When Cindy Wilson became pregnant with her first child, she shared the joys of approaching motherhood with her mother.
In long phone calls from Langley Air Force Base, where she was stationed, the 37-year-old technical sergeant exuded happiness. She sent a copy of the ultrasound photo and wondered aloud what her baby would look like.
When it came time for the delivery, her parents, Tommy and Connie Wilson, made the trip from her hometown of Hartwell, Ga., to the 1st Fighter Wing Hospital at the Hampton base to be with her.
Just before midnight on Feb. 20, 2007, she gave birth by cesarean section to a healthy boy.
But Wilson never got to hold her baby. According to her medical records, a uterine artery was cut during the delivery, causing massive internal bleeding. The estimated blood loss was equivalent to the total blood volume of an average adult.
Then, during frantic efforts to repair the damage, two surgical sponges were left in Wilson’s abdomen. Twelve hours after giving birth, she was dead.
In the ensuing months, her devastated parents got a second shock when they learned that they had no recourse – even for what seemed to them an egregious case of medical malpractice – because of a legal precedent that prohibits lawsuits when military service members are injured or killed by negligence.
A vocal group of military families, lawyers and members of Congress say the precedent renders service members second-class citizens and should be overturned.
Immediately after the delivery, Wilson seemed OK, awake and making small talk with her parents. They went to her Smithfield home for some sleep.
Around 4 a.m., her husband called. Wilson was going back to the operating room for emergency surgery.
When her parents got back to the hospital, “her room looked like a tornado had hit it,” Connie Wilson said. A piece of medical equipment was overturned and a needle lay on the floor.
Wilson’s parents and husband paced the floor, praying.
“We were even asking the Lord to take us and not take Cindy,” Connie Wilson said.
The next thing the Wilsons saw of their daughter was when she was loaded into an ambulance for transfer to Riverside Regional Medical Center in Newport News. Something told them it was over.
Tommy Wilson turned to his wife and said, “Connie, our baby’s gone.”
Cindy Wilson was pronounced dead an hour after arriving at Riverside.
In a meeting with the Langley hospital staff, “they really didn’t tell us a lot of anything,” Tommy Wilson said. “We only knew that Cindy bled to death. We didn’t know the cause of it. They didn’t take any blame.”
The commanding officer at the hospital assured the family there would be an investigation, Tommy Wilson said. “We have never heard a word .”
Master Sgt. Anthony Davis, a Langley spokesman, said the case was “thoroughly investigated and peer reviewed” in accordance with Air Force policy. He said he is prohibited from revealing the findings – even to Wilson’s family – by a federal law mandating confidentiality of medical quality assurance records.
Dr. Michael Carozza, the lead obstetrician, did not respond to inquiries from The Virginian-Pilot about the case.
Carozza was 31 at the time, having completed his residency a few months before. His Virginia medical license was issued on Feb. 21, 2007 – the day Cindy Wilson died.
According to the Virginia Board of Medicine’s Web-based directory of licensed Virginia doctors, Carozza has faced no disciplinary action. Information in the directory is self-reported by doctors.
Carozza is still on the obstetrics staff at Langley.
Wilson’s son is being raised by his father, who has remarried.
It was only after requesting and receiving their daughter’s medical records that the Wilsons learned the horrifying details of her care.
When they sought legal redress, the details didn’t matter.
“We talked to lawyers from Washington, D.C., to Texas,” Tommy Wilson said, “and they all told us the same thing: You can’t sue the military.”
The legal precedent barring negligence lawsuits on behalf of military service members goes back nearly 60 years, to a 1950 Supreme Court ruling on a series of cases that became known as the Feres Doctrine.
One of the Feres cases – in a foreshadowing of the Cindy Wilson case – involved a soldier who was barred from suing after an Army doctor left a 30-by-18-inch towel marked “Medical Department U.S. Army” inside him.
There have been similar cases through the decades in which foreign objects – usually sponges – were left inside patients who, because they were military personnel, were barred from suing.
Such cases illustrate how the Feres Doctrine has contributed to substandard care in the military medical system, according to Jonathan Turley, a law professor at George Washington University who for years has been a leading critic of the doctrine.
