Dr. Robert Petzel resigned Friday as undersecretary for health in the Veterans Affairs Department. The VA made the announcement in a brief statement from Secretary Eric Shinseki.

“As we know from the veteran community, most veterans are satisfied with the quality of their VA health care, but we must do more to improve timely access to that care,” Shinseki said, in the statement. “I am committed to strengthening Veterans’ trust and confidence in their VA health care system.”

Petzel’s resignation may be the first shoe to drop in the unfolding scandal about VA health care that intensified this week.

Shinseki testified before the Senate Veterans Affairs Committee Thursday, making his first public remarks on Capitol Hill since the publication of news reports alleging that as many as 40 veterans enrolled at the Phoenix VA medical center died while they were waiting to get doctor’s appointments and that hospital staff maintained an off-the-books appointment list designed to obscure long wait times at the facility.

Petzel had previously announced his intentions to retire in a September 2013 VA press release.

“I have appreciated the privilege to serve Veterans by developing a healthcare system that reaches beyond simple treatment of diseases to a true partnership with Veterans,” said Petzel, in the release. “VA will continue to partner with Veteran patients throughout their lives in order to improve their health and well-being.”

On May 5, the American Legion, the nation’s largest veterans organization, called on President Barack Obama to fire the top three officials at the agency — Shinseki, Petzel and retired Brig. Gen. Allison Hickey, the undersecretary for benefits — due to the allegations.

“In late April, allegations from multiple whistleblowers of a secret waiting list at a Phoenix VA healthcare system that may have resulted in the deaths of approximately 40 veterans,” American Legion National Cmdr. Daniel Dellinger said, during a May 5 press conference. “VA previously had acknowledged that 23 veterans throughout the healthcare system had died as a result of delayed care in recent years. Then yesterday, a copy of the findings of an investigation by VA’s office of the medical inspector was shared with the USA Today. Those results [show] Department of Veterans Affairs clinic in Fort Collins, Colo., were instructed last year how to falsify appointment records so it appeared the small staff of doctors seeing patients within the agency’s goal of 14 days according to the investigation. These disturbing reports are part of what appear to be a pattern of scandals that have affected the entire system.”

Dellinger said the American Legion brought its concerns to Shinseki and President Obama, but decided the time had come to go public with a call for new leadership at VA.

“The existing leadership has exhibited a pattern of bureaucratic incompetence and failed leadership that has been amplified in recent weeks,” he said. “Patient deaths are tragic, and preventable patient deaths are unacceptable. But the failure to disclose safety information or worse, to cover up mistakes is unforgivable as is fostering a culture non-disclosure. VA leadership has demonstrated its incompetence through the preventable deaths of veterans, long waits for medical care and benefit claims backlog numbering in excess of 596,000 and awarding of bonuses to senior executives who have overseen such operations.”

Dellinger said he expected the President to take steps to change VA leadership immediately and it was something he should have done months ago.

Shinseki told the Senate committee VA is conducting an internal review of all its medical facilities to determine how widespread the practice of manipulating wait time statistics is.

“We need to ensure full compliance with our scheduling policies, and as we’ve begun that, we’ve already received reports where compliance is under question. We’ve asked the IG to also take a look at a number of those cases,” he said.

Shinseki said VA’s internal audit is examining the health care system’s largest facilities this week, and he told senators he expects to be able to provide them with the preliminary results within three weeks. He also pledged accountability for any VA staff who are found to have cooked the books on wait times, but not until the IG review is finished.

“If any of this is substantiated, we will act,” he said. “It is important, however, to allow the inspector general to complete his duty, which is to conduct an objective review and provide us the results.”

A few days prior to the American Legion press conference, the White House announced plans to nominate Dr. Jeffrey Murawsky to be VA’s new undersecretary for health, replacing Petzel who has been in that role since February 2010.

Murawsky served as the associate manager for Medicine and Neurology Services at the Edward Hines Jr. VA Hospital in Illinois. Since 2009, he has been the network director of the Veterans Integrated Service Network (VISN 12), as well as an associate professor of medicine at Loyola University Chicago Stritch School of Medicine.

“Today, with Petzel’s resignation, we are one step closer to holding the VA accountable for their actions,” said Rep. Jackie Walorski (R-Ind.), a member of the House Committee on Veterans’ Affairs, in a press release. “I’m curious why Petzel, who announced months ago he was retiring, finally chose to resign the day after he was grilled in a Senate hearing. Unfortunately, it has taken dozens of wrongful deaths due to VA negligence, including 13 in Indiana, for the inefficiency at the VA to garner national headlines. I will continue to fight on behalf of our nation’s 23 million veterans and call for the resignations of Secretary Shinseki and Under Secretary Hickey.”

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