Articles Posted in Military Medicine

blmdckoshukunii-240x300Just as law enforcement authorities find themselves under fire for instances of racist, excessive uses of force, police agencies across the country seem hell-bent on giving critics more and more evidence for their argument that major policing reforms are needed.

The independent, nonpartisan Kaiser Health News Service and USA Today deserve credit for scrutinizing dozens of incidents involving officials’ actions nationwide against people protesting the Minneapolis police killing of George Floyd. As the news organizations reported (and in passages worth quoting at length):

“In a joint investigation into law enforcement actions at protests across the country after George Floyd’s death in police custody, KHN and USA TODAY found that some officers appear to have violated their department’s own rules when they fired ‘less lethal’ projectiles at protesters who were for the most part peacefully assembled. Critics have assailed those tactics as civil rights and First Amendment violations, and three federal judges have ordered temporary restrictions on their use.

RobertWilkieVA-150x150One of the nation’s largest health systems faces yet more serious questions about its leadership and external meddling in the quality and safety of its care. So, once again taxpayers may be asking themselves, with anger, What the heck is going on now at the top of the Department of Veterans Affairs?

Internal watchdogs have formally opened an investigation of Roger Wilkie, the VA’s chief, over allegations that he used his office and authority to dig up dirt on a Democratic aide who complained that she had been propositioned and groped by a man in the main lobby of the Medical Center here in the District of Columbia.

The claims were investigated, and authorities declined to pursue it further, including with the filing of any charges.

cdctbi-300x213The nation’s commander-in-chief did a big disservice to recently injured service personnel and others who have suffered traumatic brain injuries by dismissing what happened as “not very serious” and just “headaches” of little consequence.

Pentagon officials sought to deflect attention from President Trump’s comments at a global economic forum in Davos, Switzerland — off-the-cuff remarks assailed by veteran groups.

Trump, asked about the rising number of service personnel who have been sent for advanced diagnosis and treatment at facilities outside the Mideast, where they were subjected to an Iranian missile attack, made this counter factual comment:

crashempirestatebldg-240x300The U.S. government is on the brink of giving active duty military personnel half a legal loaf when it comes to a fundamental constitutional right — their chance to seek justice in the civil courts if they suffer harms while receiving medical services in noncombat situations.

If the U.S. Senate approves, as expected, a House-passed measure, and it is signed by the president, as he has said he will, active military members soon may be able to make medical malpractice claims, as they couldn’t before. But the disputes won’t be decided in the civil justice system. Instead, they will stay under military control.

That’s far less than ideal. To understand why, and how this compromise got struck, it’s necessary to dive a little into federal law.

feresstayskal-150x150Although members of Congress have fled the nation’s capital for their annual August recess, there’s guarded optimism that lawmakers may be open to reversing a seven-decades-old U.S. Supreme Court ruling that bars active duty military personnel from their constitutional right to pursue  in the civil justice system claims that they have suffered harms while seeking medical services.

Advocates of this change saw cause for optimism that President Trump met briefly in July in North Carolina and encouraged Army Sgt. 1st Class Richard Stayskal, a terminally ill Green Beret who has become the focus of efforts to fixing the Federal Tort Claims Act (FTCA), Bloomberg news service reported. Jackie Speier, a California Democratic congresswoman, introduced a bill named after Stayskal and that would allow troops to file medical malpractice suits in federal court, because, as Bloomberg said:

“Stayskal went to Womack Army Medical Center at Fort Bragg in 2017 after feeling suffocated and coughing up blood, but the hospital misdiagnosed him with pneumonia during two visits, according to his congressional testimony before the House Armed Services Committee. By the time he saw a civilian doctor six months later, the lung tumor causing the problems had doubled in size. The tumor had showed up in X-rays done before he went to dive training, but nobody told Stayskal or diagnosed him.”

jackie-150x150ginsburg-150x150clarence-150x150The U.S. Supreme Court has left it up to Congress to decide if service members may pursue in the civil justice system claims that they have suffered harms while seeking medical services, a fundamental civil right now denied to military personnel.

Justices Clarence Thomas and Ruth Bader Ginsburg — who rarely agree on much — both wanted but were unsuccessful in getting their high court colleagues to revisit an inequitable, 69-year-old  Supreme Court ruling involving the Federal Tort Claims Act. That act governs who can bring a claim for negligence at a military or other government health care facility.

