Another management shakeup in Cincinnati VA health system

Sixth leadership change in 18 months

CINCINNATI -- The Cincinnati VA Medical Center has made its sixth leadership change in 18 months, reassigning Chief of Staff Dr. Elizabeth Brill to an administrative job as it investigates "certain operations of the surgery department."

The Cincinnati VA confirmed the reassignment on Friday, June 8, one day after former Chief of Staff Dr. Barbara Temeck appeared in a Cincinnati federal courtroom to challenge her January conviction on a felony drug charge.

Dr. Brill remains chief of staff, Cincinnati VA Medical Center Director Vivian Hutson said in a statement to WCPO, but she has been "detailed" to a "temporary role as a senior advisor to the chief medical officer" in the VA's regional network office in Symmes Township.

Replacing Dr. Brill as acting chief of staff is Dr. G. Mitchell Kennedy, a Columbus-based surgical consultant to the regional management office in charge of VA facilities in Ohio, Indiana and Michigan.

"VA will conduct an internal review (this week) of certain operations of the surgery department and we will await the completion of that review before commenting," Hutson said.

Dr. Kennedy is the third physician to occupy the chief of staff role in the Cincinnati-based health system that oversees patient care for 43,000 Tri-State veterans. Dr. Ralph Panos served as interim chief following Dr. Temeck's departure in February, 2016. Former Medical Center Director John Gennaro was replaced by interim director Glenn Costie then Hutson. VA Network Director Jack Hetrick was replaced by Robert McDivitt, who is still in the job.

Dr. Temeck and Hetrick were the first to be replaced after WCPO and the Scripps Washington Bureau documented patient-care and morale problems in a series of reports that began in February 2016.

RELATED: See all of WCPO's VA coverage here

Those reports led to Dr. Temeck's indictment on three felony counts alleging she illegally prescribed pain pills for the wife of her former boss. Dr. Temeck was convicted on a single count in January, but defense lawyers have argued that jurors were confused and prosecutors failed to meet the legal standard for a conviction.

"We're here today because her life is on the line," Defense Attorney Ben Dusing told U.S. District Judge Michael Barrett Thursday. "She's not guilty of this offense.”

Temeck contests January conviction

Barrett questioned Dusing and Assistant U.S. Attorney Kyle Healey on the legal requirements for a conviction and jury instructions that allowed the panel to convict if it believed Dr. Temeck wrote prescriptions that weren't medically necessary or violated the terms of her DEA registration.

Verdict forms didn't ask the jury which standard they applied to Dr. Temeck, but Barrett has previously stated that prosecutors failed to present the required medical-expert testimony to sustain a conviction on grounds of medical necessity. That led the parties to focus their attention on the DEA registration issue.

Dusing argued that prosecutors failed to prove Dr. Temeck knowingly violated the terms of her registration, which allowed her to write controlled-substance prescriptions in the context of her work with the VA. Healey said the statute doesn't require proof that she knowingly violated the restriction. Dusing said Healey didn't supply any case law to support that assertion.

Dusing also argued that prosecutors asked jurors to consider the wrong registration when evaluating the matter.

Two of Dr. Temeck's past DEA registrations were entered into evidence. One said it was "only for use in federal or state institutions." The other said Dr. Temeck's prescription-writing authority was "restricted to government personnel for official duties only."

Dusing argued prosecutors referred to the latter restriction 11 times during closing arguments because it was broader and easier to support a conviction, but that wasn't the DEA restriction in place when Dr. Temeck wrote the prescription that led to her conviction.

"If Dr. Temeck is going to be guilty of a federal crime, the jury should be put to it the right question," he said. "They were not given the right question."

Healey's response: "By Dr. Temeck's own testimony she wrote the prescription at the lady's house. She wasn't at a state or federal institution. So, I don't know how arguing that is going to help her at trial."

Dusing is also pursuing a new trial on grounds of selective prosecution, arguing he wasn't able gather evidence that Dr. Temeck's prosecution was politically motivated because Barrett rejected discovery on that claim last November. But Healey argued there was no political intervention, so it couldn't have impacted the verdict.

"I think this jury sat and listened to the evidence very carefully," he said. "They convicted her very carefully."

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