Independent Medical Review Group Presents Preliminary Conclusions

By Jim Garamone
American Forces Press Service

April 12, 2007 – The problems wounded servicemembers and their families experienced at Walter Reed Army Medical Center here are systemic, members of the Independent Review Group said here yesterday. The group met with members of the Defense Health Board and presented preliminary conclusions at a meeting at the hospital.

"There has always been an American ethic and that ethic is that America always takes care of its wounded," said John O. Marsh, co-chairman of the group and former Army secretary. "We've got be certain that we always emphasize that ethic."

The group is looking exclusively at conditions Walter Reed and the National Naval Medical Center at Bethesda, Md. Yet the group's finding indicate problems beyond the two flagship military medical centers.

"We have reason to think that the observations we make are systemic," Marsh said. "We did encounter indications that some of the problems ... do exist in other medical facilities of our armed forces."

Former Secretary of Veterans Affairs Togo West, co-chairman of the group, said there were failures of leadership at Walter Reed. Army Secretary Francis Harvey, Army Lt. Gen. Kevin Kiley, and Walter Reed Commander Maj. Gen. George W. Weightman were fired for those failures.

West said there was a "virtually incomprehensible inattention to non-medical facilities," and an "almost palpable disdain" for the long-term treatment that outpatients need.

Marsh said the circumstances at Walter Reed created a "perfect storm." The Army did not expect the number of injured from the wars in Iraq and Afghanistan. Army officials did not invest in the Walter Reed facility once it was placed on the base realignment and closure list, and they tried to fill the void by hiring contractors to provide critical outpatient services. Medical personnel did not understand how to cope or treat servicemembers affected by traumatic brain injuries from improvised explosive devices and post-traumatic stress disorder. Finally, there is a systemic breakdown of the disability review process.

The group will recommend speeding up closure of Walter Reed Army Medical Center, West said. Under the base realignment and closure commission, Walter Reed and Bethesda are to be consolidated in Bethesda and the whole complex named the Walter Reed National Military Medical Center. The group recommends speeding up construction at Bethesda and ensuring that there is no "dying on the vine" for the facilities at Walter Reed until the complex is open. This will require funding improvements at a facility that is due to close, group officials said.

The group will recommend more money to research traumatic brain injuries and post-traumatic stress disorder. Medical personnel need to know the best diagnostic tools and treatments for these conditions.

The group will recommend more case workers for out-patient servicemembers, and better training for the case workers. The group will also study what part contracting-out played in the hospital's "perfect storm."

Finally, the group is unanimous regarding the disability review process, West said. "The horrors that are inflicted on our wounded servicemembers and their families in the name of physical disability review, simply must be fixed," he said.

All servicemembers go through three separate board proceedings to determine disability. In the Army it is four proceedings. There are different stands and results from these boards and they appear "wildly incomprehensible" to wounded servicemembers and their families, West said.

The system needs to be combined and consolidated into a reasonable process from the servicemembers point of view, West said.

"To be sure it was the degradation of the physical facilities that caught the eye of the media," West said. "Important as that is, we believe there is far more important things to be dealt with here than applying paint or crawling around basements to deal with electrical problems.

"This is our bottom line: We are the United States of America," he continued. "These are our sons and daughters and sisters, uncle and aunt, maybe even a grandparent or two. ... Their families are our families. We are their neighbors. Their anguish is ours. We can and must do better."

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