Overseas Civilian Contractors

News and issues relating to Civilian Contractors working Overseas

Pentagon Puts It’s Spin on Brain Injuries

After Our Investigation, Pentagon Puts Its Spin on Brain Injuries

by T. Christian Miller, ProPublica, and Daniel Zwerdling, NPR

ProPublica and NPR reported today that the military is failing to diagnose soldiers who suffered brain injuries in Iraq and Afghanistan. It didn’t take long to get a response. Soon after learning that the stories were about to air, the Pentagon’s public affairs machine began circulating talking points on traumatic brain injuries—just in case senior medical commanders weren’t up to speed on what the military’s been doing for troops with one of the wars’ signature wounds.

The talking points, which we obtained and were sent to top Army officials, don’t directly address the findings of our investigation [1]. We found that the military’s system has repeatedly overlooked soldiers with so-called mild traumatic brain injuries. These blast injuries, which some doctors call concussions, leave no visible scars but can cause lasting physical and mental harm in some cases. The Pentagon’s official figures [2] say about 115,000 soldiers have suffered a mild traumatic brain injury since the wars began. But we found that military doctors and screening tools routinely miss soldiers who have suffered mild traumatic brain injuries on the battlefield. Experts we interviewed and documents we obtained said the military’s count may understate the true toll by tens of thousands of soldiers.

The talking points are upbeat. One says that the Department of Defense has the “world’s best TBI medical care for our service members [3].” Leading neuropsychologists and rehabilitation therapists have told us that’s not true, however. They say the military doesn’t always provide the kind of intensive cognitive rehabilitation therapy most experts recommend. The talking points also stressed that one military screen, called the ANAM [4], for Automated Neuropsychological Assessment Metrics, will be “utilized when soldiers come home [5] to help measure the effects of any identified mild brain trauma that may have gone unnoticed or untreated.”

But when we talked to the man who ran that program, he told us the ANAM was rarely used that way. Lt. Col. Mike Russell, the Army’s senior neuropsychologist, said that more than 580,000 ANAM tests have been administered to soldiers before they deploy to the battlefield. But doctors have only used them about 1,500 times to diagnose soldiers after they’ve suffered a blow to the head.

The talking points tick off a number of initiatives the military has undertaken to better diagnose and treat the soldiers. But as we note in our stories, the problem is not the lack of initiatives, it’s that nine years into the war, nobody at the Pentagon knows how big the problem is, nor how best to treat it. You can find the complete talking points memos [6] and PowerPoint [7] here.

Phone calls to the medical command’s spokeswoman were not immediately returned.

June 9, 2010 Posted by | Civilian Contractors, Defense Base Act, Traumatic Brain Injury | , , , , | Leave a comment

Brain Injuries Remain Undiagnosed in Thousands of Soldiers

Civilian Contractors treated in the Military Medical System also have gone undiagnosed and untreated.  When they do ask for help AIG and CNA denies them screening, diagnoses and treatment based on them not having medical evidence that they need to be screened.

by T. Christian Miller, ProPublica, and Daniel Zwerdling, NPR

The military medical system is failing to diagnose brain injuries in tens of thousands of soldiers who served in Iraq and Afghanistan, and many of them receive little or no treatment for lingering health problems, despite years of promises, an investigation by ProPublica and NPR has found.

WASHINGTON, D.C.–The military medical system is failing to diagnose brain injuries in troops who served in Iraq and Afghanistan, many of whom receive little or no treatment for lingering health problems, an investigation by ProPublica and NPR has found.

So-called mild traumatic brain injury has been called one of the wars’ signature wounds. Shock waves from roadside bombs can ripple through soldiers’ brains, causing damage that sometimes leaves no visible scars but may cause lasting mental and physical harm.

Officially, military figures say about 115,000 troops have suffered mild traumatic brain injuries since the wars began. But top Army officials acknowledged in interviews that those statistics likely understate the true toll. Tens of thousands of troops with such wounds have gone uncounted, according to unpublished military research obtained by ProPublica and NPR. Read the Entire Story here

June 8, 2010 Posted by | AIG and CNA, Civilian Contractors, Contractor Casualties, Traumatic Brain Injury | , , , , , , | Leave a comment

After three years, another delay in brain injury screening for US soldiers

Number of soldiers returning to combat with brain injuries is unknown

by Bryant Furlow

June 7, 2007—It is the signature wound of the Iraq war, but nobody is keeping track of how many soldiers have suffered traumatic brain injury (TBI), or who they are.  Many—perhaps  most—soldiers with combat-related TBIs have
gone untreated.  They face the possibility of serious life-long health problems, including epilepsy.

After three years of lobbying by the Pentagon’s top brain injury experts, the Department of Defense ordered that post-deployment screening  of soldiers for brain damage begin in June.

But that has not happened.

The order to begin screening soldiers for brain injuries by June 1, 2007 was issued in March by then-Assistant Secretary of Defense for Health Affairs William Winkenwerder. He ordered that two single-sentence questions be added to post-deployment and redeployment healthassessment forms, asking whether soldiers have suffered blows to the head or whiplash.

