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What is the Feres Doctrine of Medical Malpractice?

The Feres Doctrine

A doctrine that bars claims against the federal government by members of the armed forces and their families for injuries arising from or in the course of activity incident to military service.

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https://en.wikipedia.org/wiki/Feres_v._United_States

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Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™  Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

***

LINK: http://www.msn.com/en-us/news/us/dying-us-soldier-fighting-for-the-right-to-sue-military-over-medical-malpractice/ar-AAAZ09p?li=BBnb7Kz

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Injured War Contractors Sue Over Health Care

And … Disability Payments

By T. Christian Miller
ProPublica, September 27, 2011, 10:11 am

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Private contractors injured while working for the U.S. government in Iraq and Afghanistan filed a class action lawsuit [1] in federal court on Monday, claiming that corporations and insurance companies had unfairly denied them medical treatment and disability payments.

The Law Suit

The suit, filed in district court in Washington, D.C., claims that private contracting firms and their insurers routinely lied, cheated and threatened injured workers, while ignoring a federal law requiring compensation for such employees. Attorneys for the workers are seeking $2 billion in damages.

The Defense Base Act

The suit is largely based on the Defense Base Act, an obscure law that creates a workers-compensation system for federal contract employees working overseas. Financed by taxpayers, the system was rarely used until the wars in Iraq and Afghanistan, the most privatized conflicts in American history.

Hundreds of thousands of civilians working for federal contractors have been deployed to war zones to deliver mail, cook meals and act as security guards for U.S. soldiers and diplomats. As of June 2011, more than 53,000 civilians have filed claims for injuries in the war zones. Almost 2,500 contract employees have been killed, according to figures [2] kept by the Department of Labor, which oversees the system.

An investigation by ProPublica, the Los Angeles Times and ABC’s 20/20 [3] into the Defense Base Act system found major flaws, including private contractors left without medical care and lax federal oversight. Some Afghan, Iraqi and other foreign workers for U.S. companies were provided with no care at all.

Assessment

The lawsuit, believed to be the first of its kind, charges that major insurance corporations such as AIG and large federal contractors such as Houston-based KBR deliberately flouted the law, thereby defrauding taxpayers and boosting their profits. In interviews and at congressional hearings, AIG and KBR have denied such allegations and said they fully complied with the law. They blamed problems in the delivery of care and benefits on the chaos of the war zones.

Conclusion

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On Military Brain Injury Treatment

Leader Steps Down Abruptly

By T. Christian Miller, ProPublica, and Daniel Zwerdling, NPR – June 23, 2010 6:33 pm EDT

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WASHINGTON, D.C.–The leader of the Pentagon’s premiere program for treatment and research into brain injury and post traumatic stress disorders has unexpectedly stepped down from her post, according to senior medical and congressional officials.

Brig. Gen. Loree Sutton told staff members at the Defense Centers of Excellence [1], or DCOE, on Monday that she was giving up her position as director. Sutton, who launched the center in November 2007, had been expected to retire next year, officials with knowledge of the situation said. The center has not publicly announced her leaving.

Tell Us Your Story [2]

Did you or a loved one suffer a traumatic brain injury while serving? ProPublica and NPR want to hear your story. Tell us about your experiences with TBI. [2]

Sudden Departure

Sutton’s departure follows criticism in Congress [3] over the performance of the center and in recent reports [4] by NPR and ProPublica that the military is failing to diagnose and treat soldiers suffering from so-called mild traumatic brain injuries, also called concussions.

It comes just as the Pentagon prepares to open a new, multimillion-dollar showcase treatment facility outside Washington, D.C., for troops with brain injuries [5] and post traumatic stress disorder, often referred to as the signature wounds of the wars in Iraq and Afghanistan.

Late Wednesday, in a sign of disarray within the program, Sutton cancelled a scheduled appearance at the opening of the National Intrepid Center of Excellence [6], a gleaming new facility of waving glass and futuristic virtual reality treatment rooms in Bethesda.

“The war in Iraq and Afghanistan could end tomorrow; our mission to restore health, hope and humanity will endure for decades,” Sutton wrote in her farewell message [7]. “We simply must uphold our commitment to all who have borne the burdens of war on our behalf.”

Sutton did not respond to requests for comment. Her replacement, U.S. Army Col. Bob Saum, also declined to comment.

Adult-Resources

DCOE

Cathy Haight, the acting spokeswoman for DCOE, said Sutton’s departure, though apparently well ahead of schedule, was part of a routine command rotation. Haight said Sutton decided to leave after turning down the Army’s offer to take a new position overseeing the military medical system in Europe.

