BANGOR, Maine — The results of a federal investigation into the events preceding to the fatal shooting of a former U.S. Marine Corps lieutentant last summer near the Togus VA Medical Center in Augusta reveal a years-long pattern of increasing frustration for both the patient and his caregivers.
Canceled and rescheduled appointments, delays in receiving medication and a continuous shuffling of his service providers frustrated the late Marine Corps Lt. James “Bing” Popkowski, 37, of Grindstone so much that by the end of last year, he was known to say he had “no use for the VA,” according to the report.
Because of a sustained pattern of missed appointments and non-responsiveness by Popkowski, the VA rescinded many of his benefits in June, a month before Popkowski was fatally shot near the medical center by a VA police officer and Maine Warden Service officer on July 8.
Though the 22-page report, which was released Thursday by the Department of Veterans Affairs’ Office of Inspector General, does not refer to Popkowski by name, U.S. Rep. Mike Michaud’s office confirmed Monday that the report is about Popkowski.
Michaud said in a written statement that he requested the report to provide “all the answers” for Popkowski’s family and, in the long run, to improve care for all U.S. veterans.
“If it’s found that any of the recommendations in this report require legislative changes, I will introduce legislation to accomplish them,” Michaud said. “Nothing can bring Lieutenant Popkowski back, but it is my sincere hope that the implementation of this report’s recommendations will help prevent a future tragedy from hap-pening.”
Angela Adams, a close friend of Popkowski’s who administers a Facebook page in his honor, said his death could have been avoided if some of the report’s recommendations had been followed years ago.
“James knew what he deserved,” Adams said. “He deserved to be treated like a human. Even if he were a prisoner, he would have been treated more fairly. He would have had three square meals, a cot to sleep on, and his medications couldn’t have been denied.”
According to the report, Popkowski first went to the Togus VA Medical Center in December 2005 after treatments at another facility for a rare and aggressive form of cancer that started when he was still on active duty.
For Popkowski, who also was being treated for major depression, problems meeting with his doctors began almost immediately. His second VA clinic visit in January 2006 was canceled by clinic staff, but Popkowski did not receive notification, according to the report.
In May, he contacted Michaud to report problems obtaining prescription refills and to complain about the quality of his care at the medical center. A month later, Popkowski was given a new primary care physician and a new appointment date with a mental health care provider.
After a few months of missed appointments, including three consecutive “no-shows,” according to the report, Popkowski was taken off his doctor’s roster.
Popkowski also missed several appointments in 2008, though one provider documented concern for Popkowski in October of that year, stating that he considered the veteran “a high risk for suicide due to, among other circumstances, cancer, a shortened military career and isolation.”
That mental health care provider left the medical center soon after, and Popkowski’s care was assigned to another mental health care provider through a program called “telehealth.” Popkowski continued his telehealth appointments through May 2009, then began calling the medical center to express anger about delays in receiving medications, a pattern that persisted through the rest of the year.
Because of allegedly “threatening comments” made by Popkowski during a phone call in December 2009, his case was reported to the VA police, who in turn notified local law enforcement. The problems intensified in early 2010, when the medical center’s Disruptive Behavior Committee told Popkowski that he would be seen only at the main medical center and that if he did not attend his appointments, his medications would be discontinued.
Popkowski said he didn’t want to change providers, according to the report, but he went to see a new primary care physician at the Togus facility in early May. Popkowski angrily left that appointment early because the doctor was “not fully aware of his past medication history,” according to the report. That was the last time Popkowski was seen at a VA clinic prior to his death.
In the meantime, the VA was attempting to gauge the state of Popkowski’s cancer for the purpose of adjusting his monthly compensation. After Popkowski did not show up to an appointment and did not respond to a mailed questionnaire, he was notified that his monthly compensation would be lowered from $2,673 to $770, effective May 15, 2010.
Then in June, the VA sent Popkowski another letter.
“Because you did not report for a required examination, the law says we must change the evaluation of your service-connected disability that is subject to improvement. Here is the condition and its evaluation: Your [cancer] which was 100 percent is now considered 0 percent disabling.” Though the letter identified ways for Popkowski to appeal the decision, he did not.
On July 8, Popkowski was shot during an armed confrontation hours after he posted a sign implying that doctors were killing him by denying him stem cell medicine, according to the Bangor Daily News archives. Witnesses said Popkowski had brandished a rifle toward officers in a threatening manner. An investigation into the incident by the Maine Attorney General’s Office, which will determine whether the officers acted appropriately, is continuing, a spokeswoman at the AG’s Office said Monday.
The Office of the Inspector General’s report identified three ways the medical center could improve: ensuring smooth transitions when there are changes in a veteran’s provider or care setting; improving communications between medical center personnel and external clinics; and reviewing the procedures of the Disruptive Behavior Committee “to ensure clear and consistent messages about patient risk and to promote patient-centered solutions when risks are identified.”
In written responses, the Togus VA Medical Center agreed to make a variety of changes requested by the Office of the Inspector General no later than the end of February 2011.
“Whether addressing these three issues previously would have resulted in a different outcome for the veteran is unknown,” reads the report.
Adams, who knew Popkowski for most of his life, disagreed.
“There were things that the VA could have done,” she said. “This is an honored veteran who was discharged because he got cancer. Veterans from across the United States will benefit from this report, and that will be the best honor for James. Like he always used to say, ‘Hell yeah.’”