A hearing into the deaths of patients at a veteran's hospital in Phoenix, Arizona, saw a contentious exchange on Wednesday between a key House lawmaker and the head of the Department of Veterans Affairs Inspector General's office.

"You want the truth?" a visibly irked Richard Griffin asked House Veterans Affairs Committee Chairman Rep. Jeff Miller, R-Florida, after Miller dismissed his attempt to explain how IG reports are developed.

"You are out of order!" Miller responded, cutting Griffin off and moving on to another lawmaker to pose questions.

The hours-long committee hearing was the testiest since revelations in May that veterans waiting for an appointment at the VA Medical Center in Phoenix died before seeing a doctor. Dr. Sam Foote, who retired this year from the Phoenix facility and was one of the whistleblowers alleging that up to 40 vets died waiting for care, told lawmakers on Wednesday he believes more than 290 veterans died while on unauthorized or secret wait lists. 

Foote slammed the IG report as "a whitewash."

The IG's Aug. 26 report found instances of poor care and delays at the facility but stopped short of concluding the delays caused the deaths.

Miller and other lawmakers argue that if veterans were critically ill and required care that was delayed, it should follow that the delay factored in the death. In one case cited in the report, the hospital staff did treat a patient with a heart condition properly and failed to insert a necessary device into his chest. 

The veteran's heart did stop and after he was admitted for care, he died four days later from complications, said Dr. Katherine L. Mitchell, medical director of the Phoenix VA's Iraq and Afghanistan Post-Deployment Center.

Dr.  John D. Daigh Jr., assistant IG or healthcare at the VA, said the report does state the veteran should have been given the device sooner. "I don't know why he died," Daigh said. "You'd like to think he died because he had arrhythmia and that if he had the device he wouldn't have died ... but I don't know that."

Daigh also told the committee he is willing to say that the delayed care contributed to patient deaths.

The IG's role is to determine if care provided was timely or not, Griffin told the committee, and the report concludes in a number of cases that the care given to veterans was poor.

"We did not apply standards of determining medical negligence during our review," he said. "Our findings and conclusions in no way affect the rights of a veteran or his or her family from filing a complaint under the Federal Tort Claims Act with the VA."

Decisions regarding the VA's potential liability rest with the VA, the Justice Department and the judicial system, he said, and not with the IG's office.

At the heart of the Wednesday hearing is concern that the VA improperly persuaded or forced the IG to play down any connection between delayed care veterans received their deaths.

Miller and some other lawmakers believe that the IG report's statement that it cannot conclusively rule that the patient deaths were caused by the delays was added only after VA officials reviewed an early draft of the report.

Griffin said it is common practice among IGs of any agency to provide an early copy of a report to the agency under review. This gives the agency a chance to correct any information that may be factually incorrect. In the case of the IG report the VA pointed out one bit of data that needed to be changed.

But Griffin said nothing else was changed or added to the report based on any input from the VA or other outside agency. He said the draft the original draft provided the committee was unfinished and that the inclusion of the statement now under scrutiny was added to make it clear the IG is not able to draw such a conclusion.

Griffin told Miller that the committee had never before asked for an early version of an IG report because they are unfinished.

Miller bristled at the comment, saying he did not care "whether another committee ever asked for a draft report. Shame on them. This committee is going to get the truth about all the facts!" he said.

Later in the same hearing, VA Secretary Bob McDonald showed his own frustration with the committee's line of questioning on the IG report, according to a report in Stars and Stripes.

Asked if he will investigate leaks to the media, such as the draft report sent to Miller's committee, McDonald responded that the "three I spend waiting to testify is three hours of time I'm not spending working on veterans issues."

-- Bryant Jordan can be reached at bryant.jordan@monster.com.