“The two questions have been added,” a senior US Department of Defense health official told epiNews on Tuesday. “But we are delayed in getting final approval for the change to the electronic form.  ” The official said the problem would be remedied within a “matter of weeks.”

But even the updated PDF (“paper”) versions of the health assessment forms were not available at military web sites Tuesday.  The electronic version of the health assessment questionnaire is an interactive form available only on a secure military web site.

Asked about the delayed screening policy, Dr Deborah Warden, National Director of the  Defense and Veterans Brain Injury Center  (DVBIC) in Washington, DC says only that she is “not aware of the final decision regarding TBI screening.”
Warden has lobbied for post-deployment TBI  screening since at least 2004, when conversations with field hospital staff and wounded soldiers led her to believe that many cases of combat-related brain damage were going undetected.

Soldiers with TBIs can develop serious side-effects, including memory problems, confusion, emotional problems, delayed reaction times, and with time, even epilepsy. To date, no systematic effort has been made to screen for brain injuries among soldiers leaving combat duty or military service.

As Many Returned to Combat as Evacuated for Treatment?
In November 2004, Warden spoke to the Armed Forces Epidemiological Board about the effects of combat TBIs.
She told the assembled experts that failing to promptly identify and treat soldiers for TBI can lead to increased brain damage.
Of the blast injury patients seen at Walter Reed Army Medical Center by August 2004, Warden told the audience, 59 percent had sustained TBI.

In Iraq, Warden told military epidemiologists, just as many soldiers treated for head injuries at military field hospitals in Iraq were being “returned forward” to active duty as were being evacuated out of theater for TBI evaluation and treatment.
Even mild TBIs are associated with “relatively large” changes in  soldiers’ reaction times, Warden said at the time—a clear threat to combat units’ readiness and safety.

Further Reading at epinews

March 2, 2010 Posted by | Traumatic Brain Injury | , , , , , , , | Leave a comment

DoD delayed brain injury scans

USA Today’s Gregg Zoroya reports that the Pentagon’s
top epidemiologist has admitted the delays were deliberate—
part of an effort to avoid “another Gulf War Syndrome”
veterans’ health headache for the military.
By Gregg Zoroya, USA TODAY

For more than two years, the Pentagon delayed screening troops returning from Iraq for mild brain injuries because officials feared veterans would blame vague ailments on the little-understood wound caused by exposure to bomb blasts, says the military’s director of medical assessments.

Air Force Col. Kenneth Cox said in an interview that the Pentagon wanted to avoid another controversy such as the so-called Gulf War syndrome. About 10,000 veterans blamed medical conditions from cancer to eczema on their service.

The Pentagon did not acknowledge the syndrome until Congress created a committee to study it in 1998.

For troops who think they may have a condition not designated as war-related, Cox said, often “they’re reacting to rumors, things that they’ve read about or heard about on the Internet or (from) their friends.”

That uncertainty, Cox said, means “some individuals will seek a diagnosis from provider to provider to provider.” It also makes treating veterans “much more difficult and much more costly,” he said.

Asked whether mild traumatic brain injury (TBI) could turn into another Gulf War syndrome, Cox said, “It could.”

“That’s baloney,” says Rep. Bill Pascrell, D-N.J., founder of the Congressional Brain Injury Task Force. “There was no need to delay this.”

In a January 2006 report, scientists at the federal Defense and Veteran Brain Injury Center urged that troops be screened for TBI “immediately.” The Pentagon will soon require that troops be checked as they come home, according to Cox.

Cox says research shows screening is the most appropriate step.

An Army mental health report last month indicated that 11% of 2,195 soldiers surveyed in Iraq and Afghanistan show signs of mild brain injury, but fewer than half were identified and evaluated in the field.

That’s more proof of the need to screen troops as they leave Iraq, says Air Force Lt. Col. Michael Jaffee, a neurologist who heads the brain injury center. Screening includes a series of questions about a soldier’s experience and symptoms relating to head injury, such as balance or memory.

About 1.6 million U.S. troops have served in Iraq.

Sen. Patty Murray, D-Wash., says, “Here we are five years into this war, and the Pentagon is just now coming to grips with how to track and treat those … with TBI.” Murray is a member of the Senate appropriations subcommittee that oversees spending on veterans issues.

One concern, Cox says, was that mild TBI symptoms often resemble simple problems such as a lack of sleep or stress.

Screening for brain injury is vital to the health of troops in the field, says Staff Sgt. Marcus Brown, 30. He was transferred to Fort Carson, Colo., where the Army has operated a pilot screening program for traumatic brain injury since 2005. There, Brown was screened for brain injury for the first time after serving two tours in Iraq and surviving three IED blasts.

Doctors need to screen soldiers for brain injury as they leave the war zone, Brown says, because “most soldiers, especially NCOs (noncommissioned officers), are not going to show any type of weakness in front of their soldiers.”

March 2, 2010 Posted by | Traumatic Brain Injury | , , , , , | 1 Comment