Delays in receiving medical care contributed to patient deaths at the Department of Veterans Affairs hospital in Phoenix, a top official in the agency’s inspector general’s office testified Wednesday.

Dr. John Daigh, assistant VA inspector general for healthcare inspections, acknowledged that patients were harmed by the long waits for treatment at the facility, where top administrators concocted phony appointment lists to hide the delays.

Daigh also said he could not “conclusively assert” that no patients died because they could not get timely care.

That language is crucial because the IG’s final report on patient deaths in Phoenix included a line that it could not “conclusively assert” any patients died because of the unacceptable delays documented in the investigation.

That phrase was not in draft versions of the report sent to top VA officials for comment and review. It only appeared in the final version published Aug. 26.

VA administrators seized on that phrase when they leaked a statement to the media before the final IG report was issued, touting the finding that deaths from delays could not be proven.

Richard Griffin, acting inspector general, was more reluctant than Daigh to concede harm to patients and possible patient deaths from delays.

Griffin said the lack of timely care “could have” contributed to patient deaths.

“It may have contributed to their death,” Griffin said as he was pressed for an answer by Rep. David Jolly, R-Fla. “But we can’t say conclusively it caused their deaths.”

Griffin was more definitive later in the hearing when questioned by Rep. Jeff Miller, R-Fla., chairman of the committee.

“Can you conclusively say no deaths occurred from delays in care?”

“No,” Griffin replied. “We don’t know. It’s a causality thing.”

The Washington Examiner first reported last week that the statement from the IG noting deaths from delays could not be conclusively proved was inserted after the draft version was sent to top agency executives for comment.

Inspector generals are independent watchdogs within federal agencies.

Griffin said the controversial language came at the suggestion of one of his own senior executives, not anyone at VA. There were multiple drafts of the report, which were sent to the agency for fact-checking and comments.

In late July, the unnamed IG official asked whether there was conclusive proof any of the veterans on bogus waiting lists died as a result, Griffin said. If not, that should be stated clearly, the IG official said.

No one at VA had anything to do with inclusion of the language, Griffin said. Only minor changes were sought by VA officials. A few were accepted and others rejected, he said.

The final version of the report confirmed allegations of widespread falsification of patient waiting lists to hide delays.

It also identified 293 patients who died while on various waiting lists, and 20 who died after enduring unacceptable waits or poor-quality care.

However, the IG could not conclusively prove any of those deaths were caused by the delays.

Miller and other committee members criticized Griffin for using a standard of proof that is virtually impossible to meet. Griffin repeatedly insisted the direction to use that high standard came from Miller’s committee, an assertion Miller denied.

Jolly noted that while the final IG report did say investigators could not conclusively prove any patients died as a result of substandard care, it did not also state there was no way to conclusively prove they did not.

“The reason it matters is because for six months we have been investigating the deaths of veterans,” Jolly said. “IG words matter, frankly more than any political appointee. We challenge political appointee words all the time and a lot of times they are wrong and misleading. We expect the IG not to be.”

VA Secretary Robert McDonald, who testified after Griffin, said he did not know who leaked the agency statement touting the language from the final IG report.