Newspaper article International New York Times

U.S. Troops Are Often Left in the Dark on Health Errors ; Service Members Have Little Recourse When Medical Mistakes Occur

Newspaper article International New York Times

U.S. Troops Are Often Left in the Dark on Health Errors ; Service Members Have Little Recourse When Medical Mistakes Occur

Article excerpt

The nation's 1.3 million active-duty service members are in a special bind, virtually powerless to hold accountable the health care system that treats them.

Lt. Col. Chad Gallagher was T.J. Moore's squadron leader when the 19-year-old recruit arrived for basic training last spring at Lackland Air Force Base in San Antonio. He was watching at the quarter-mile track nine days later when Mr. Moore, on an easy mile- and-a-half test run, collapsed at the finish line and was rushed to a hospital.

And he was in Indiana shortly afterward to deliver a sorrowful eulogy at Mr. Moore's funeral. "He had tears in his eyes," Mr. Moore's mother, Anita Holmes, said in an interview at her home here. "He said, 'I didn't do enough to protect T.J."'

A year later, Ms. Holmes says she still does not know what Colonel Gallagher meant by that.

Outside experts who reviewed her son's medical records at the request of The New York Times identified a serious medical error at the Lackland clinic: a decision to allow Mr. Moore to make the run even though doctors had pulled him from normal training after he failed the same test just days before. Test results revealing a genetic condition that in rare cases can lead to sudden death during physical exertion were apparently overlooked.

But the official Air Force explanation -- in a 15-page report in a white binder, delivered to Ms. Holmes in December after months of inquiries -- was that the military had followed proper protocol. No mistakes were identified. No one was faulted.

"I raised T.J. as a single mother on little income for 19 years, and kept him safe. They had him for nine days and sent him home to me in a box," said Ms. Holmes, who called the report "garbage."

"No one," she added, "has really given me good answers about why."

Tens of thousands of serious medical mistakes happen every year at American hospitals and clinics. While a handful of health care organizations have opted for broad disclosure amid calls for greater openness, most patients and their families still face significant obstacles if they try to find out what went wrong. But as Mr. Moore's case illustrates, the nation's 1.3 million active-duty service members are in a special bind, virtually powerless to hold accountable the health care system that treats them.

They are captives of the military medical system, unable, without specific approval, to get care elsewhere if they fear theirs is substandard or dangerous. Yet if they are harmed or die, they or their survivors have no legal right to challenge their care, and seek answers, by filing malpractice suits.

Only 18 months ago did the Pentagon explicitly allow them to file complaints about their treatment, although some had done so earlier. But even then they are barred from learning the results of any inquiry. Under federal law, investigations at military hospitals and clinics are confidential, in part to keep the findings from the roughly two million civilian patients they treat per year -- spouses and children of service members, retirees and others, who can and do file malpractice claims.

In scores of interviews, active-duty patients, relatives and military medical workers described how, in that information vacuum, attempts to ferret out the truth about suspected medical mistakes -- through freedom-of-information requests, complaints, meetings with military medical officials -- produced anodyne letters of condolence, blanket denials of poor care or nothing.

"There is just no transparency. You can't sue. You have no insight into the process," said Cheryl Garner, a military intelligence officer who retired last year. "As active duty, we just don't have much recourse."

The experiences of active-duty patients point to broader questions of accountability in a system of 54 hospitals and hundreds of clinics that has recently come under intense scrutiny. As The Times has reported, military hospitals often fail to conduct safety investigations that the Defense Department mandates when patients suffer serious harm or die. …

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