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October 8, 2006

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

by Larry Scott

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 was 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.

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Larry Scott served four years in the U.S. Army with overseas tours as a Broadcast Journalist in Korea and the Azores and a stateside tour as a Broadcast Journalism Instructor at the Defense Information School (DINFOS). He was awarded DOD's First Place Thomas Jefferson Award for (more...)
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