VA hospital investigating its treatments It said 114 cancer patients might have received the wrong radiation doses. Another case involves blood samples.

In the last six years, 114 prostate-cancer patients at the Philadelphia VA Medical Center might have received radiation doses below what was prescribed, the hospital said.

The men underwent brachytherapy, in which radioactive rods or seeds were implanted in and around the prostate to destroy cancer cells. Most patients who receive the seeds alone have low-risk prostate cancer, experts said.

"The program was suspended as soon as the problem was discovered," hospital spokeswoman Fern S. Billet said. "We are in the midst of an investigation to find out what happened."

Two patients have since died, but it was unclear whether their deaths were related to the problem, she said. The other men had diagnostic tests performed at the VA's expense, and doctors were evaluating those scans.

VA officials also are investigating an incident in which an Air Force veteran on the blood thinner warfarin had his blood drawn twice July 30 and was put in a research study without his knowledge or consent.

Marc Holmes, 66, of Queen Village, was one of as many as six patients whose blood was drawn without their consent, the hospital said.

"What precipitated them selecting us?" asked Holmes, who has suffered from blood clots. "Was there something wrong with us medically? Are they under any obligation to tell us? I would imagine they would be."

Billet, the spokeswoman, confirmed that the hospital had no authorization to draw the second vial of blood from Holmes and said an investigation board was formed to review the matter. The research has been put on hold, she said.

Asked whether the VA seemed to be having a number of quality issues lately, Dale Warman, another medical-center spokesman, stressed that "the brachytherapy and warfarin dosage issues are unrelated, and it is a coincidence that they were discovered within a short period of time."

He said caregivers were taking steps to fix both problems. Like most hospitals, the medical center received full accreditation from the Joint Commission, the main U.S. accrediting body, after an unannounced visit in June.

An outside expert said he was suprised to hear about the problem with low radiation doses for prostate-cancer patients, which was first announced July 2. "The routine in the U.S. is to assess the implant at three to four weeks out," said Eric M. Horwitz, clinical director of the radiation oncology department at Fox Chase Cancer Center.