Special Assistant for Gulf War Illnesses
Dr. Rostker: This is part of our continuing series of case narrative releases.
The case that we are releasing today relates to a PFC David Fisher who was in the 3rd Armored Division and was assigned the task of examining a number of bunkers in southern Iraq. The bunkers at one point were suspected of having chemical weapons because they were in the area of responsibility of the Republican Guard, the elite Iraqi forces.
Private Fisher examined the bunker, went back to his bivouac area and approximately eight hours later reported severe pain and the rising of a blister. The delay of eight hours is significant because that is characteristic of a mustard exposure.
He was seen in the battalion aid station. A diagnosis of blister mustard agent was provided, I believe, on the second visit, and Colonel Dunn, an Army expert in NBC health effects was notified. He came in and confirmed that it was a mustard exposure. Urine samples were taken which also confirmed mustard because of the byproducts of the mustard in the urine and the Fox vehicles were called in and examined his clothes.
It was rather difficult to get a reading because of the prevalence of fat, soils and waxes, the contaminants associated with the oil fires, but there were spots on the garments and on his vest that indicated mustard.
The clothes, his [inaudible] utilities, were secured, treated as contaminated waste and buried. I believe the flack jacket was returned to the States. Everything in theater provides a strong indication of a mustard exposure incidental to the examination of the bunker, rubbing on something that would have the persistent agent mustard.
The only questions in the case are the fact that in the CONUS, the retest of the urine and the retest of the garment did not show positive for mustard. We believe both have a quite plausible explanation, but it does introduce a small element, and so our assessment was this was a likely exposure rather than a definite exposure.
We have been in contact with Private, later promoted to Sergeant, Fisher. He is in the process of making a claim to the VA, primarily for his concerns about memory loss. He has indicated to us that there are no recurring problems with the residuals, from the scarring from the blister burns.
We've also had lengthy discussions with Colonel Dunn. The information contained here has largely been in the public domain through Congressional testimony, testimony before the PAC and is widely reported on GulfLINK. In fact, it's a very interesting case in that regard because the system was quite primed to record a chemical incident and you find it all the way up through DCS/Ops in the Army within two days or so of the event occurring in the Gulf, so it's an indication of how quickly the system could in fact and did in fact promulgate information.
The particular value added of our exercise was to bring together in one place all of the pieces of information, both in theater and post theater. In fact, in talks with Private or Sergeant Fisher, he indicated that he learned things about his own case by reading the case narrative, things that as the subject of the case he was not aware of because it occurred after the events and away from his particular involvement, but that the representation of his particular involvement in the case, the incident, what happened, how he got burned and the like, was quite accurate and that's been confirmed in the case narrative by others in the crew whose accounting is also provided as well as Colonel Dunn.
Q: To put this in perspective, is it fair to say that PFC Fisher's case is the only most likely known case of exposure to a chemical agent by any U.S. military troops?
A: That's correct in terms of us drawing a conclusion at this time. There is another blister case associated with the Marines and that is still under investigation. I would point out that Private Fisher/Sergeant Fisher's case is the most well documented, with substantial medical evidence and corroborating evidence. It was sufficiently documented to have Sergeant, then Private, Fisher awarded the Purple Heart.
The other case, the case of Sergeant Santos in the Marines, is much more controversial in that the documentation that is clearly there in the Fisher case does not exist and we're even looking at further examinations in the other case. But this is the only case.
The other case also -- it's hard to explain why only one person would have been exposed given the nature of the incident. The Fisher case tracks quite closely with why an individual, single individual, would have been exposed.
Q: How would you describe the message traffic after this alleged incident? Can you compare it to other incidents? You know, is it more forthcoming? It looks like more of an urgency where you think there is such a case?
A: I would characterize it as robust. We've often said that the way to have made a chemical officer's or a medical officer involved with NBC, the way to make their day in the Gulf was to bring them a chemical case and this was one case that was brought and it reverberated through the system. Go into GulfLINK and do a word search on Fisher and you'll get a lot of hits.
Q: What does that tell you, then?
A: We would draw the conclusion that the system was primed, was ready, and that substantiated cases were well documented in the system. There is an implication of cost that the other cases which are fragmented, pieces of information, are not well documented, so the system worked. It certainly worked in the Fisher case and one has to draw some analogy to other cases.
Q: Was any part of the message traffic then classified or any part of his medical records or the information kept from him?
A: I don't know the answer to the question of the medical record. We frankly have not looked into that. I believe the -- remember, GulfLINK has a lot of declassified information and it may well have been classified, but declassified literally years ago. I'd have to pull up the actual message traffic and review it to see if the secret stamp was crossed out. It may well have been classified, no higher than secret, at the time, but has fully been declassified.
Colonel Dunn wrote on this and published on this case as early as 1991, so the information has been available to the public almost, if not immediately, almost immediately.
