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Army Surgeon General Eric Schoomaker, shown testifying at a congressional hearing in September, has implemented policies to help Army hospitals address a rash of drug overdoses.
Army Surgeon General Eric Schoomaker, shown testifying at a congressional hearing in September, has implemented policies to help Army hospitals address a rash of drug overdoses. Alex Wong/Getty Images
Following the controversy over shoddy care at Walter Reed Army Medical Center and other facilities, the Army has changed the way it treats injured soldiers. But problems remain.
Courtesy Susan Nichols
Sgt. Robert Nichols, who was injured in an explosion while serving in Iraq, died of an accidental drug intoxication from pills his Army doctors had prescribed.
Sgt. Robert Nichols, who was injured in an explosion while serving in Iraq, died of an accidental drug intoxication from pills his Army doctors had prescribed. Courtesy Susan Nichols
The last time Susan Nichols brought her husband home from Brooke Army Medical Center in San Antonio, she knew something was very wrong. He couldn't even play with their 6-year-old son and 5-year-old daughter. Instead, he just watched them play basketball with the neighborhood kids.
"He was constantly dizzy, or he just couldn't handle being out because of the pain, or the medication just knocked him out completely and he couldn't even walk," Nichols recalled while sitting on the patio at her home in San Antonio. "And the last day that we all saw him, he could barely stand up straight without leaning against a wall to prop him up."
Two days later, on Jan. 22, Sgt. Robert Nichols was found dead in his room at Brooke Army Medical Center.
The autopsy report said he died of an accidental drug intoxication from the pills he had been prescribed by his Army doctors. Some of them, mixed together, made a deadly combination.
Since June, there has been a rash of overdoses at Army hospitals, including some, like Nichols', that have resulted in deaths. The medications prescribed for soldiers are so potent that they can be dangerous when taken with other drugs or alcohol. Overdoses have become another problem for the Army to grapple with in the wake of criticism of the care at Walter Reed Army Medical Center and other military hospitals.
Eleven medications were found in Nichols' body, including painkillers to treat his physical wounds from an explosion in Iraq and drugs to ease the nightmares, insomnia and memory loss caused by his post-traumatic stress disorder and traumatic brain injury.
Susan Nichols said that several times before he died, Robert Nichols asked his doctors to reduce the medications "because he felt like he was a zombie and he could only function for a small portion of the day."
'Trying to Interrupt the Root Causes'
Brig. Gen. James Gilman, commander at Brooke, said Nichols' death is still under investigation, so he could not discuss details. But he said the Army has made changes to try to prevent a repeat of that kind of death.
"We obviously went back and looked at medications and whether there are additional steps to take to make it safer," Gilman said. "It would be unthinkable not to reassess everything that you're doing when an event like this happens."
Robert Nichols' widow said multiple doctors gave her husband multiple prescriptions. Now, for each patient, one doctor is in charge of all prescriptions, and drugs are given out in small doses, instead of a two- or three-week supply.
In addition, soldiers were told at the beginning of March that they could no longer drink in their barracks rooms — because alcohol can make a fatal mix with these medications.
The new rules apply at all of the Army's 35 Warrior Transition Units set up to treat injured soldiers.
"We're trying to interrupt the root causes of what might be causing the problem," said Lt. Gen. Eric Schoomaker, the Army surgeon general. He put the policies in place after 15 recent deaths at Army hospitals — at least six as the result of an accidental overdose of prescription drugs.
Those overdose deaths included Sgt. Gerald Cassidy, who died in his room at Fort Knox in September. He may have been alive — but unconscious — for two days or more, without anyone checking on him.
Doubts Remain for Soldier's Family
Patients in the new outpatient Warrior Transition Units live in their own rooms in barracks on base or sometimes even off base in their own apartments. At some bases, there are now surprise searches of barracks rooms for alcohol and attempts to restrict who can keep and drive a car. These moves have angered some injured soldiers, but the drug overdoses have continued.
During a break at a recent congressional hearing, Schoomaker spoke about the medications themselves — which are more powerful than in the past.
"There're a lot of medications out there that people aren't aware of that may be much more dangerous than they think they are, especially if they're used in combinations with others," Schoomaker said. "Then if you add to that, you know, a psychological challenge or traumatic brain injury, that might make it difficult to remember the dosing and the like. So we're using as many tools as possible to try to limit that."
But Susan Nichols doubts the alcohol ban will stop these problems. Her husband told her that Brooke tried to crack down on drinking in the barracks late last year.
"But what wound up happening was the soldiers in the Warrior Transition Units would go off post and drink. And there was a rise in DWIs off post, which was considered bad PR," she said.
Besides drinking off post, some soldiers were hiding their alcohol in the rooms of injured Marines, who weren't covered by the Army policy. But on Tuesday, the day NPR asked about it, the alcohol ban was put into place for the Marines at Brooke, too.