Investigation reveals Army's risky medical practices

The U.S. Army in recent years has rushed a number of medical innovations onto the battlefields in Iraq and Afghanistan with little testing or data to support them, and then altered or abandoned them when they didn't live up to expectations.

Things like advanced battle dressings, a blood-clotting drug and alternative procedures for emergency blood transfusions were introduced into military hospitals without the rigorous review common in civilian hospitals, and Army officials sometimes changed or disregarded data from their own scientists that questioned their effectiveness, The Baltimore Sun found in an investigation.

In some instances, wounded service members were among the first humans on whom the treatments were used. And while virtually all of the Army's published research supports the treatments, some Army studies concluding that they are ineffective or potentially dangerous haven't been published.

The aggressive push is a point of pride to some Army doctors and officials, but others deride it as reckless and say they felt pressured to defy their own judgments in favor of the military's favored, but unproven, treatments.

And controversy over the experimental nature of the Army's combat medicine continues in Iraq today. A new formula for blood transfusions, hailed by the Army as its greatest medical breakthrough of the war, has been adopted by civilian hospitals around the world, based largely on the military's experience. Some civilian studies also support it, yet others, including a two-year study at Baltimore's Shock Trauma center, raise doubts that the procedure works.

Among The Sun's findings:

• Roughly 17,000 packages of a blood-clotting substance were shipped to Iraq last year for distribution to Army medics, despite warnings from the service's own scientists against using it on humans. It was quickly recalled when animal tests revealed potentially deadly complications.

• An $89 bandage given to every combat soldier and honored by the Army as one of its "greatest inventions" was deployed despite two unpublished studies from the service's research lab showing that it was no more effective than gauze. After mixed reports from the battlefield, it is being recalled and replaced.

• Liberal use of a blood-clotting drug, injected copiously into wounded soldiers in 2005 and 2006, became the Army's "standard operating procedure" more than a year before any clinical studies evaluating the drug's use on trauma patients had been completed. The drug has since proven largely ineffective in three unpublished Army studies and potentially dangerous in at least one, and is now used only in extreme cases.

• Transfusions of fresh whole blood, considered dangerous and unnecessary in civilian medicine, became standard treatments early in the Iraq war, based on anecdotes and theoretical arguments. They unwittingly exposed 20 or more patients in Iraq and Afghanistan to hepatitis. Studies of the practice have since found mixed results, and it is now used only in emergency situations.

Read the story on the investigation this Sunday in The Baltimore Sun.

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