Although former nursing assistant Reta Mays acknowledged her guilt in the deaths of eight veterans this week, more investigation will continue over whether the VA should have provided greater oversight to protect patients.
The Veterans Affairs Office of Inspector General had started an inquiry over unnecessary deaths at the VA, but put that on hold during the criminal investigation, Michael Missal, the inspector general for the agency, said this week.
“The work of the VA OIG is not finished,” Missal said.
He said a healthcare inspection will examine clinical aspects of the case, “including the policies, procedures and events at the medical center.”
“What happened at the Louis A. Johnson Medical Center was tragic and heartbreaking,” Missal said, adding that the Inspector General’s Office was informed of suspicious deaths there in late June 2018.
“Within 24 hours we had a team on the ground and within days, we identified Reta Mays as a person of interest. Working with the facility, we had her removed from patient care immediately. That act alone may have saved countless lives.”
U.S. Senator Joe Manchin, D-W.Va., said he wants to hear more from the Inspector General’s findings.
“There’s much more to come out. We need much more information from the Inspector General and the prosecutor,” Manchin said last week on MetroNews’ “Talkline.”
Mays, 46, of Harrison County, entered a guilty plea Tuesday afternoon to seven counts of murder and another count of assault with attempt to murder. Prosecutors said the last charge was because the victim lived for a period of time and Mays’ actions could not be determined to be the exact cause when the veteran died weeks later.
She faces consecutive life terms for seven murder counts and another 20 years for a count of assault with attempt to murder. For now, she has been taken to West Virginia’s Northern Regional Jail.
Mays admitted to killing veterans Robert Edge Sr., Robert Kozul, Archie Edgell, George Shaw, a patient identified only as W.A.H., Felix McDermott and Raymond Golden while also administering insulin to “R.R.P.,” another patient who was not diabetic with intent to kill him.
Autopsies on exhumed bodies have pointed to insulin injections that weren’t needed. The veterans died of low blood sugar level — severe hypoglycemia — caused by the insulin shots.
The charges and plea follow a two-year investigation that began after the VA Medical Center reported several suspicious deaths.
Mays began working at the veterans hospital in June 2015. She was removed from her job in July 2018.
Federal prosecutors say the hospital did not require nursing assistants to have a certification or be licensed to keep their jobs.
Her job as a nursing assistant required her to measure patients’ vital signs, test blood glucose levels and sit one-on-one with patients who required observation.
Mays, the information alleges, “was not qualified or authorized to administer medicine, including insulin.”
“When we hire people in that type of a setting, especially for our veterans — who have committed their life, they’re willing to give their life for our country when they put that uniform on — we should do everything we can to get the best person,” Manchin said.
“What was the screening process? What was the background check? Did we do it thoroughly? Why wasn’t the director of nursing suspicious earlier. They weren’t suspicious at all until the Inspector General came in and said ‘we’ve got a problem here.’ So something tells me something went awry there, and we’re going to find out why that happened.”
Mays worked the night shift, 7:30 p.m. to 8 a.m. in Ward 3A, which housed fragile patients who were not well enough to be discharged but whose conditions did not require the intensive care unit.
The plea agreement that she signed specified that each of the injections happened during the night shift while she was sitting one-on-one with the patients.
“Our hearts go out to those affected by these tragic deaths,” stated Wesley Walls, spokesman for the Louis A. Johnson VA Medical Center.
Walls noted that the medical center discovered the allegations and reported them to VA’s independent inspector general more than two years ago. Clarksburg VA Medical Center also fired the individual at the center of the allegations.
“We’re glad the Department of Justice stepped in to push this investigation across the finish line and hopeful our court system will deliver the justice Clarksburg-area Veterans and families deserve,” Walls said.
Lawyers for some of the families of the veterans who died have called for a greater examination of the VA’s responsibility. The lawyers are heading up civil suits.
“The VA hired a serial killer to take care of their patients. Seven of them were murdered by this person, and the VA up to this point has done nothing to try to resolve any of the civil cases with any of these families. It’s unconscionable in my view,” said Dino Colombo, a lawyer for some of the families.
“They gave this person, Reta Mays, the ability, the medication, the patients, the opportunity to commit murder.”
Another lawyer for families, Tony O’Dell, agreed that the VA’s role needs more examination. O’Dell said the hospital should have been better at identifying “sentinel events” that led to deaths.
“Just human curiosity would lead you to want to investigate to determine how this happened,” O’Dell said. “Had they done that, we wouldn’t have gotten into the second one or the third one or the fourth one.”