Untested in battle

Our view: Increased vigilance is needed to ensure that innovative Army medical treatments won't put soldiers further in harm's way

April 03, 2009

There is an old saying in the Army that there are three ways of doing everything: the right way, the wrong way and the Army way. When it came to emergency medical treatment in front-line hospitals in Iraq, the Army preferred its own way of providing some unproven treatments, sparking serious concerns over the impact of such practices on thousands of soldiers with battlefield wounds.

An investigation by The Baltimore Sun's Robert Little found that some new military medical procedures were rushed into theaters of war with little oversight or evidence of their effectiveness. And, more troubling, senior Army doctors sometimes disregarded studies that found these treatments were ineffective or even dangerous. The Army's inspector general should review the practices identified in the newspaper's report to ensure that medical procedures used in Iraq and Afghanistan are properly vetted and no long-term harm has come to veterans.

In one case, for example, 17,000 packages of a blood clotting substance were shipped to Iraq last year for distribution to Army medics. It was quickly recalled when tests on pigs revealed potentially deadly complications. In another example, physicians in and out of the military questioned the Army's liberal use in Iraq of a blood clotting drug that was later found potentially dangerous and its reliance on frequent transfusions of fresh whole blood, a practice now used only in emergencies.

Col. John Holcomb, the former head of the Army's Institute for Surgical Research, and others who oversaw treatment in Iraq sometimes moved so aggressively to implement unproven medications and techniques into battlefield hospitals that some doctors told The Sun that they felt pressured to defy their own judgment.

While Army medical personnel worked feverishly to save soldiers' lives, the Army's surgeon general has come to recognize problems with some of the practices featured in The Sun's report. Aspects of the Army's system of testing and implementing medical treatments in combat have been restructured over the last year to provide new safeguards.

Still, more reforms are needed, including more careful assessment of new drugs or practices before they are accepted for use in the field. Lt. Gen. Eric B. Schoomaker, the surgeon general, has promised to make sure the service is not using novel but unsupported medical treatments.

He should be held to that promise.

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