Q: Because it was such an early confirmation of exposure, have you been tracking his health? I mean, he is actually a pretty good guinea pig and could be for the last six or seven years. Have you done intensive medical analysis of him as he's gone through this process?
A: He is an individual who has the right of his own privacy. We have been in contact with him throughout our investigations. And we understand that he is making a claim with the VA. But he has not been the subject of a specific inquiry.
Let me contrast that in the case of depleted uranium where we have soldiers with fragments, where they are the subject of an intense -- but this not that unusual in the sense that people do get mustard burns in training accidents and like. We certainly had those in World War I. So there is a vast understanding of this particular chemical and the long-term effects of it.
There is an immediate blistering. He was treated for that blistering. It was not a vapor ingestion. It was believed to be a rubbing against a -- some contaminated surface in one of the bunkers. And so it was treated as very minor and very localized.
Q: You say with his privacy, respect his own privacy, are you saying he's not being cooperative with you?
A: Now, he's been superbly cooperative. And he had indicated to us that he has the scars. But that that's not what any of his problems are. And there is nothing in the medical literature to link a mustard exposure of this type to any long-term effects.
Q: How would you characterize his current medical concerns that he is seeking treatment for to the other thousands of Gulf War veterans who you are trying to help?
A: We have said repeatedly -- I have said from here repeatedly -- that our primary concern is the health of our active duty folks and the veterans. And we encourage anyone who has any concern about their health to come in -- if they are in the DoD to the CCP, and if they are veterans to the VA. And that's, in fact, what Fisher is doing.
Q: Well, I perhaps didn't phrase it correctly. Are his complaints similar to what are on the registers? Or are his complaints different?
A: As best I can tell, they are similar. I mean, we've heard many people complain of short-term memory loss. It's one of the things we're quite concerned about. So I don't see this being a particularly unique case. But every person is unique and has to be assessed by competent medical authorities and that's what treatment he'll get at the VA.
Q: What is the research record of someone who has Lewisite in the blood or urine and the effect of the Lewisite when the blood moves up into the brain?
A: We don't believe that he was exposed to Lewisite. We believe that he was exposed to mustard. The identification of Lewisite -- remember we have talked about the problem with some of the internal workings of the system, that it -- when in field trials, it was noted that the silicon parts -- the wheels would provide a Lewisite false alarm. And so that has been changed in the Fox vehicles.
So we believe that the exposure was a mustard exposure and it was not necessarily ingested into the lungs, which is where you really fear for life-threatening effects. But it did provide a surface burn and that that was localized, and that there were no long-term effects.
Q: When all is said and done, do you think that this may be the only case that the Pentagon would say likely or that high -- I notice your scale in this report -- do you think that this may be the only confirmed or near-confirmed case that may come out of all this?
A: That's a speculative question and I will only tell you that we treat each case on the merits of the case and we will see where they come out. I don't want to speculate.
Q: Where is Mr. Fisher now? He's out the military?
A: He is out of the military. Privacy indicates that I can't tell you where he is. But I believe some of the news media, in fact, even located him. But I'm not allowed to provide that information.
Q: The trouble in all your -- you're looking at so much empirical evidence on the ground there. And there's some other evidence back in CONUS where you're doing some testing on that stuff, do you still view it likely rather than definite?
A: I mean, that's our call. And if there was corroboration in samples in CONUS, it would have been a definite. And likely is -- you know, we believe that that is an event that likely occurred.
Q: But can't -- I mean, I'm not physicist, but can't the mustard gas kind of dissipate after time?
A: No, it's a very -- it's one of the persistent agents. So one of the things we have looked in is, "Well, where would it have come from?" Because it was not found there. And UNSCOM has told us in the last PAC meeting, that they do not believe, the UN does not believe that any chemicals were sent south of Khamisiyah.
They have been tracking what the Iraqis said they had and can place when it was shipped from which to depot to which depot. And they believe that the furthest south that either sarin or mustard was sent was Khamisiyah. So we don't have any basis from the UN or any corroboration with found munitions that would place it -- mustard -- in these bunkers at that period of time.
But it is quite possible that mustard was there at an earlier period of time and would persist. And what I have been told is that it could persist for 50 years. It will not evaporate and it is a persistent agent, as compared to sarin, which is a totally different agent, but is highly volatile and will dissipate and break down into harmless components relatively quickly.
These were all also physical wet-spot type contacts. This was not a vapor, vaporizing agent that would have been detected by the air modes from the Fox vehicle, even on the alarm. And it took the vehicles to get up to the suspected wet spots to register, you know, touching it and vaporizing it themselves by touching the liquid to register the mustard on the alarms.
Q: Those Fox vehicles -- I mean, are they not designed to test clothing?
A: It -- remember, they have a wheel. The wheel picks up the liquid. They put the wheel against the heat probe. It's that kind of thing. No, it's not normally used to test clothing. It's a reconnaissance vehicle. But it was the access they had to the mass spectrometer.
Q: Okay, thank you.
A: Thank you.