BAGHDAD, Iraq -- Pfc. Caleb A. Lufkin landed on the helipad at about 12:30 p.m., screaming at the sky as a small all-terrain vehicle carried him past the palm trees and concrete bunkers to the emergency room. Doctors inside cut off his blood-covered boots and prepared to sedate him and insert a breathing tube, and he pleaded with them to keep him alive.
"Don't let me die," he said.
"I won't let you die," answered Capt. David Steinbruner, an Army doctor. "I promise. I give you my word."
Lufkin was bleeding from multiple blast injuries and compound fractures, so the medical team at the 10th Combat Support Hospital gave him red blood cells to replace his lost blood and plasma to help him clot. But they quickly concluded that he was on a perilous course toward a massive transfusion and that his odds of survival were decreasing with each minute that he continued to bleed.
At 12:41, without waiting to see if surgery or more transfusions would be enough to stop the bleeding, they ordered a 7.2 milligram dose of Recombinant Activated Factor VII.
When Lufkin arrived at the Army's combat hospital in Baghdad on May 4, he was the first of three American soldiers brought in over a 24-hour period, each with injuries severe enough to require blood transfusions and emergency surgery. Like more than 1,000 of the war's seriously wounded troops, each was treated with Factor VII, a powerful and largely untested blood-coagulating drug that the Army considers a wonder of modern trauma care, but which researchers have linked to deadly blood clots that lodge in the heart, lungs and brain.
All three soldiers left Baghdad alive, their doctors anticipating full recovery. One experienced no problems and later said he was grateful for whatever steps were taken to save his life. But two later suffered unexplained blood clots and died from subsequent complications.
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Some doctors worry that the Army, in its effort to push the limits of modern trauma medicine, is going too far with its enthusiasm for Factor VII, that giving it to the war's casualties could be doing more harm than good. But the physicians in Baghdad say that a war is no time to be cautious and that they'll consider any new advancement or technique that might save lives.
"All we can do is give these guys the best chance we can, with the best equipment and training we have," said Lt. Col. Bob Mazur, who served as the chief emergency room doctor in Baghdad that day. "This is war, and bad stuff happens."
