$4 million hyperbaric chambers remain empty at naval hospital

Hyperbaric chambers, like those hauled to Portsmouth, above, help people suffering from more than a dozen conditions, including injuries sustained by troops in combat. (Michael Kestner photos | The Virginian-Pilot )

By Kate Wiltrout
The Virginian-Pilot

PORTSMOUTH

It took almost $4 million, a decade of planning and a 500-ton crane to install two massive hyperbaric chambers at Portsmouth Naval Medical Center in 2000.

Seven years later, not a single patient has been treated there.

Designed to help people suffering from more than a dozen conditions - including the kind of injuries suffered by troops in combat - the chambers were never outfitted with the specialized piping and instrumentation needed to make them work. Funding for that died in Congress six years ago.

In an interview with The Virginian-Pilot on Wednesday, the hospital's top official said he isn't sure it's worth $9 million to finish the chambers.

"I think there's medical benefit in hyperbaric therapy for specific medical processes," Rear Adm. Thomas Cullison said. "I'm not sure there's $9 million worth of economic benefit for using the chambers as designed to get there," he said.

Today, the sky-blue steel chambers sit idle at the Charette Health Care Center, in a specially designed wing completed in 1999. That frustrates both the politicians who supported the project and the retired Navy doctors who say the therapy could help speed the recovery of hundreds of patients each year - including service members injured in Iraq and Afghanistan.

"Without question, to go that far in the construction of a very, very unique facility and not complete it is just senseless," said former Congressman Owen Pickett, who helped secure money for the chambers' construction.

"Rather than doing an all-or-none, politically charged finish-this-thing or don't-finish-this-thing solution, I'd like to look at it from an academic point of view," said Rear Adm. Thomas Cullison, above.

Pickett, whose district included Virginia Beach and part of Norfolk, retired from Congress in 2001. The project's other local champion - Rep. Norm Sisisky - died in office that same year.

In response to inquiries from The Pilot, Sen. John Warner, R-Va., has asked the Navy to reassess the unfinished project.

"We're just asking them to take another look at that, in light of the passage time and the best care for returning veterans," John Ullyot, Warner's spokesman, said this week. "We're willing to work with them, should this be a priority of theirs."

In 2000, getting the chambers into place required moving power lines and putting the behemoth structures - 92,000 and 77,000 pounds, respectively - on a barge, floating them down the Elizabeth River and hoisting them into place after removing part of the roof.

Unlike local hospitals, which can treat one or two people at a time, the Portsmouth facility would fit as many as 26 patients and would be one of the largest in the nation.

It could treat patients in wheelchairs and on gurneys, and even allow doctors to operate on critically ill patients in the larger chamber, a 20-foot sphere.

Hyperbaric medicine goes far beyond treating divers with decompression sickness, also called the bends. Pressurized oxygen is used regularly to help heal chronic wounds, crush injuries, thermal burns and skin grafts. Bones and tissue damaged from radiation in cancer treatment also benefit, and the treatment helps diabetic patients with wounds in their extremities avoid amputation.

Hyperbaric chambers sometimes are used outside hospital settings for other conditions, such as cerebral palsy and autism, but there is controversy over their effectiveness.

Dr. Frederick Lassen, a retired Navy captain who was director of surgery at the Portsmouth facility, said he regrets that the chambers aren't being used to treat injured troops, whose wounds he thinks could benefit from hyperbaric therapy.

Lassen, an ear, nose and throat physician now in private practice, wrote to politicians about the unfinished chambers last fall.

Retired Rear Adm. William McDaniel headed the hospital when plans were being made for the chambers.

"I cannot tell you one iota as to why they are not being utilized," McDaniel said in a phone interview from Oak Harbor, Wash. "It's been shown that for a lot of people with chronic infections, hyperbaric therapy really does a lot of good."

McDaniel said local hospital officials at the time were excited about the prospect of sending civilian patients to Portsmouth Naval Medical Center for hyperbaric therapy.

Instead, military doctors at Portsmouth still must refer patients who need hyperbaric treatment to local hospitals - and pick up the tab. Cullison said the Navy paid $56,000 for those off-site treatments in 2006 and an additional $48,549 this year.

The medical center's budget this year is $386 million.

Internal Navy reports obtained by The Pilot showed a much higher cost for outside treatment in 2000, the year the chambers were put into place. According to that analysis, the hospital spent $1.4 million on more than 1,000 treatments at local hospitals. Based on that figure, the report estimated that the hospital could recoup the cost of finishing the chamber in 1.1 to 7.3 years.

Cullison said he doesn't trust those numbers and cited a different analysis for the Navy's decision last year not to ask Congress for the money to finish the project. He questioned earlier studies that concluded that the Navy chambers would be used to provide more than 4,000 treatments a year to active duty military members, dependents and retirees.

"Even though one extremely optimistic estimate may cover the cost of piping (the chambers), most of them don't," Cullison said.

Instead of ripping out the chambers and converting more than 6,000 square feet of unused space into something else - or spending millions to finish the project - Cullison advocated more study.

"Rather than doing an all-or-none, politically-charged finish-this-thing or don't-finish-this-thing solution, I'd like to look at it from an academic point of view," he said.

Cullison, who has been in command of the hospital since late 2005, said he is in favor of bringing in a contractor to provide hyperbaric treatment in one or two portable chambers on hospital grounds.

Doctors could gauge from those results whether it makes sense to finish the existing chambers.

"We've had them there for seven years now already," Cullison said. "A couple, three more years of trying to figure this out in a more rational way is going to cost us less than taking them out and realizing it was a bad decision and trying to put them back.

"It would make more sense to me to just leave them there for now and work around them."