The Marine who was shot and killed by police outside Togus Veterans Affairs Medical Center last summer had repeatedly complained about the hospital’s poor communication, discontinuity of care and a prescription regimen that at times left him without pain and mental health medication.

James Popkowski grew increasingly depressed, eventually making threats against medical staff at the clinic where he was being treated, according to a report released last week by the Department of Veterans Affairs Office of Inspector General.

“By all accounts, he enjoyed a successful military career until it was cut short by a devastating disease and serious complications resulting from the treatment of that disease,” the report’s author, Assistant Inspector General Dr. John Daigh Jr., wrote. “The veteran’s experience with the VA had a difficult start, followed by alternating periods of smooth and difficult interactions.”

Popkowski, 37, of Medway, was a first lieutenant in the Marines when his service was cut short in 2003 by a rare form of leukemia. He left the Marines with an honorable discharge and later complained of Graft vs. Host Disease from a stem cell transplant he received as part of the cancer treatment.

Popkowski died July 8 from a single gunshot wound to the neck after a confrontation with a federal VA Police Officer and two game wardens near the entrance to the VA Medical Center at Togus, where he’d received treatment in the past.

Popkowski allegedly left a painted note on his property accusing doctors of “killing him” by depriving him of his stem cell medication.

The attorney general’s office is continuing to investigate, spokeswoman Kate Simmons said Monday. Simmons declined to comment further, but investigators have said preliminary information indicates the officers felt threatened by Popkowski, who was armed with what witnesses said looked like a rifle.

Officers were responding to reports of gunfire coming from the woods. A witness walking in a Togus parking lot said after the shooting he heard bullets flying in the direction of the hospital.

Congressman Mike Michaud requested the Office of the Inspector General’s investigation into Popkowski’s care. The results of that investigation were released Dec. 9.

“The death of Lt. James Popkowski was as tragedy,” Michaud said. “I requested this report so that all the facts could be gather on the care that VA provided to him. His family deserves to have all the answers, and all veterans stand to benefit from a thorough review of what happened.”

The OIG investigation recommended review and changes to Togus’ policy for assigning case managers and coordination of care. The report also urges Togus to improve internal communications and develop better procedures assessing and communicating risks associated with veterans who exhibit disruptive behavior.