A. Communication

We are unsure why some medical personnel at Fleet Hospital 15 believed hospital doctors treated several Marines with chemical warfare injuries. Procedures did not allow these medical personnel to have misperceptions corrected until we investigated the incident nine years after the fact. In the future, investigation and reporting of such issues should occur immediately after the deployment.

B. Organizational and Administrative Record Keeping

Not all organizational and administrative medical records were available in this case. Navy instructions at the time of the Gulf War dictated destroying sickness reports, sign-in/sign-out logs, appointment records, etc., after two years. Current policy maintains the two-year retention requirement.[74] The Navy and the other military branches should consider keeping unit medical records from contingency deployments on electronic media for longer than two years.


This is a final report; however, if you believe you have information that may change this case narrative, please call 1-800-497-6261.

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