“If a general officer declines (a new position)…they are in a transition to retire,” Haight said.

In recent months, legislators have questioned Sutton’s ability to carry out the mission of the centers, which is to catalyze research and treatment across the military for soldiers returning with brain injuries and psychological wounds.

Congress directed the military in 2008 to create the brain injury center and other facilities for wounded soldiers. At an April hearing [8] of a House Armed Services subcommittee, Rep. Susan Davis [9], D-Calif., said that the center had failed to carry out its role.

“The Defense Center of Excellence, while having achieved some notable small scale successes, has not inspired great confidence or enthusiasm thus far. The great hope that it would serve as an information clearinghouse has not yet materialized,” Davis said.

“The center has also made some serious management missteps that call into question its ability to properly administer such a large and important function,” Davis continued.

Sudden Scrutiny

Scrutiny of Sutton rose another notch earlier this month, when NPR and ProPublica reported on the military’s problems in handling soldiers with mild traumatic brain injuries. Such injuries leave no visible scars, but can cause lasting mental and physical difficulties.

Military statistics show that about 115,000 troops have suffered such injuries since 2002, but in interviews, Army experts acknowledged the true toll may be far higher. Unpublished research we reviewed suggests that tens of thousands of soldiers may have gone undiagnosed. Our reporting also showed that even when soldiers were diagnosed, at one of America’s largest Army bases, they have had to fight to receive appropriate treatment [10].

Veterans’ Shocked

Still, some veterans’ advocates were shocked and saddened that Sutton was leaving. They said she had been a forceful, visible advocate for wounded troops and their families who had never received the full support of the military’s medical establishment.

Assessment

Critics of the military’s health system have noted a power vaccum at the top of the military medical structure. Four people in just over three years have rotated through the Pentagon’s top health policy position, the assistant secretary of defense for health affairs.

“She was always there for the troops,” said one veterans’ advocate, who did not want to be named for fear of criticizing the military. “She’s become the scapegoat.”

In an April interview with NPR and ProPublica, Sutton shrugged off the criticism. “Leading change,” she said, “is a journey not for the faint of heart.”

“We are very proud of the team that we have built, the concept in terms of the center of centers, the network of networks,” she said. “Are we anywhere close to where we want and need to be? No. Of course not.”

Link: http://www.propublica.org/feature/leader-of-militarys-program-to-treat-brain-injuries-steps-down-abruptly

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What’s So Special About War Doctors?

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By Dr. David Edward Marcinko; MBA

[Publisher-in-Chief]

Back in the day, I did some trauma training at Martin Army Hospital in Columbus, GA. This 250-bed facility is the center for medical services at Fort Benning. Opened in 1958, it is one of the largest and most comprehensive community hospitals in the Army. The hospital is recognized as one of the best in the nation for quality of care as certified by the Joint Commission on Accreditation of Healthcare Organizations, and service to the community by the Army and TRADOC Communities of Excellence Evaluations.

MEDDAC

Fort Benning’s MEDDAC, a major subordinate command of the U.S. Army Medical Command, furnishes medical care to an eligible patient population in excess of 72,000 beneficiaries. Since the establishment of Fort Benning in 1918, medical services have always been available. In the early days, medical care was dispensed from tents, temporary wooden buildings, and leased space in the Columbus Hospital. In 1924, services were moved into what is now the National Infantry Museum, and in 1958 Martin Army Community Hospital was opened.

Martin Army Hospital 

Martin Army Community Hospital is named in honor of the late Major General Joseph I. Martin, Medical Corps. The hospital was opened in 1958 at a cost of slightly over $6 million. As the demand for outpatient health care grew, a 59,000 square foot ambulatory care wing was added in 1975 at a cost of $3.8 million.

To support the purchase of modern medical equipment and to ensure the compliance with the JCAHO standards, an extensive electromechanical upgrade project was completed in 1980. This was my era. The latest major construction occurred in 1990 when the Emergency Room underwent renovation at a cost of $835,000. The ER now contains the latest technology available to preserve life, and can provide these services more efficiently than in the past.

Professional Training Programs

In addition to its medical mission, the MEDDAC has an extensive professional teaching and training mission, and in 1972 established the Army’s first Family Practice Residency Program. This 3-year program maintains approximately 30 residents who provide medical services throughout the hospital.