“We see cases in the military involving conduct that would be viewed as perfectly medieval in the civilian world,” Turley said. “Decades ago, civilian doctors were sued over the practice of leaving sponges in patients. It used to be very common.”
After a few lawsuits, the medical profession came up with a simple solution: Count the sponges before and after the procedure.
Now it’s rare to see that type of malpractice in civilian medicine, Turley said. But because there is no fear of lawsuits , it keeps occurring in military medicine.
“I consider the Feres Doctrine to be one of the most grotesque rules created in the history of this republic,” Turley said. “It has done untold damage to thousands of military personnel and their families.”
In part because the Feres Doctrine bars military personnel from pursuing negligence claims, there are no definitive data comparing military and civilian medical malpractice rates.
One thing is clear, however: What happened to Cindy Wilson is exceedingly rare. According to the U.S. Centers for Disease Control, about 50 women a year die in the United States from all complications of labor and delivery.
The Feres ruling grew out of the Federal Tort Claims Act of 1946, which waived the ancient common-law doctrine of sovereign immunity in certain circumstances to allow lawsuits against the government for negligent acts.
Initially that law was interpreted to forbid lawsuits by military personnel only for combat-related injuries. The Feres decision widened that exclusion to bar any lawsuits over injuries “incident to military service.”
Here’s a sampling of cases in which lawsuits have been barred over the years:
- When sailor Dawn Lambert went to have a fallopian tube removed, military surgeons left five sponges and a plastic marking device in her abdomen. They remained there for months until a second surgery left her infertile.
- For 11 months, Navy Lt. Cmdr. Walter Hardin’s red lesions were classified as eczema. His condition was correctly diagnosed as cancer shortly before he died.
- Air Force Staff Sgt. Dean Witt’s appendicitis was misdiagnosed and he was sent home with antibiotics. When he collapsed at home, he was rushed into surgery and came out brain-dead.
- According to his medical records, Marine Sgt. Carmelo Rodriguez was correctly diagnosed with melanoma when he entered the service. But no one told him about it or suggested any treatment. The cancer spread throughout his body and he died 10 years later.
- Navy Petty Officer Joe Cragnotti went to a military hospital with pneumonia, which is treatable with antibiotics. It went untreated, and he suffered permanent brain damage.
Cragnotti’s mother, Barbara Cragnotti of Medford, Ore., is president of Veterans Equal Rights Protection Advocacy, a group of military families that lobbies to abolish the Feres Doctrine.
“People don’t know about the Feres Doctrine until it happens to them,” she said. “Once you sign on the dotted line, the military can treat you any way they want without any recourse because of this law.”
The ruling has been criticized by judges all across the ideological spectrum. A 5-4 Supreme Court decision reaffirming it in 1987 drew dissents from Justices John Paul Stevens on the left and Antonin Scalia on the right. Scalia wrote that Feres “was wrongly decided and heartily deserves the widespread, almost universal criticism it has received.”
Attempts to repeal the doctrine have surfaced periodically in Congress for more than 20 years, but all have failed. Turley, the law professor, said he is flabbergasted that lawmakers continue to let it stand.
Why have the repeal efforts been unsuccessful?
“Because it would cost a huge amount of money to upgrade the military medical system to meet basic civilian standards,” Turley said. “Congress simply doesn’t want to spend the money. Soldiers and sailors are a real bargain to kill and injure in the United States.”
The latest attempt to repeal Feres is the Carmelo Rodriguez Military Medical Accountability Act of 2009, introduced by U.S. Rep. Maurice Hinchey,
D-N.Y. It’s named for the Marine who died of cancer, a constituent of Hinchey’s.
The measure would allow lawsuits on behalf of military personnel who are killed or injured by medical malpractice. It contains an exception for combat-related injuries and requires that any paid claim be reduced by the amount of any other government compensation resulting from the injury.
Hinchey said the issue is one of simple fairness.
“I think military personnel should be treated in normal ways,” he said. “Their medical issues should be dealt with responsively and attentively, the way we anticipate and expect the medical problems of ordinary citizens should be dealt with. We see far too much negligence in military medical care.”
He conceded, however, that his bill faces a tough fight.
It must overcome objections such as those posed by U.S. Rep. Randy Forbes,
R-Va., who sits on the House subcommittee considering the measure. Forbes’ district includes Smithfield, where Cindy Wilson lived while she was stationed at Langley.
