Fort Bliss Says It Will Examine Its Handling of Brain Injuries

Medical commanders at one of America's largest military bases have ordered a review into the care provided to soldiers suffering from traumatic brain injury, in response to an investigation by NPR and ProPublica.

Col. James Baunchalk, the commander of William Beaumont Army Medical Center at Fort Bliss in El Paso, Texas, told members of Congress that he was concerned by our report [2], which found that soldiers there struggled to receive adequate care for mild traumatic brain injuries.
The hospital is "committed to delivering the very highest quality care and support to our soldiers and their families, including those who may be affected by traumatic brain injuries," Baunchalk wrote in a June 21 letter to Rep. Harry Teague [3], D-N.M., a copy of which was obtained by NPR and ProPublica [4].
The Pentagon's official figures show that more than 115,000 troops have suffered mild traumatic brain injuries, also called concussions, since the wars began in Iraq and Afghanistan. But our story said those figures likely understate the true toll, with some studies suggesting that the injuries go undiagnosed in tens of thousands of troops [5]. While most recover quickly, some grapple with lasting mental and physical problems from exposure to explosions.
Our story focused on several soldiers at Fort Bliss, the third-largest American military base by troop population. The soldiers told us they endured long waits to see specialists and met with frustrating skepticism from doctors over the severity of their conditions. All had ongoing problems with memory, concentration and other cognitive functions.
We also wrote about Building 805, a small clinic at the base that was supposed to screen soldiers with traumatic brain injuries. Although the base has recently added billions of dollars of barracks and other facilities to accommodate newly arriving troops, Building 805 has remained shuttered for almost a year, for want of computer wiring, commanders told us.
Teague, who visited the base [6] on Sunday and met with soldiers mentioned in our story, said he would continue to press the hospital to make sure that adequate care was being delivered.
"I would like to further examine how the overall quality of TBI care at Fort Bliss serves our soldiers compared to what they may have access to in civilian medicine," Teague wrote in a June 25 letter [7] to Baunchalk. "I would like to ensure that the system of TBI care, in general, adequately addresses the needs of our service members and is adequately resourced."
Base officials did not immediately respond to requests for comment on their letter to Teague. The letter listed a series of programs in place to treat soldiers and catch problems in care, but some of the information appeared to contradict material that base officials provided to us.
Fort Bliss told Teague it had 10 medical staff members "assigned full time" to the traumatic brain injury program. But in a letter responding to our questions [8] in April, officials listed only four employees providing such care full-time. They listed seven other clinicians who worked part-time with brain-injured patients.
Fort Bliss also told Teague that Building 805 was "completed at the end of January 2010." But in interviews with us and in their written response to our questions, base officials told us that Building 805 "was completed in July 2009," though utilities were not installed until February 2010.
Fort Bliss officials also told us during our visit there in April that Building 805 would be open at the end of May. In their letter to Teague, they said that they had not even issued a contract to install the computer wiring until June 17 — nine days after our stories ran.
Sgt. Victor Medina and his wife, Roxana Delgado, who were featured in our stories, said they were pleased that Teague and others have paid attention to soldiers' concerns about treatment for brain injuries. Medina had to fight to get referred off base to a private medical facility specializing in cognitive rehabilitation.
But, they said, more work remains to be done.
"We're seeing a lot of progress in terms of attention and interest," Delgado said. "But we want to see more. We want to see real reform."

Update: Fort Bliss got back to us on Thursday to respond to our questions with this letter [9]. They reiterated that the Fort Bliss program has 10 "full time" clinicians devoted to traumatic brain injury, though one slot is vacant.
They also said that Building 805, a clinic for screening soldiers with traumatic brain injury, was completed for occupancy earlier this week. The process to move in clinical staff has begun, according to the written responses.
Finally, Fort Bliss acknowledged for the first time that the base has not yet received full validation under Defense Department guidelines for its traumatic brain injury treatment program. Fort Bliss is designated a "Level 2" facility, meaning it is supposed to have one of the top 10 treatment programs in the U.S. to address mild and moderate brain damage. Fort Bliss officials said Thursday that the base passed an initial round of examination, but does not expect to receive full validation of its program until Fall 2010.