Did VA Budget Cutbacks Lead to the Death of Clinton Fuller?

Instead of administering life-saving medical care, VA called 911 and had veteran taken to another hospital where he died

On September 30, 83 year-old Clinton Fuller, a veteran of three wars, had a friend drive him to the Department of Veterans’ Affairs (VA) Medical Center in Spokane, Washington. Fuller has having problems with his asthma and emphysema and needed medical attention.

Before they got to the hospital, Fuller collapsed in the car. His friend pulled up to the VA’s Urgent Care unit at 4:35pm and was informed that they had closed at 4:30. Then, instead of helping Fuller, VA employees called 911 and ordered an ambulance. Fuller was taken to another hospital where he died about an hour later.

This story has been making headline news around the world. And people are asking how this could happen in America, especially to a veteran who, in theory, has access to the finest healthcare in the country. That’s a good question.

The Spokane VA operates 46 hospital beds and 38 nursing home beds with staff on duty around-the-clock. The Urgent Care unit does NOT operate around-the-clock, however. It used to be open 24/7. But, in July of this year, the hours were cut back. Now, the unit is only open from 8am to 4:30pm. Spokane VA Director, Joe Manley, made the decision to cut the Urgent Care hours. 

I interviewed Manley in July when he made the decision. Manley said his decision was “not budget driven” and justified the cut in service by saying very few patients were seen during the evening and overnight hours and he could “better utilize staff by moving them to other duties.” However, Manley never fully identified those duties.

Other staff members at the Spokane VA had a different view. A number who emailed me at VA Watchdog dot Org stated without reservation that the cut in Urgent Care hours was driven by budget concerns. Staff members were needed on other shifts in other parts of the facility and because there wasn’t enough money in the budget to hire them, they were pulled from Urgent Care and the hours cut.

When Urgent Care cut back hours, the outcry in the veterans’ community was loud and clear. Joining the chorus was U.S. Senator Maria Cantwell (D-WA). Cantwell stated, “I’ve heard from concerned veterans in eastern Washington who worry that under this plan, they will no longer have affordable access to the care they may need in an emergency.”

Then, Cantwell demanded answers from the VA. In a letter dated July 26, Cantwell wrote, “…I am concerned about the potential impacts of this reduction in urgent care service availability on veterans in the Inland Empire and other significant impacts on health care delivery capacity in the region.” Cantwell then asked the VA to respond to a series of questions aimed at finding out how veterans would be cared for during the hours the Urgent Care center was closed. 

The answers to those questions may be moot. Clinton Fuller is dead. Fuller, a decorated veteran of World War II, Korea and Vietnam, was seen regularly at the Spokane VA. Like most veterans, Fuller assumed he would be cared for. As do millions of other veterans who now watch and worry as VA services are cut at hospitals and clinics across the country.

And, there are no good answers coming from the VA’s Manley as to why his employees called 911 instead of offering necessary medical assistance. It was determined that veteran Fuller needed a breathing tube inserted in his trachea so he could breathe. No one at the VA did that. 

In an Associated Press interview Manley said, “The patient arrived at our facility in respiratory distress. The most skilled people we had went out to the patient, but you have to have the professional equipment to do the work. Calling the fire department was quicker than getting equipment and bringing it back out or finding someone who could offer the medical assistance.” 

This excuse is not flying in the Spokane veterans’ community. A “trach tube” is standard equipment at an Urgent Care unit and any person with Paramedic training knows how to insert it properly. It is inconceivable that a tube was not available and that there was no person qualified to insert it. Veterans’ groups are already calling for the VA’s Office of Inspector General (OIG) to investigate Fuller’s death. 

From all appearances, Director Manley got caught in a budget crunch that turned into a nightmare. For nearly six years I have watched the Republican-controlled House and Senate continually underfund VA healthcare. The Bush administration is quick to point out that they have increased the VA’s healthcare budget by 51% during their first five years in office. But, those numbers don’t add up. When you add in general inflation, excessive inflation in the healthcare sector and federal employee pay increases, the VA healthcare budget just about breaks even. Then, when you add the increased demands on the VA system made by aging veterans of many wars plus the “new vets” returning from Iraq and Afghanistan, the VA healthcare budget is actually going backward!

As we near Election Day 2006, every incumbent is waving the flag and telling us how they support the troops and veterans. But, their dismal voting records paint a different picture. The Republican-controlled Congress has much to answer for, including jeopardizing the health, welfare and even the lives of our veterans.

Is the VA responsible for the death of Clinton Fuller or was it just an unfortunate happenstance? Would immediate medical treatment have saved his life? There will probably never be a definitive answer to that question.

But, at the very least, the death of Clinton Fuller should cause the VA to re-examine its budget process. In three reports this year the Government Accountability Office has found that the VA is not adequately assessing the healthcare needs of veterans and budgeting accordingly. And, our do-nothing Congress should pause to consider their part in the death of Clinton Fuller. 

God Bless You, Clinton Fuller. May you rest in peace, Brother. Your country walked away from you in life. May they remember you in death.