In February 1998, investigators from the Office of the Special Assistant to the Under Secretary of Defense (Personnel and Readiness) for Gulf War Illnesses, Medical Readiness, and Military Deployments (formerly called the Office of the Special Assistant for Gulf War Illnesses) interviewed doctors, nurses, and administrators who had been stationed at Fleet Hospital 15 in Al Jubayl, Saudi Arabia, during the Gulf War. During these interviews, two nurses and one administrator told us of possible chemical warfare agent injuries to several Marines of the 2d Reconnaissance battalion during the Gulf War, although they had not personally examined the injured Marines. We investigated these reports and found that, before the start of the ground war, six Marines from this unit sought treatment during early February 1991 for symptoms described as blisters, bumps, or sores on their hands, ears, and necks. These Marines had been assigned to different reconnaissance teams operating different observation posts when the blisters appeared.
Field medical personnel considered a number of causes for these blisters, ranging from mustard agent exposure to a leishmaniasis infection; however, they did not make a definitive diagnosis because many symptoms of these conditions were absent. Since the injuries were not severe or debilitating, field medical personnel declared the Marines fit for duty and returned them to their unit. The blisters healed within a few weeks, and the Marines participated in ground war operations without further complications.
In the course of our investigation, we contacted and interviewed several of the Marines who sought treatment at the hospital, and interviewed hospital personnel, including the doctors who treated the Marines. In addition, we commissioned a chemical warfare medical expert to interview the Marines and evaluate their injuries. Finally, we reviewed the hospital admissions log that the nurses believed documented the chemical warfare agent treatment.
After a thorough investigation, we assess that it is unlikely mustard exposure caused these skin lesions. This assessment is supported primarily by the opinion of a medical expert who specializes in identifying chemical warfare agent casualties. He personally interviewed and examined three of the Marines and conducted a telephone interview with another, showing them skin conditions caused by various exposures. None of the Marines thought the pictures of blisters caused by mustard exposure resembled their blisters. The information the medical expert gathered led him to assess it is unlikely these Marines' blisters were caused by Mustard exposure.
In addition to this expert opinion, our assessment is supported by information gathered in interviews with medical, chemical, and command personnel; and the Marines, corpsmen, doctors, and nurses directly involved. Evidence of a chemical warfare agent exposure could include a confirmed chemical warfare agent detection, notations about the blisters in the Marines' medical records and statements from Fleet Hospital 15 doctors confirming they treated Marines for chemical warfare agent exposure - evidence we lack in this case. We were unable to find any doctors who remembered treating anyone at Fleet Hospital 15 for chemical warfare agent injuries. The only medical personnel from Fleet Hospital 15 who recalled treatment for chemical warfare exposure were not present when the Marines were treated. All the Marines we interviewed confirmed what the admission logs and medical records indicated: they received treatment for respiratory ailments, not chemical warfare agent exposure. Although one Chemical Agent Monitor reportedly detected mustard on a Marines glove, the re-test with the same monitor revealed no agentthe first report had been false-positive alarm. Finally, we have no knowledge of Iraq transporting chemical warfare agents within 200 miles of the reported exposure site on the Kuwait-Saudi Arabian border.
Nevertheless, we lack specific evidence to preclude our assessing chemical warfare agents definitely did not cause these blisters and we cannot identify the cause of the blisters. To make this assessment, we require physical evidence from the site of suspected exposure (e.g., sand from the berm or urine and blood specimens taken when the blisters occurred). This evidence was not available to our investigators, because it was not collected at the time of medical treatment.
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