Posted on 06/05/2004 4:48:15 AM PDT by ebersole
WASHINGTON, June 4 (UPI) -- The first U.S. soldier charged with cowardice since the Vietnam War is suffering from damage to his brainstem that likely was caused by the anti-malaria drug he was given in Iraq, a military doctor has concluded.
Staff Sgt. Georg-Andreas Pogany was diagnosed this week with "likely Lariam toxicity," according to medical records from Naval Medical Center San Diego reviewed by United Press International.
Pogany suffered a panic attack in Iraq last year after seeing a dead body and was charged by the Army with cowardice, an offense punishable by death and a charge not seen since the Vietnam era, which ended almost 30 years ago. The charge later was reduced to dereliction of duty.
For months Pogany has been caught in legal and medical limbo, waiting for the Army to pursue charges against him and evaluate a list of mental and physical symptoms that started when he took Lariam in Iraq.
Pogany's tests this week showed eye and ear abnormalities and balance problems consistent with reported side effects of the drug, the medical records state. He is one of 10 servicemembers diagnosed in the past few weeks with damage to the brainstem and vestibular, or balance, system after being given the drug while serving in Iraq or Afghanistan. His case is the most notable so far, because "panic attack" is listed as a Lariam side effect. Lariam is generically known as mefloquine; Pogany took the generic form.
Nine months after first charging him with cowardice, the Army still has not told Pogany what charges he still might face, if any, said Pogany's attorney Richard Travis. During that time period, Army officials delayed Pogany's medical treatment and ignored data Travis sent the Army on mefloquine side effects, he said. Travis said Pogany's career in the Army is over.
"I think this went from the realm of incompetence to the realm of being vindictive," Travis said. Fort Carson has declined to answer questions about Pogany or mefloquine. A spokesman for the Army Special Operations Command at Fort Bragg, N.C., did not respond to a request for comment.
Last summer, the Food and Drug Administration took aggressive steps to make sure patients taking mefloquine are warned in writing of the possible side effects, including anxiety, hallucinations, paranoia and suicidal thoughts.
While the military is required by law to record the use of mefloquine in soldiers' medical records, none of the soldiers diagnosed at the Navy Medical Center in San Diego had the drug included in their records, according to Sen. Dianne Feinstein, D-Calif.
The Army invented mefloquine.
Pogany is based at Fort Carson, Colo., where he is attached to the 10th Special Forces Group. He served briefly in Iraq with Special Forces Chief Warrant Officer William Howell. Howell killed himself near Fort Carson in March after returning from Iraq. He also took mefloquine, and his wife, Laura, believes the drug is responsible for his suicide.
Five Special Forces soldiers have committed suicide during the war on terrorism. According to the Army, four of the five had been taking mefloquine just prior to their suicides.
The drug label lists "rare reports of suicide," but the Food and Drug Administration says it does not know if the drug can trigger suicide. The Army has told UPI that it does not believe mefloquine can cause suicide and says there have not been serious or widespread problems with the drug.
Pogany, 33, said he had just taken his third weekly pill when he suffered the attack after seeing the body of a mangled Iraqi. He raised the issue of mefloquine after news outlets including UPI asked if he had taken it.
On March 26, an Air Force doctor wrote in Pogany's medical records, "Based on the patient's historical account of the anxiety symptoms that occurred in Iraq, it is very plausible that the symptoms that he experienced could be related to his use of mefloquine."
In May, Pogany was referred to Walter Reed Army Medical Center in Washington and then to the Department of Defense Spatial Orientation Center, a diagnostic and treatment facility in San Diego. There, he was tested by Dr. Michael E. Hoffer, chairman of the Orientation Center, who diagnosed the damage to Pogany and the other soldiers.
Hoffer wrote on the medical report that Pogany complained of dizziness, blurry vision and sensitivity to light, hearing loss and ringing in both ears. Three eye tests showed "nystagmus," the report said. The term refers to involuntary, jerking movements of the eye that can indicate vestibular and brainstem damage.
A leading veterans' advocate, citing Pogany's case, warned Congress in January that soldiers who experience mental problems during or after deployments need help and not punishment.
"Nowhere is this apparent disregard for psychological injuries more apparent than in the case of Sgt. Georg-Andreas Pogany, who was charged with cowardice," Steve Robinson, executive director of the National Gulf War Resource Center, told a House Armed Services Committee panel on Jan. 21.
Robinson, a former Army Ranger, told UPI that some soldiers have heard about the Pogany case and are afraid of seeking help because of what happened to him. "This Pogany case has had a chilling effect on soldiers coming forward. I have talked to soldiers who have said it," he said.
Robinson also asked Congress to look into mefloquine. "This drug needs to be investigated to determine if it is harming and in some cases killing our own soldiers," Robinson told that panel.
Travis, Pogany's attorney, has said the Special Forces have created an atmosphere that makes soldiers afraid to seek help. "I think it is the Special Forces that does create an atmosphere where you cannot approach your commander and ask for help," Travis said.
