Military Failed to Properly Track Brain Injuries: IG Report

Military Failed to Properly Track Brain Injuries: IG Report
Some 1,892 American flags are installed on the National Mall in Washington, on March 27, 2014. Jewel Samad/AFP/Getty Images
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On Jan. 7, 2020, Iran launched more than a dozen ballistic missiles at Iraqi bases housing U.S. troops in retaliation for the United States killing Iranian general Qassem Suleimani.

No U.S. troops were killed in the strike, but the Pentagon initially reported that 34 suffered traumatic brain injuries. Officials then increased that number to 50, before saying a month later that more than 100 troops had suffered brain injuries.

Nearly two years after the fact, there are still conflicting numbers for how many brain injuries resulted from the January 2020 Iranian strike, according to a report from the inspector general (IG) for the Department of Defense (DOD).

The IG report (pdf), released Nov. 3, said there are two sets of data tracking brain injuries stemming from the January 2020 Iran attack: one from U.S. Central Command (CENTCOM) and another from the Joint Trauma Analysis and Prevention of Injury in Combat (JTAPIC) Program Office.

The IG stated that CENTCOM reported 110 service members as having sustained a traumatic brain injury, while the JTAPIC identified 87.

The IG said this could mean that 23 service members’ traumatic brain injuries were never documented in the electronic health records.

The IG used the Iranian missile attack to highlight the records problem, but the report said the failure to properly track brain injuries is endemic throughout CENTCOM.

According to the IG, DOD regulations require military branches to report all potentially concussive events (PCE) to the JTAPIC in a monthly tracking report. But CENTCOM hasn’t done this since October 2014, the IG stated.

“This occurred because USCENTCOM relied on EHRs [electronic health records] to identify DoD service members who were involved in PCEs rather than creating monthly tracking reports.”

CENTCOM personnel said the requirement to provide monthly reports to JTAPIC is redundant with the information contained in electronic health records. However, electronic health records don’t always include the necessary information to track PCEs or the service members involved, the IG stated.

Improper data tracking means the DOD can’t ensure that all service members receive proper treatment, the IG stated.

“The lack of information made it difficult to determine if the service member was involved in a PCE, if the TBI [traumatic brain injury] was sustained in USCENTCOM, or if the service member had been cleared for return to duty status,” the IG stated. “Therefore, the DoD may not know the number of Service members involved in PCEs in the USCENTCOM Area of Responsibility.

“Finally, without consistent and adequate information on PCEs, service members may not be eligible to receive disability benefits or care from the Department of Veterans Affairs after separating from the military.”

The IG recommended that CENTCOM start submitting the monthly reports and that the chairman of the Joint Chiefs of Staff appoint an office to monitor compliance with the reporting requirements. Both agencies agreed to the recommendations, though their written responses are mostly redacted from the IG report.

Since 2000, more than 413,858 service members have been diagnosed with a traumatic brain injury.

Such injuries are thought to be a major factor driving rising suicide rates among America’s veterans. A June report (pdf) from Brown University’s Costs of War Project revealed that U.S. veteran suicide rates are about 1 1/2 times higher than the general population and have surpassed any service member suicide rates since before World War II.

The report attributed the inordinately high suicide rates in large part to the use of improvised explosive devices (IED) in the terror wars, which has led to a spike in brain injuries among combat vets. Many brain-injured vets are redeployed, exacerbating their mental trauma, the report stated.

“Caused by blast injuries from IEDs, collisions, and rollovers, or any situation causing blunt trauma to a service member’s head, [brain injuries] are the ‘signature injury’ of the Iraq and Afghanistan conflicts, affecting between 8 and 20 percent of military personnel,” the report stated.

“Yet [service members] have been persistently redeployed even after surviving one or more of them, which ought to raise serious red flags.”