FAYETTEVILLE, N.C. — The decision to remove Womack Army Medical Center's commander came over Memorial Day weekend, after officials at the hospital's higher headquarters learned a patient at the hospital died less than a week after another patient death.
Col. Robert Tenhet, commander of Northern Regional Medical Command, said the decision was made to preserve trust in the hospital and ensure patient safety.
Speaking from his offices at Fort Belvoir, Virginia, Tenhet said the two deaths, coupled with an ongoing investigation, led to his decision to remove Col. Steven J. Brewster and suspend three of the hospital's deputy commanders.
He also said further disciplinary action against former leadership couldn't be ruled out until after several investigations were complete.
Womack is one of the Army's largest hospitals. It has the largest emergency department and serves the largest population.
Tenhet said the hospital was already under investigation at the time of the deaths following an accreditation process that revealed shortcomings in Womack's infection control procedures.
He said the deaths and the earlier accreditation issue are not related. And said the two deaths would be investigated by the hospital, with Northern Regional Medical Command overseeing the investigations.
Tenhet, who is set to be promoted to brigadier general, is a native of Spring Lake and has spent more than 13 years assigned to Fort Bragg units, including Womack.
He took the helm of Northern Regional Medical Command on May 5 and was aware of the ongoing investigation of Womack when a patient died following a May 16 visit.
Within days, Tenhet ordered the officer in charge of the emergency department at Womack removed from that position.
"I started to lose confidence in the commander," Tenhet said, saying there were complacency issues at the hospital.
After a second patient died within a week, Tenhet recommended over the holiday weekend that Brewster be removed. The Army's surgeon general, Lt. Gen. Patricia Horoho, who also has strong ties to Womack and Fort Bragg, agreed.
Brewster was set to change command in June and had planned to retire, Tenhet said. But the change could not wait.
"In medicine, it's not like other jobs," he said. "... We are life and death."
"These are hard decisions you make, but you have to look at the mission as a whole," he said.
Tenhet met with Brewster and the three deputy commanders on Tuesday morning. The three deputies have been temporarily reassigned to other Fort Bragg units, he said.
Tenhet said he then assembled Womack staff to announce the removal of Brewster and to name Col. Ronald Stephens as the new Womack commander.
Stephens had been slated to take command of the hospital on June 18. He is now charged with assessing the hospital's resources and its gaps in care and vulnerabilities.
"We have to maintain our patients' trust," Tenhet said.
On Wednesday, Tenhet, whose father receives care at Womack, and acting Fort Bragg commander, Maj. Gen. Clarence K. K. Chinn, said they had confidence in the new leadership and those who remain at Womack.
"He's absolutely the right commander to come in," Chinn said of Stephens, a former corps surgeon for the 18th Airborne Corps.
Chinn said he and his family have had procedures at Womack over the past month and wouldn't hesitate to visit the hospital again if needed.
"We have that trust and confidence not only in Army Medicine, but in the leadership here," Chinn said. "The community should feel confident and feel comfortable. . We've got a good team there."
The key now is ensuring that customer service and care are on par with Army standards, Tenhet said.
"Having worked there myself, we've had some quality people there at Fort Bragg," Tenhet said. "They are wonderful facilities. I want to make sure that's not just on the surface."
Chinn said Womack was already a premier hospital. He cited the 3,400 clinic visits, eight births, 36 surgeries and more than 1,000 scans, X-rays and similar procedures that occur daily at the hospital.
Jonathan Steele, president of Local 1770 of the American Federation of Government Employees, represents about 2,000 Womack civilian employees.
He said there have been concerns about Womack workers being stretched too far to cover more patients. He also said complaints of toxic work environments and abrasive leadership have risen in recent years.
Steele said the union has advocated for a civilian position within Womack leadership to address those concerns, and he was disheartened to learn of the leadership change from Womack employees instead of from Army medical leaders.
"We've had significant issues," Steele said of the union's relationship with Womack. "We've definitely had some disagreements."
But Steele said he wanted to encourage Womack employees and other union members who may use the hospital to "come to work, be professional and provide excellent customer service."
Tenhet said Womack was at 97.5 percent capacity by Army Medicine metrics and was looking to grow the workforce at Womack.
The hospital is searching for 27 new doctors, he said, and will continue to build capacity as the hospital's beneficiary population grows.
Following the news of the Womack shakeup, Fort Bragg's elected officials voiced their concern for the situation.
Sen. Kay Hagan, a Democrat, called the reports of improper care "very troubling."
"Our service members and their families deserve the absolute best care possible, and they should be able to put their full faith and trust in those responsible for providing that care," she said.
Hagan's office has contacted the Army, and she said she would monitor the Womack investigations.
Republican Sen. Richard Burr said he had concerns about Womack's "capacity and to meet the growing needs of their patients."
"The recent deaths must be investigated, and they underscore the urgency of conducting the systemwide review of care in military treatment facilities that (the Pentagon) announced yesterday," Burr said.
Rep. Renee Ellmers, a 2nd District Republican, said the removal of Womack's commander was a sign of bigger issues in military health care, both for current troops and veterans.
In a release, Ellmers referenced the news at Womack and the ongoing scandal in the Department of Veterans Affairs health system.
"While the details continue to unfold, the initial reports of substandard care and the neglect of our country's warriors and veterans should shock and outrage not only the Fort Bragg community, but the nation as a whole," Ellmers said.
Rep. David Price, a 4th Distict Democrat, said he was disturbed by reports of substandard care at Womack and other military health facilities.
"I want (the Department of Defense) to get to the bottom of it. We need to know if the cause is human error, poor administration, lack of training, or other factors so that we can take steps to fix them," Price said. "In particular, we need to know whether these are isolated incidents or evidence of serious systemic problems. Like America's veterans, our service members and their families deserve quality health care, and we must make sure that they receive it."
Horoho, the Army surgeon general, initiated an investigation into Womack in March, after the findings of the Joint Commission on Accreditation of Healthcare Organizations led to a two-day standdown that delayed medical procedures at the hospital. The Joint Commission is a national nonprofit that accredits more than 20,000 health care organizations and programs.