It’s undeniable that military medical care is in need of improvement, Forbes said. He said, however, “I don’t think the answer is always just having more litigation.”
The present system provides compensation for service-
related injuries, regardless of whether they result from negligence, Forbes pointed out.
In Wilson’s case, her family received the standard $100,000 military death benefit and the payout from her $400,000 Air Force life insurance policy. The government covered the burial costs.
Moreover, Forbes said, “How do you look someone in the eye and say we’re going to take a service member who was not in a combat situation and give them an elevated position for compensation and recovery that we would not give to someone who was in combat? I think that would create a huge problem in terms of morale.”
Forbes would not concede that military medicine across the board is inferior to civilian care .
“It depends on where you are,” he said. “There are hospitals across this country in the private sector where I would not want to go and get treated.”
“My first priority would be to say, how do we take the steps to make sure those kinds of negligent things don’t happen?” Forbes said. “Because no amount of money, no amount of litigation, is going to restore a life to someone like Sgt. Wilson.”
Had the family been able to sue over his daughter’s death, it wouldn’t have been about the money, Tommy Wilson said. It would have been about accountability.
“The only reason we would have wanted to sue them was to try to bring light on the way military people are treated,” he said.
“It’s a shame that they’re not given any better medical attention than they are.
“Cindy loved this country. She loved it with a passion. And she loved the military. And it took her life.”
Bill Sizemore, (757) 446-2276, bill.sizemore@pilotonline.com
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Botched Surgery
I was given a second hip replacement. 24 hrs later the doctor told me it would have to be redone. Due to a lack of remaining femur, a bone graft was done. The doctor told me it could never be redone due to a lack of viable bone. About 5 years later, the prosthesis (I guess) split the graft and allowed the prosthesis to slide approximatly 2 inches inside my leg. Quite painful and aggravating, my back is paying dearly. I have rheumatoid arthritis and no discs in my back. My question is. Do I qualify for VA disability because they are the ones who ruined my life. (I am now house bound)
Kindest regards, Hypnos
Additionally
This article was printed on May 18th, 2009 ~ the day I delivered my daughter. Ironic?
MY Langley Experience
I was a big fan of Langley, particularly their L&D unit. The women's clinic had obvious issues, such as wait times, ignorant and rude receptionists, ect. I had my son there in 2007 with very few problems. However, my last pregnancy was a totally different story. I was seen there by the same two doctors who were involved in this case, Dr. Corroza and Dr. Leis. Also, I was present the day this happened and remember them shipping her off to Riverside. My friend was been seen for labor contractions so I watched the whole thing unfold. I am so deeply saddened for the family.
This pregnancy, I delivered my daughter, Savannah Grace, on May 18th. She was stillborn after 40 weeks and 3 days. There were many many many problems with my care. I was not considered high risk and 30 calls the week prior to my delivery, 30 phone calls in to the doctor went unanswered. When she finally did call me back, she told me that it wasn't fair to her time with her husband. Well, I hope that time with her husband was worth it because it cost my daughter her life. We have not made any decisions but a Patient Care Conference yeilded two apparently legally preps doctors who wouldn't answer my qu
one more thing...
And one more thing STLCOUGAR- military doctors and nurses can have their licenses taken away if malpractice or negligence is proven. They just can't be sued! Notice it's the greedy lawyers trying to overturn the Feres Doctrine. They don't give a darn about us military dependents- they just see dollar signs. I'm more afraid of greedy lawyers than military doctors! I've had 3 surgeries at military hospitals- my husband has had several and my son has had one- all with successful outcomes. Military surgeons count sponges exactly the same way civilian surgeons do.
Cougar
On the other hand, my breast cancer surgery was delicate, in that the tumor was sitting right on the chest wall. The surgeon got it all, didn't puncture the chest wall, and left such a straight scar that I don't need the plastic surgeon to repair me after all!
For every horror story, there is at least one success, you know!!!
I wish the good stories were more reported. It would probably be 1000:1, but satisfied people don't tend to comment in this forum.
