.

Yours truly,

Viet Nam Veteran

Cc: Senator John Kennedy

Senator Bill Cassidy

Congressman Cedric Richmond

Congressman Mark Taka no

Secretary Robert Wilkie

Page 2 of 2

qb
Floyd Hamilton, lll 6512 Joyce Street Af exandria, Louisiana 7 t3O2
318-541-3520 f lra n'' iliorr j r d (u) irr-'i: r rrai i.c o' r,

April26,2019

The Honorable Nancy Pelosi

Speaker of the House of Representatives,
1236 Longworth H.O.B.
Washington, DC 20515

RE: Accountability of VAMC in Alexandria/Pineville, Louisiana for Morbidity and Death of

Veterans and Restoration to Families

Dear Madam Speaker:

I write this fetter believing in your sincerity when you said, "l am committed to preseruing the
sacred trust of our men and women in uniform and the 200,000 seruice members who become
veterans each year. Nothing should sfand in the way of any seruice member or veteran of
receiving access to the care and benefits they eamed and deserue." I am confidence that you
can and will facilitate my quest for justice and reparation to my family for the suffering and death
of my father, a bronze star receipt from World War ll, along with other veterans/families who
have suffered and continue to suffer from the Machiavellian behavior of Shivani Negi, MD who
is employed by the Veteran Administration Medical Center of Alexandria/Pineville in Louisiana.
The actions of Shivani Negi, MD resulted in my father suffering oxygen deprivation which
caused irreversible brain injury.

I have sought help for this issue since September 23,2006. I have" followed the policy for
patient complaint"; "filed administrative torts with VAMC", "asked for support from the Office of
Inspector General (OlG), Federal Bureau of lnvestigation (FBl); Attorney General's office of
Louisiana, US Attorney General's office, three election cycles of Louisiana state Senators and
Congressmen as well as US Senators and Congressmen from Louisiana during these thirteen
years. I have fought and highlighted the "medicaltravesties" through US Fifth Circuit Court of
Appeals via three separate legal processes and despite affidavits from numerous families,
testimonies and proof of "illegal medical license procurement", the Alexandria/ Pineville VAMC
continues the employment of Shivani Negi, MD and offers her legal protection as an employee
of a federal agency. I represented myself, pro se, in the courts because local lawyers refused to
represent me as a plaintiff against the Veteran Administration. Lawyers licensed outside of
Louisiana could not take my case because Louisiana is based on Napoleonic code law unlike
that of any other state in America. Louisiana does not offer reciprocity with that of any other
state, so there's no way to practice law in Louisiana unless you pass the Louisiana bar exam.

I am enclosing copies of the written correspondences that I have had with elected officials from
Louisiana so that you can see that there is no one within this state nor those elected to
Washington DC representing this state who are willing to efficiently examine the facts/evidence
and stop the cover-up and torpor with respect to rectifying this serious matter. Most recently
(March 2019), I ask for assistance from the Veteran Administration Chairman who referred me
back to Louisiana US Congressman Abraham who conducted a sham investigation in Spring
2018 using scripted testimonies read by selected persons documented by media coverage from
KALB TV station.

r-t1
 Floyd Hamilton,lll 6512 Joyce Street Af exandria, Louisiana 7 LgO2
318-541-3520
fha m i lton3 rd @ hotma i l.com

I graduated high school in Alexandria, Louisiana then

was drafted into the Army during the Viet
Nam War. As an only child, my military service was within
the United states, while active, I was
asked to play tennis for the US Army team. Following my
military discharge, I married my high
school sweetheart, graduated from Louisiana State University
and went into retail management,
enjoyed time with my two young sons while continuing to play
tennis, umpire for USTA and
coach tennis' March 2003, I built an indoor tennis court facility which
received a USTA National
Facility of the Year Award. Following my father's oxygen-deprivation
brain injury, I visited with
him twice daily for 970 days. I am now financially exhausted. I
had to sell my indoor tennis
facility and my home then move in with my mother. My mother,
at age 88, continues to work at a
clothing boutique; she never received veteran spousal benefits.

I attend a meeting of veterans, on the second Monday of

each month, to discuss problems
associated with securing service-connected support and other troubling
issues that continue at
the Alexandria/Pineville VAMC, much of which involves behavior
and decisions made by
Shivani Negi, MD. Assistance from a nationally recognized veteran advocate
is requested when
veterans' medical care become so negligent that their health is threatened.
He has handled
more than a hundred cases in Louisiana over the last decade. Many
of the veterans who attend
the meeting are frustrated but determined. One of the attendees was denied
seryice-connected
support for 22 years before he received a favorable review and supportive
care. As a coach, I
interact with many people and I am easily taken into their confidences.

I appreciate the attention that you have given to read this

letter. I look forward to your prompt
reply and to rejoice in the actions taken. Thank you for your many years
of efficient service for
the betterment of government in the United states of America.