The Army and the Department of Veterans Affairs recently announced that they will study the drug to determine if it is causing severe and long-term problems, but the Pentagon has said it does not believe mefloquine is causing widespread or serious side effects. It said the study might take up to two years.
But pressure appears to be growing for a quicker review of the drug and better monitoring and reporting of any problems. This week, Sen. Feinstein sent a letter to Defense Secretary Donald Rumsfeld citing the diagnoses of "permanent brainstem damage" and asking for a timetable of the drug study.
She also has written Health and Human Services Secretary Tommy Thompson "to express my concerns about the Defense Department's use of the drug as an anti-malairal for its servicemembers deployed to Iraq and Kuwait." She asked Thompson to "work with the FDA to reassess the safety of mefloquine, including working with the Department of Defense to evaluate the safety of this drug under highly stressful conditions, including deployment situations."
In March, the Pentagon released a report about suicides among Army soldiers in Iraq last year. The Army said only four of those 23 suicides occurred in units given the drug -- although soldiers in other units where suicides occurred have told UPI they also took mefloquine.
Three special operations soldiers who served in Afghanistan and had apparently taken mefloquine allegedly killed their wives at Fort Bragg in the summer of 2002. Those three soldiers also committed suicide.
In the investigation into the Fort Bragg killings, the Army said that Lariam could not have triggered a cluster of five apparent homicides and three suicides from that summer because some suspects did not take mefloquine.
Based on a three-month investigation, UPI reported in May 2002 that mounting evidence suggests that mefloquine has caused such severe mental problems that in a number of cases it has led to suicide.
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mbenjamin@upi.com; dolmsted@upi.com
and people here will continue to shout that the Military orders concerning medications MUST be taken without question.
Be extremely wary of these words.
"I'm from the Government, I'm here to help you."
I've taken lariam. I do not recommend it for any reason. The side-effects last well over 6 months. Of the four side effects listed, anxiety, hallucinations, paranoia and suicidal thoughts, I do not recall suffering hallucinations. But the other three were quite enough, thank you.
I've had panic attacks myself due to vestibular disorder, caused
by an inner-ear infection. I cannot describe the horror of a
panic attack. If there is a hell on earth, a panic attack is
it. You have no control over it. If this guy's vestibular system
is damaged by this drug, I truly feel for him, because he may
be in for hell for the rest of his life.
It was strongly recommended and encouraged, but most of us have decided not to do it because we've heard about bad side effects.
If I were somewhere like Malaysia or Indonesia, I might have a different approach, but malaria is not common in Iraq at all these days.
This article just reinforces to me that most of us made the right decision.
I can see that a local commander might want to charge at first glance, but these potential side effects that occur in a lot of people who take this medicine should have been looked into earlier.
In my peculiar view of the world, this is worse than the silly and embarrassing abuses of suspected terrorists.
5.56mm
I had a vestibular disorder of my ear that was so bad that I thought I was having a stroke. After the bad attack, it was difficult to go out. The supermaket aisle looked like the LA freeway to me or an airport take-off strip.
I got all mixed up in a department store and couldn't tell if I recognized someone or not.
Mostly it went away because I gradually reintroduced myself to normal activities, but in the stress of war this would be terrible. I am glad they have figured this out.
Probably if these guys come home and get treated for their vestibular disorder with a balance medication, the psychiatric problems would subside. This works for me, but my problem is in the ear nerve and not the brain. When I have episodes, I take a medication to control dizziness. I make myself do what I really have to do because this retrains my brain. I tend to be a bit wobbily and my car sometimes goes up on the right curb, but I do OK. I don't enjoy movies that change scenes all the time. It makes me dizzy and nauseated. Too much moving around a person and too much to deal with in traffic is difficult. Very loud parties with a lot of people and noise. I guess everyone can see why a vestibular disorder and war don't go together.
I ended up in the ER with the ear problem. I thought I had a brain tumor because of the way I felt. I had problems for months
driving. Vestibular disorder is no laughing matter--it can be a serious, serious, sometimes catastrophic problem, and more doctors should be familiar with it.
Because Lariam was first invented by the military and then the "rights" were sold to Hoffman-LaRoche
Gin and tonic! ("Tonic Water" had quinine in it.)
I never thought I'd say this but.. Just Damn! Now that's what I call taking our soldiers' interests to heart.Not.
I wonder how long, if ever, they will change this med. to one less dangerous? Should I hold my breath?
..."soldier charged with cowardice..."
What about Jessica Lynch? I read her interview in TIME and she said when her humvee was under assault and her crew fighting for their lives, she fell to her knees, covering her head and prayed not to die. That's cowardice.
The press had reported she'd opened fire on her attackers but, she stated she'd never fired a single shot.
Correct me if I'm wrong but, wasn't she awarded for bravery?
Ms Lynchs'M-16 had jammed. She recieved an award for conduct above and beyond the call of duty. Before anyone prattles on let me remind you that she was just a file clerk and actually survived . this might be standard fare for a combat arms soilder, but, she was rear, rear echelon.
DO NOT hold your breath! ""I think this went from the realm of incompetence to the realm of being vindictive,""
I use to take the stuff; it causes panic attacks.
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