Military Medicine
It's amazing to see how someone can make a comment and tell folks to get out of what they choose to do, just because the medical is not up to par and those that made mistakes, are not being held accountable. That is the biggest downfall in the military and this country. Then to have someone like Forbes make comments about private sector hospitals? Maybe he should visit some military hospitals and be treated there, so he can see what folks, active, retired, etc. have to go through. It's not about the money, it's about the fact that the oath taken for the job is not being honored and the mistake makers are not being punished for dismembering or killing those who needed medical treatment. So, maybe the YA sayers need to look at both sides before flapping at the lips....
Military Doctors ARE THE WORST DOCTORS IN THE COUNTRY!!
As an RN/Nurse Practitioner, I can absolutely state that military doctors are the worst doctors in medicine. If they stay in the military one day past their obligations to pay for their training, it's because they are unable to make it in private practice. I've seen countless cases of military doctor mistakes that would have resulted in massive malpractice suits if they weren't shielded by this immunmity law--and these docs should be removed from the practice of medicine. My ex-BF had a simple bunion surgery that resulted in both of his feet being totally destroyed by a totally incompetent surgeon. If a civilian doctor had done this, two things would have happened. First, my ex would NEVER NEED TO WORK FOR MONEY AGAIN and second, the responsible doctor would never practice medicine again in the country. It's not enough to get a money award--these doctors need to be removed from the practice of medicine before they maim and kill again!! Our military deserve better than these military butchers--MUCH BETTER!!!!!!!!
Military "Care"
I will never forget my delivery of my daughter in Germany at a military hospital in '86. My daughter was breach and the doctor found out as she started coming out. He pushed her back in with his hand and turned her, which could have killed me. A few minutes after the birth they sent me downstairs to the ward where they handed me my sheets, all flat, to go make my own bed. This involved lifting the mattress and tying the sheets underneath. I was shocked and worried about hemorrhaging. This was the first time I had walked in weeks because my daughter was late and lying on a nerve. I had been carried into delivery. My husband agreed to do it but had I been there without him like some of the women I don't know what would have happened.
To marym6324
I am not motivated by greed. For 10 YEARS I tried to get my ankle tended to. I was constantly in that person's office---I saw the X-rays and, when I asked questions about them, was dismissed with a wave of his hand as he headed out the door. I chased him with ONE FOOT! Civilian doctors told me that improper diagnosis and treatment was what caused me to spend 10 YEARS in agony! Do not get all high and mighty with me---if you had to spend 10 years of your life in agony because of a doctor who didn't give a tinker's and then 3 MONTHS in a cast after radical surgery that should not have happened had the injury been attended to properly in the beginning, you would want a huge chunk of the person who did it to you, too. Try this Above all DO NO HARM--part of the oath doctor's take. We entrust doctors with our lives and our families lives and, in the military because they are not accountable, they do NOT care!
Sbarker
The military is smaller than you think. If a doctor messes up at an Air Force base in Hawaii, one of my Air Force friends will probably tell me (Navy in Norfolk), so I can avoid him if he transfers. Our microcosm of national health actually works pretty well that way. By word of mouth.
And if a military doctor were dismissed for cause, well, everyone is bragging on how easy it is to get rid of a doctor at a civilian institution in all 50 states, so I doubt it would be long before this person's career was finished, whether we were able to sue him for malpractice in the military or not.
Military Doctors
I cannot begin to feel what many of you have had to endure. I am sorry for your pain and loss. I have had good treatment from the Military withy several surgeries throughout my career. While I can understand not being able to sue the Military for compensatory dollars, I do believe it's time for the Medical Military to be held accountable for their actions, or, the lack of proper actions. The medical practitioners need to be held accountable for their mistakes that should not be made. Loss of licenses to practice with letters to all states regarding their inadequacies, removed from the military, military punishment just like any other military person who is derelect in their responsiblities. The medical community takes care of itself, unfortunately, and should have an Oversight / Quality control board watching their activities. The issues presented should not happen, the system needs to be updated and brought into the 21st century.
Respectfully,
less pay/more hours
I say to all those who hate military medicine- get out of the military! Go pay through your nose for health care insurance and see how much better care you get in the civilian world. People need to stop trying to blame someone for all their health issues and take some personal responsibility. Unfortunately as long as humans are providing health care- there will be the occasional and tragic mistake made. My guess is that it happens just as much in civiliain hospitals as it does in military hospitals.