Viet Nam Veteran

r{8
 526

1 were simply asked to include the ethics committee in your DNR

2 orders, requests for DNR orders?
3 A. We only consulted the..ethics committee when we had a
4 qUestiqn .or something that we werentt certai-n about. It
5 ,,i;wa$n,f,.r,.stan$ald,,p4ggedure !-o order .tha!. The ethics committee
6 was there if like a confli-ct, if say, family -- if
we had
7 there was like no cl-ear written advanced directive or power of
8 attorney and say the family members were disagreeing, because
9 all children have equal weight 1n, you know, what happens to
10 their parents. And so if it was like say three siblings and
11 they completery disagreed on what to do, then r would consult
L2 the ethics committee.
13 a. But it wasn't required as part of your job to stop
L4 consulting patients with DNRs and refer them to the ethics
15 committee?
L6 A. No, s j-r.
L'1 O. You agree with me, don't you, that entire weekend., Mr.
18 Hamilton, Jr. was a full code?
I9 A. Yes, sir, he was a full_ code.
20 O. And you knew he was a ful_l_ code?
2L A. Yes, sir.
22 O. You knew the family wanted him a ful_l_ code?
23 A. Yes, sir.
24 o. And you knew that the family didn't want to sign a DNR?

25 A. Yes, sir.

q
 EXI{IBIT 6
480

1 extubation?
2 Yes, but Dr. Negi disagreed with that assessment by Dr.
3 St. Cyr based upon the patient,s clinical presentation.
4 Do you see that?
5 A. Yes.

6 0. Okay. So you knew that Dr. St. Cyr wanted him to remain
7 in ICU and intr:bated, correct?
8 A. I knew that was Dr. St. Cyr's thoughts.
9 o. Right. And you disagreed with that?
10 A. Yes, sir.
11

L2

13

L4

15

L6

17

18

19

20

27 0. Mrat did you telt him?

22 A. f told him --
23 0. This is the Saturday, the 23rd.
24 A. Yes, sir.
25 o. What did you tell him Saturday, the 23rd?

D^,At,Cil^'s
W 50
 48t

1 A. I told him that the patient was doing well on CpAp mode
2 and we were going to extubate hjm and see how he does off the
3 venti.Iator and observe him in the ICU and see how he does, and
4 if he does okay, then move him to the floor.
/' A. AI1 right. And did he refer you to Dr. St. Cyr's note
6 that he wanted to keep him in and possi-bly do the trach next
7 Thursday?

{e A. Yes, f believe he did.

9 O. Okay. And did you -- is Mr. Handlton correct? He said
10 you said that was the most hing you ever heard?
11 A. No, sir, I didn't say that.
I2 o. You wouldn't have used those words?
13 A. No, sir. I would have never used those words.
74 a. Do You think it's at Dr. st. Cyr was
15 consi'dering a trach procedure the foll0wing
Thursday?
1,6 A' r didnft agree with tiu"pi.,g the patient
on cpAp for that
I7 long.
,/,,, o' okay. r'm for-l0wing up on the conversation
that you had
19 with Mr' Hamirton. you told hirn. He referred
you to Dr. st.
20 cyrrs notes' what happens next? Does he
urge you not to
21 extubate him?
,/ zz A. That part, I don't remember. f told
him that __ I just
23 know that I told him that the patient
was stable. He,d come,._
24 off the ventilator. gVe could observe
him in the ICU, see how
25 he does that day, observe him overniqht,
and if he did wel1,

EL
Mhhiuu -aBqfl 5l
 s89

THE COURT: Mr. Broadwell, this is obvlously a new

2 area. It's going to take a l-ittle while?

3 MR. BROADWELL: No, itrs not.
4 THE COURT: AIl right.
5 MR. BROADWELL: Itm almost through.
6 THE COURT: Okay. I was going to take a short
7 break, but if you're about finished --
B I'm about to wrap up.
MR. BROADWELL:
9 THE COURT: At t- right .

10 A. okay. r was on call that night and so r was admitting a

11 new patient from the emergency room, and the patient had an t0
I2 infection. r don't remember what the infection was. But the
13 pati-ent had an infection and there was a workup going on for
74 the infection. so r was writing orders in the chart that
15 took -- you know, that were -- to treat the infection and to
76 work it up.
11 About maybe 10:00 -- it was about r-o:00 o'cr_ock at
1B night, the nurse just kept incessantry paging me. And r mean,
I9 it's 10:00 o'crock at night. yourve been there since T:00
20 a'm' rt's busy. r mean, you're overl-oaded with work,
and she
2I just kept incessantly paging me. r knew the patient
was sick
22 and r the patient had a fever. r
knew
"f! goi'g
knew what on
23 with the patient.
24 So r wrote a remark in the order that r shour-dn,t
have
25 written. I wrote, Donf t call me anlrmore. And the minute f

&3 nir[u,rj*ra 5a