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Veterans Affairs Secretary David Shulkin is pledging a top-down review at the VA medical center in the nation's capital. A watchdog report warns that patients are being put at risk because of bad inventory practices that can lead to dirty syringes and medical supply shortages.

Shulkin is describing the problems identified by the VA inspector general as unacceptable. He says he is installing one of his advisers, Lawrence Connell, as acting director of the medical center to ensure fixes are made.

Wednesday's inspector general report points to a number of "serious and troubling deficiencies" at the Washington facility. They include 18 of 25 sterile storage areas for syringes that were found dirty and poor record-keeping that led to equipment shortages.

The VA has removed the facility's director.