Updated at 3 p.m. ET

Rep. Ronny Jackson made sexual and denigrating statements about a female subordinate, smelled of alcohol while on duty and humiliated his staff during his long stint as a White House physician, according to a scathing new report from the Defense Department's inspector general.

In one incident, the report states that when Jackson was on a presidential trip to Manila, Philippines, in 2014, he made inappropriate comments about a female medical subordinate's breasts and buttocks, got drunk with junior staff and banged on the female subordinate's door in the middle of the night, raising a commotion in the hotel.

When the woman woke up and answered the door, Jackson told her, "I need you," according to the Pentagon report. After another staff member came into the hallway, the report adds, Jackson insisted they all go to his hotel room.

Jackson, a 53-year-old retired Navy rear admiral, began his White House tenure during George W. Bush's administration, working as a physician in the White House Medical Unit, which is overseen by the Defense Department. He was later appointed to the post of physician to the president by former Presidents Barack Obama and Donald Trump.

The inspector general's office says Jackson "disparaged, belittled, bullied, and humiliated" his subordinates and fostered a toxic work environment that undermined the unit. It also says he "engaged in inappropriate conduct involving the use of alcohol" during two presidential trips — one to Manila and another to Bariloche, Argentina, in 2016.

The word "alcohol" appears 56 times in the 37-page report, which draws on initial complaints and interviews with at least 60 witnesses who previously worked in the White House Medical Unit.

Out of 60 former staff members of the White House Medical Unit who had interactions with him and were interviewed, the report states, "Only four witnesses told us that they did not experience, see, or hear about RDML Jackson yelling, screaming, cursing, or belittling subordinates."

The Pentagon report was sparked by a raft of allegations that surfaced in 2018, when Trump nominated Jackson to be secretary of veterans affairs. Jackson later abandoned his nomination. The accusations led to Wednesday's Pentagon report — but they did not halt Jackson's political career: The Republican was elected to Congress last November, representing a district in the Texas Panhandle.

Jackson has denied the allegations of misconduct. The Pentagon's inspector general says the former White House physician turned down chances to comment on its findings, but Jackson issued a statement Tuesday night, as news of the report's conclusions began to emerge.

"Three years ago I was the subject of a political hit job because I stood with President Trump," Jackson said, according to the Texas Tribune. "Today, a Department of Defense Inspector General report has resurrected those same false allegations from my years with the Obama Administration because I have refused to turn my back on President Trump."

As it issued its findings, the Pentagon's inspector general's office cautioned that it had been prevented from handling the case as it normally would, citing interference from the White House that occurred during Trump's presidency. It did not interview current employees at the White House Medical Unit, for instance, citing the "chilling effect" on those witnesses after the Office of the White House Counsel insisted on being present for their testimony.

Despite that setback, the inspector general's office says it is confident that the testimony, documents and other evidence it found was enough to make a clear determination. It recommends that the secretary of the Navy "take appropriate action" regarding Jackson, without providing details.

While it laid out Jackson's failings, the inspector general's report also says its inquiry found no evidence to support two other potentially damaging allegations against the high-ranking official.

"We found no evidence to support the allegation that RDML Jackson 'got drunk and wrecked a government vehicle,' " the report states. It also did not find proof that Jackson expected rum to be stocked in his quarters during official travel or that his subordinates feared retribution if they didn't buy alcohol for their boss.

The inspector general's office concludes that on several occasions, Jackson took Ambien to sleep while flying on Air Force One. It adds that the practice prompted concern among his staff that he might not be able to perform his duties if he were called on to care for the president. The report calls for new "fitness for duty guidance" around using drugs such as Ambien.

Drawing on witness testimony, the findings relate how during the trip to Manila, Jackson's eyes were bloodshot and he was visibly drunk when he knocked on a female subordinate's hotel room door around 1 or 2 a.m.

The woman told the inspector general's office, "when a drunk man comes to your room and they say, 'I need you,' your mind goes to the worst. I really felt it was a sexually inappropriate comment."

A male member of the medical staff said he came to see why Jackson was "pounding" on the woman's door — and after he saw the look on his female colleague's face, he told investigators that he tried to divert Jackson back to his own room. But, he said, Jackson insisted: "No, no. We need her. We need her. Get her. We need her."

The woman changed out of her pajamas and grabbed her medical bag, because she wasn't sure what was going on. When she arrived in her boss's room, she said, Jackson was evidently intent on eating balut, a Philippine specialty, as a sort of culinary challenge.

As the report states, "Balut is a fertilized bird egg that is incubated for a period of 14 to 21 days depending on the local culture, and then boiled or steamed. The contents are eaten directly from the shell."

The female staff member described the scene in Jackson's hotel room in an interview with the inspector general's office.

"Dr. Jackson was in [the room] holding this ... grocery bag of ... balut. [RDML Jackson] said, 'Take my phone. Take my phone. We need to take pictures. I want to film this. I want to film myself eating these eggs.' And he's screaming. I kind of describe this is like frat boy type behavior."

Jackson's attempt to eat the balut, which is often made with duck eggs, was short-lived.

The physician to the president screamed, " 'It f***ing stinks. I can feel its f***ing feathers,' " the woman said. At that point, she recalled thinking, "I'm done. This is not where I want to be. I don't know what this man was coming to my room for in the first place, but this is clearly not related to my job. I'm going."

Copyright 2021 NPR. To see more, visit https://www.npr.org.

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