Other specialty training programs include the clinical portion of the Army’s Physician Assistant Program, a residency in Health Care Administration, Podiatric Surgery internship, training in several enlisted specialties, and numerous clinical rotations or externships conducted in cooperation with local colleges and universities. Located near the Infantry Museum is the Army Substance Abuse Program, Exceptional Family Member Program, and the Early Intervention Program. In addition to these facilities, the MEDDAC operates four Family Practice Clinics, five on-post Troop Medical Clinics (TMCs), a Reception Station, and two satellite TMCs in support of Ranger School training in Georgia and Florida.

A New York Times Re-Post

As so, it is with some degree of pride that we reprint this story from the NYTs.

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DOCTOR AND PATIENT

By Paulinwe W. Chen; MD

One morning as a medical student on the surgery service, I learned about a patient who had been hemorrhaging on the operating table the night before. The intern who had assisted during the operation took great pains to describe every detail of the failed efforts of several senior surgeons and the final, ultimately lifesaving, maneuvers of the department chairman. “He came in and just got control of the bleeding,” the intern concluded, waving his hands as if the chairman’s work had involved magic.

Assessment

“How did he manage that?” one of my classmates asked. “He’s one of the best,” the intern answered matter-of-factly. “He was a surgeon in Vietnam.” 

More Lesson from the War Zone: http://www.nytimes.com/2009/12/11/health/11chen.html?ref=health

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Conclusion

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Military Electronic Dental Records [eDRs]

US Defense Department Leads the Way

By Staff Reporters

MilitaryAccording to Peter Bauxbaum on May 13, 2009, the Defense Health Information Management System [DHIMS] is in the process of deploying AHLTA [Armed Forces Health Longitudinal Technology Application] Dental; a module eDR included with the new AHLTA 3.3 release.

It is the U.S. military’s first integrated dental and medical electronic health record.

Link: http://govhealthit.com/articles/2009/05/13/dod-electronic-dental-record.aspx?s=GHIT_190509

Assessment

And so, when will eHRs for osteopaths [eOsteoRs], podiatrists [ePodRs] and optometrists [eOptRs] become available? Is this an occasion when the military is an early HIT adopter?

Conclusion

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More on Captain Cecelia T. Perez RN

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Army Bronze Star Medal Interview

[By ME-P Staff Writers]ME-P Logo.2

Recently, Medical Executive-Post writers caught up with Captain Cecelia T. Perez for more information on the exact circumstances surrounding her Bronze Star Medal Award.

Interview Synopsis

Self-effacing and humble, Cecelia simply stated in her email interview that the medal was “basically for saving lives” while in Iraq. 

Only when pressed for more details, did Cecelia explain – “My friend Bill and I set up trauma sites separate from the rest of our company. First, in Talafar, Iraq for five months and then at COP Gabe in Baquoba, Iraq during our brigade’s retaking of that city.” 

She noted that “we had some serious trauma to deal with as we responded to Iraqi Army mass casualty events at their aide station which was also located near us.” 

Unfortunately, “they did not have a PA or doctor like we did, so Bill and I, along with our medics, responded to their requests for help.”

Of course, Cecelia mentioned several times that it was a medical team group effort.

But, “they obviously appreciated our efforts as gender, racial, and cultural barriers disappear in the midst of the bleeding and the wounded.”  

Assessment

We say: A real American Army Hero would have it no other way!

Conclusion

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The Bonze Star Medal Confirmed

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Bonze Star Medal for Captain Cecelia T. Perez; RN

Breaking News Washington, DC

***  

THE UNITED STATES OF AMERICA 

TO ALL WHO SHALL SEE THESE PRESENTS, GREETING: THIS IS TO CERTIFY THAT THE PRESIDENT OF THE UNITED STATES OF AMERICA AUTHORIZED BY EXECUTIVE ORDER, 24 AUGUST 1962 HAS AWARDED 

THE BRONZE STAR MEDAL  

To: CAPTAIN CECELIA T. PEREZ

CHARLIE COMPANY, 296th BSB, 3rd BRIGADE, 2nd INFANTRY DIVISION 

For: Exceptionally meritorious service while assigned as the Brigade nurse during Operation Iraqi Freedom. Captain Perez’ exceptional dedication to mission accomplishment, tactile competence and unparalleled professionalism contributed immeasurably to the Unit’s success during combat operations. Her actions reflected distinct credit on her, the multinational Division-Baghdad, and the United State Army.  

– 5 July 2006 to 5 October 2007 –

GIVEN UNDER MY HAND IN THE CITY OF WASHINGTON, DC

Joseph F. File, Jr. Major General, USA

Commanding: PO #259-100

16 September 2007

Conclusion

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