Upon feeling unwell and unsteady on his feet, his wife took David to the Lake City VA Medical Center near Ocala, Florida (a smaller facility where he felt he would be more comfortable), he was diagnosed with a heart attack and was immediately transferred to the VA center in Gainesville where he received a heart catheter and three stents were placed within the week (within this first year a defibrillator was also placed) and was told his heart was working at 20 percent capacity At this time, he was also diagnosed with PTSD. Open heart surgery was not mentioned as an option to increase heart capacity, something which still baffles his family who trusted in the advice and care given.

Conversely, another family member who had a heart attack and was treated outside of the VA system, received open heart surgery within weeks of the initial heart attack.

A year after the stents were placed, he met with his primary care in the VA once a week. He was on heart medication for 10 years, with no referral for open heart surgery.  David’s wife recalls their conversations about why the heart surgery was not scheduled sooner as it was frequently discussed by his physicians that his heart capacity was extremely low and surprising that he had lived so long. Shortly after his heart attack, David developed indigestions problems, for which he was prescribed Prilosec and had several colonoscopies. As his condition progressed, Instead of heart surgery, David received daily iced heart medications via FED EX to his home.

Ensuing symptoms David experienced and follow-up tests pointed to Agent Orange exposure.  He had liver tumors that were not discovered in addition to colon tumors that when undetected until 2019, despite numerous colonoscopies for other GI issues.  Throughout his treatment, there were numerous delays in being seen for treatment.

In 2019 David was finally approved for open heart surgery.  Unfortunately, a week after scheduling the heart surgery, he had emergency colon surgery (due to undetected tumors which had burst) and was sent to a VA rehabilitation facility.  During that recovery, his family did not believe he was cared for properly, including regular bathing. During his time in the rehab facility, he coded.  In fact, another family member who is a nurse visited David at the rehab facility and noticed he was displaying signs of having a mini-stroke.  When pointed out the rehab staff, only then was David assessed and the stroke diagnosis confirmed.

David passed away 30 days after his colon surgery, at home in hospice after coding in the rehab facility.  He was 70 years old.

Both David and his wife felt that in the end, all the care provided was not to increase his quality or quantity of life, but for the VA system to avoid a lawsuit. Should all providers be allowed to practice at their full scope within the VA, patients like David may have more time with their family and receive the care they deserve. The trickle effect of allowing all providers to do what they were trained and licensed would allow for those duplicative services and funds being poorly managed to now be utilized elsewhere, such as social services, better care and more staff in rehab facilities so that no patient at the end of his life goes through what David and his family experienced.