Active duty military personnel cannot bring a medical negligence claim for care at a military facility. This is called the “Feres doctrine,” after the Supreme Court decisionFeres v. United States, 340 U.S. 135 (1950). Under the Feres doctrine, members of the United States armed forces are barred from making a claim against the United States for personal injury or death arising “incident to service.” Military medical treatment received by a service member, while on active duty, has been held by the courts to be “incident to service,” and, thus not actionable, even if that treatment was for a purely elective procedure, and even if the procedure was performed negligently.

feresstayskal-267x300Members of Congress have taken steps aimed at allowing service members to pursue actions in the civil justice system when they suffer harms while seeking medical services, a fundamental civil right now denied to military personnel.

Members of the U.S. House Armed Services Committee heard powerful testimony from a Green Beret, an airman, and a judge advocate general about the  need for a bill introduced by Rep. Jackie Speier (D.-Calif.) — a measure that has won bipartisan backing — to correct problems caused by a 69-year-old U.S. Supreme Court ruling in a case involving the Federal Tort Claims Act. That act governs who can bring a claim for negligence at a military or other government health care facility.

Active duty military personnel cannot bring a medical negligence claim for care at a military facility. This is called the “Feres doctrine,” after the U.S. Supreme Court decision, Feres v. United States, 340 U.S. 135 (1950). Under the Feres doctrine, members of the United States armed forces are barred from making a claim against the United States for personal injury or death arising “incident to service.” Military medical treatment received by a service member, while on active duty, has been held by the courts to be “incident to service,” and, thus not actionable, even if that treatment was for a purely elective procedure, and even if the procedure was performed negligently.

Scotus-300x167Although Uncle Sam makes a special vow to provide medical care for those who fight for this nation, he also enjoys special legal shields from lawsuits from them if anything goes wrong with medical services they’re provided. But recent news reports show how past and present service personnel not only suffer shabby medical care but also “grossly unfair” situations when pursuing malpractice claims  — and why lawmakers and courts may need to step in to provide fairer remedies.

Kaiser Health News (KHN) and the ABC-TV news affiliate in Los Angeles both deserve credit for spotlighting tough cases involving service personnel and medical malpractice, particularly the Federal Tort Claims Act and the Feres doctrine, a 68-year-old Supreme Court case that bars active-duty military members from suing the federal government for their own injuries.

Walter Daniel, a former Coast Guard officer, has petitioned the Supreme Court to “amend the 1950 [Feres] ruling, creating an exception that would allow service members to sue for medical malpractice the same way civilians can,” KHN reported, noting this would affect patients in a military health system “with 54 hospitals and 377 medical clinics, serv[ing] about 9.4 million beneficiaries, including nearly 1.4 million active-duty members.

VA-300x202So, see, Ike, Marc, and Bruce may be pretty swell guys. They’ve done well in business: Ike in comic books and entertainment, Marc in the law and consulting on white collar crime, and Bruce as a medical  concierge who gets affluent patients in to see big name doctors.

But this odd trio —Ike Perlmutter, Bruce Moskowitz and Marc Sherman — never served in the U.S. military. They’re certainly not veterans. Perlmutter and Sherman have zero experience in health care. And Moskowitz, while a doctor, is a respected primary care practitioner — not someone known for his direct experience in running big, complex operations.

They also, however, happen to be FOT — Friends of (President) Trump. They pay him to belong to his Mar-a-Lago country club. And, apparently at his request and with the assistance of powerful partisans and the acquiescence of sheepish bureaucrats, Perlmutter, Moskowitz, and Sherman have become  “shadow rulers” of the U.S. Department of Veterans Affairs.

Airemergency-196x300With tens of millions hopping on jets to get to summer vacation destinations, it’s worth noting that medical emergencies aloft aren’t as rare as many travelers might imagine — and it may be beneficial if a doctor happens to be aboard when the need arises.

The nation’s top doctor, U.S. Surgeon General Jerome Adams, of course, may have spotlighted sky-high medical care, when he answered flight attendants’ emergency page to all those aboard a Delta flight from Fort Lauderdale to Atlanta. Details are a bit sketchy. But a passenger on the early May trip apparently passed out, and worried crew needed medical assistance and an evaluation of potential next steps.

Adams said he was pleased to step up and assist the crew as the flight, which was on the tarmac, returned to the airport gate, where a crew member took the ailing passenger off for care, while the Delta plane resumed its planned trip.

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