11 May 1998
………Several months after my abrupt departure from LARMC in 1996, another LARMC case, the "death of Baby V case," was reported as a complaint to the offices of LTG Blanck and Congressman Henry Hyde. The complaint and related information, which I have seen, describe a situation at LARMC in which Baby V's father, who was a military doctor, did not want to have a child with a birth defect and sought LARMC permission to allow his yet unborn child to die without treatment. According to the complaint, the baby's father gave a LARMC ethics committee misleading prenatal information and, when the ethics committee was unable to reach a unanimous decision, COL (P) Kiley reportedly made a command decision, before the child was even born, to allow the father, a military doctor, to withhold treatment once the child was born.
When born, Baby V had a condition (meningomyelocele) that is easily repairable by remedial surgery, but often fatal if not repaired. The baby was allowed to leave the hospital without corrective surgery and died of meningitis within 2 weeks. Two families had reportedly offered to adopt the infant in order to save her life, but this offer was reportedly refused. COL (P) Kiley's decision, made before Baby V's birth, created a situation that apparently permitted Baby V's death. The circumstances surrounding Baby V's birth and death need to be investigated.
The three cases (Dr. T, the February 1996 LARMC Inspector General case, and Baby V) show repeated endangerment of patient welfare under one Army Medical Center Commander, who should be required to account for his own role in the events described. Both of my Army Medical Corps Residencies-Emergency Medicine at Madigan Army Medical Center (where I have returned) and Internal Medicine at Eisenhower Army Medical Center-have taught me to uphold the standard of care for the patient's welfare. Neither of these centers would tolerate retaliatory actions against physicians and nurses that endangered patient care……..
………Over two years have passed since I originally reported these problems and was confined to a psychiatric ward after doing so. The quality and integrity of the Army medical system are vital to the taxpayers who support it, to the parents who entrust their sons and daughters to it, and to the men and women in uniform who must rely on it. Congress must act if the Army is unwilling or unable to do so.
Thank you for your attention.
Stephen Whitlock Smith, MD
Fellow, American College of Emergency Physicians
Fellow, American College of Physicians
Lieutenant Colonel, US Army Medical Corps
Steilacoom, WA 98388
Cc:Lieutenant General Ronald Blanck, Army Surgeon General
Brigadier General George Brown, MAMC Commander
Madigan Army Medical Center Public Affairs Office
Representatives Dicks, McDermott, Pelosi, Spence
Senators Boxer, Feinstein, Thurmond