The Feres Doctrine
My son Michael Fremer was killed at Fort Polk, La on 2/13/08 because of Army Negligence during the conclusion of a training exercise. The Army can not be held accountable because of the Feres Doctrine. This law needs to be changed. Why is the Army exempt from being held accountable for Negligence? Our young men and woman are risking their lives. This is how our country treats the soldiers and the families?
The Military uses the Feres Doctrine to protect themselves against Medical Malpractice in the Cases involving Dean Witt and Carmel Rodriguez. It also protects the Military in cases involving Marines being exposed to Toxic chemicals on US Bases on US soil. The Military is exempt from being held accountable on all of these matters. The Feres Doctrine needs to be overturned so the Military is held accountable.
Thanks,
less pay/more hours
Who in there right mind would want to be a healthcare provider for the military and their whiny dependents? You make less money- work longer hours and the public repays your hard work with a front page article saying your care is 'substandard'? I worked as a Navy nurse for 4 years and couldn't get out of the military fast enough. Now I'm married to a Navy doctor who for some reason has stayed in the military because he likes to serve his country. So- he makes about half of what he could make as a civilian doctor and we move our kids about every 2 years. Trying to retain good doctors in the military is already an issue- guess where they go when they leave? To the civilian hospitals where they can make more money and work less hours and they don't get shipped to war zones! So allowing them to be sued would just make civilian medicine that much more attractive to military health care providers.
It is difficult when you have a patient like the lady who brought in her 2 year old with a 'stomach mass' to the ER. Unfortunately coming to the ER with vague complaints means that they might have to perform a diagnostic test which just might cause discomfort regardless of your ag
Mary
"Mistakes happen; so do misfortunes. Someone doesn't have to be punished every time a bad outcome occurs!!!"
Are you suggesting that leaving sponges in a patient is just a simple mistake that warrants no punishment? What's to stop the surgical staff from being more careful the next time if all the military says is "Don't worry about it - 'stuff' happens"?
Unsworn
You said it all right there, "If he were a civilian, I would own him . . ."
Attitudes like yours make me truly glad I never went into the medical field, despite high grades in high school and college.
Too many people almost seem to *hope* for a less than optimal outcome from their medical conditions so they can collect big bucks or "own" a doctor.
Mistakes happen; so do misfortunes. Someone doesn't have to be punished every time a bad outcome occurs!!!
i'm glad
I'm glad I send via email this news to every military I know so they can get individual health care. I'm not very happy with the private sector either (it should be at least 85% cheaper than is now), but if those civilian doctors are so negligent, they should be kicked out. I mean, if soldiers and sailors are subject to very strict rules not protected by the constitution, shouldn't be the same for civilians who work on the DOD? If they cannot be sued for money (If I lost my mother because of malpractice, does that money is going to bring my mother to life? NO. Personally, I wouldn't want the money), they should have their license removed for a certain period of time, and if it was a proven negligence, that physician should go to the jail.
Where has accountability gone?
I feel the families pain. I've been seeking my own answers for a year. Everyone is courdial, but no one is accountable. I've tried myself to contact Congress and Senate, only to be told to write more letters. I wish the family the best. At times in my own situation, I've felt that the media is my best recourse.
My story
As long as everyone is throwing out their anecdotal evidence I'll throw out mine. I was diagnosed with two very serious diseases during different times in my naval career. Both were caught in time and successfully treated with drug regimens that costed tens of thousands of dollars each although I paid not a penny. One involved a hospital stay of months. All of my caretakers were professional and I am grateful to them and the Navy and Air Force for the treatment I received.
Military Medicine needs help
MaryM, I'm truly happy you've gotten great care. I wish I could say the same. In my career, I've had a botched hernia surgery, misdiagnosed torn ligaments that required reconstructive surgery that were only discovered because I went to a civilian doc later and then I had knee surgery performed by a doc who was kicked out of the service because it was found out that he never had a license to practice medicine. All of these happened to me personally.
I agree society at large is too litigious, but we as service members have no recourse when negligence happens to us. There is a difference between honest human error and negligence, but leaving sponges or other surgical implements in a patient is well on this side of negligence.