Deputy Auditor General Wayne Simon continued his testimony in the second day of public hearings at the Commission of Inquiry into the Karl Heusner Memorial Hospital’s purchasing operations this morning.
At the break around 4:30 Thursday afternoon, Simon had been outlining a number of questionable purchases made by the KHMH from PharmaBiz International, a pharmaceutical company registered in Belize and part-owned by a KHMH-employed gynecologist, Dr. Jose Guerra, in the period between September 2006 and January 2008.
Today, he went into further detail about a number of instances in which the hospital failed to enforce its internal checks and controls to safeguard against misuse of its finances in the purchase of pharmaceutical and medical supplies.
The hospital purchased some $22,937 worth of certain “Specially Authorized Drugs” (SAD’s for short) in 2007, which it said was needed for patients not responding to regular drug treatments.
According to the Ministry of Health’s Central Medical Stores’ (CMS) Samira Gongora, the attending physician requiring the drug would write out a form in triplicate for the Medical Chief of Staff to authorize once he was satisfied it was necessary to buy. CMS would get the form, source the drug, seek the approval of the Director of Health Services and send KHMH the bill later, after the drug was found.
The hospital, Simon said, could find none of its records in relation to several purchases made in 2007. The officer in charge told the auditors that there reportedly existed a “verbal agreement” between former KHMH pharmacist Eugene Echegi and Chief Pharmacist Sharon Sanchez-Anderson to make the drugs available without having to do the paperwork. Anderson told investigators that that was true in only one case, for the drug seftrazone, because it was regularly used.
KHMH purchased five orders of seftrazone injections from Bradley’s Imports, Best Medical Supplies, PharmaBiz (twice), and Union Distribution for a total of $10,046; four orders of fentanyl citrate from the former Universal Health Services (now Belize Healthcare Partners), Santiago Lindsey (an unknown pharmaceutical seller) and Gillian Campos twice (former KHMH pharmacist now at BHPL, who also owns Evergreen Pharmacy in Corozal Town) for a total of $5,750; four orders of 250 ml sevarine from Campos for $3,720; two orders of vanacomycin injections from Universal/BHPL for $1,450; and one order of omeprazole from Belize Chemicals. Simon concluded that apart from the seftrazone, the other drugs “definitely” should not have been ordered, if Anderson’s version of the agreement between her and Echegi is accurate.
Regarding instances of the hospital doing business with persons affiliated to it as employees, Simon cited Dr. Guerra’s PharmaBiz, which sold $159,800.75 of pharmaceutical and medical supplies to KHMH in 2007, without apparently informing them of Dr. Guerra’s relationship to the hospital.
And apparently, the questionable transactions did not stop with lower-level employees. Dr. Khalid Ghazy, former Director of Medical Services, allegedly purchased sutures for the hospital in Chetumal, Mexico, in 2007 to the tune of $2,000, of which he later reimbursed $500. Simon said the auditors were given none of the documents they requested concerning this purchase, and so were unable to determine whether the hospital got value for money.
Dr. William Coleman, now with the Northern Regional Hospital in Orange Walk Town as a surgeon, was implicated in the payment of $6,500 for orthopedic supplies he allegedly purchased in June of 2007. Dr. Coleman was with the KHMH at the time, but the hospital has no records of the purchase and the employees questioned could not definitively tell Audit whether the hospital had in fact received the goods, though the head of the Central Surgical Unit, Marilyn Myvett, claimed she had come across items “resembling” some described on a list sent by Dr. Ghazy to then-Finance Director Cecil Knowles, complaining that the Orthopedic Department of the hospital lacked these pieces of equipment.
Gillian Campos billed the hospital $25,242 between September 2006 and August 2008 for pharmaceutical and medical supplies she was asked by Echegi and employee Lisa Humes to source and provide. She told investigators she had done so through Evergreen or through other City pharmacies, though Audit could not verify her claim.
Some of the hospital’s revenue books, Audit found, could not be found, though Billing and Collection employee Sharon Smith had “searched relentlessly” for them. There was no way to tell whether the money in those books was actually collected, Simon told the Commissioners.
Regarding Tiffara Anderson, the cashier named in an alleged theft of $28,051.21, management failed to notify the Commissioner of Police or Director of Public Prosecutions (at that time, Gerald Westby and Lutchman Sooknandan respectively). But Anderson’s supervisor, Frank Barrow, was let go from his post for failing to catch Anderson.
Anderson was dismissed in April of 2007 and signed a promissory note to pay back the money in installments of $500, with a 10% interest clause kicking in if she defaulted. At January 2008, she still owed upwards of $24,000 and the matter had died until Carlos Perrera, current Director of Finance, contacted credit company Credit Master Systems to help KHMH get back the money.
Another nest of questions was in the Radiology Unit, headed by Freddy Mansoor. Mansoor had a number of problems justifying his mostly incomplete and missing records for supplies and equipment in his unit, though former employee Dawna Romero swore to investigators that she had kept detailed records when she worked there.
Overall billing processes at KHMH suffered from being as much as half a million dollars or more behind in collection. Up to June of this year, patients still owed the hospital $733,141.10 in unpaid bills.
The last major revelation was the handling of a grant of $1 million issued to the hospital from the Venezuelan government in 2007 for rehabilitating facilities. While $300,000 of the money was used for this purpose (mainly fixing water pipes and air conditioners), the majority, $700,000, was put toward buying medical supplies.
Records here were incomplete, but the hospital spent all but $12,651.27 of the money, every purchase approved by Knowles and then CEO Dr. Alvaro Rosado or accountant Shevon Fairweather.
When Audit conducted an inspection of some of the goods bought under the grant, they found two monitors in non-working condition, two others gone, and a corroded boiler sold to a Shipyard man for $500 so that a new one could be installed.
Despite the obvious gaps, Simon told reporters he was satisfied with the cooperation of the management in the investigation and the level of access to the hospital’s records (what records there were).
Amandala asked how this was so if the Audit team could not get some of the vital records they needed; Simon responded that the hospital’s employees tried their best, but some documents simply could not be located and Audit “are not policemen; we were not asked to investigate.”
Similarly, Simon would not say on record whether he thought the corruption was systematic, or if any crime had been committed by any of the names mentioned over the last day and a half.
Testimony wrapped up around 11:30, and chair of the commission, Justice Adolph Lucas, outlined the schedule of hearings for the next week or so.
The hearings continue on Monday with Laurel Grant scheduled to appear in the morning and CEO, Ministry of Health, Dr. Peter Allen, in the afternoon. After a break on Tuesday and Wednesday, hearings are scheduled for Thursday, December 3, and Friday, December 4, followed by another break from December 7 to 9.
The breaks, said Justice Lucas, are due to the Belize Institute of Management being booked for other engagements.