Purple Heart recipient Ralph Nicastro died after waiting 15 months to see a specialist at the Veterans' Administration hospital in Phoenix, Arizona, about a lump on his neck.
Nicastro wasn't alone. Some 40 veterans in Phoenix have also died after waiting to see a doctor.
His widow, Sonja Nicastro, said her husband chronicled his attempts to get an appointment with the VA in his journal.
"No one ever answers," he wrote. "No one ever calls me back."
Phoenix is considered the epicenter of a growing scandal in the VA. One major concern is the deaths in Phoenix and whether they were caused by delays in treatment.
There's also concern over allegations that the Phoenix hospital tried to hide the delays in getting care by keeping a secret list of patients.
The allegations have prompted the House Committee on Veterans' Affairs Committee to issue a rare subpoena this week to VA Secretary Eric Shinseki.
In a unanimous vote, the committee agreed to subpoena all emails and other records in which Shinseki and other VA officials may have discussed destruction of that so-called secret list.
Allegations of delays and false records aren't limited to Phoenix, though. The VA has acknowledged that in recent years, 23 patients across the country have died as a result of delayed care.
Its medical inspector said a Ft. Collins, Colorado, clinic falsified records just last year.
Although Secretary Shinseki is promising investigations at every VA clinic and hospital to counter growing allegations of problems, some veterans groups say they've lost confidence in the VA.
"The question we have is - what's next? Are there other VA facilities that are having this problem where people are allegedly cooking the books?" Paul Rieckhoff, founder and CEO of Iraq and Afghanistan Veterans of America, or IAVA, said.
Rieckhoff said it's also a concern at a time when suicide is epidemic among vets. The VA recently estimated that 22 veterans commit suicide every day.
"When veterans do step forward and ask for help they need to know that the VA is going to have their back," Rieckhoff said.
Meanwhile, the American Legion is already calling for Shinseki's resignation.
The VA has struggled for years to manage backlogs and excessive delays in treatment. But with these latest reports that may link the delays, the deaths and false records, a major political storm is brewing.
It's a storm that could cast clouds on several Senate races this fall, and one that won't likely end until veterans and their families get some answers.