@StateDept’s Blackhole of Pain Inside the Bureau of Medical Services (MED)

Posted: 12:46 am  PT

 

We previously blogged about the ongoing problems encountered by Foreign Service families with special needs children when dealing with the State Department’s Bureau of Medical Services (MED) (see @StateDept’s Mental Health Services Drive Employees with Special Needs #FSKids Nuts).  Note that as employees prepare for the summer job rotation, MED will be reviewing the medical clearances of employees and family members in preparation for their transfer.  Whatever is the number that is now stuck in MED’s labyrinth, expect that number to go up with the upcoming rotations as kids with special needs are snared in the system that is supposed to help but instead has caused so much disruption and pain.

We understand that medical clearance decisions can be appealed to a panel of three doctors. But we’ve been informed that one of the three in this review panel is the reviewing officer of the the other two. We’d like to know how many cases that come before this review panel are decided in complete agreement by all panel members, and how many cases are decided by the two panel members against the decision of the third panel member/rating official? Perhaps something for the congressional oversight panels to look into? Or something to FOIA if this is going the class action route.

Congress should also look into State’s Medical Services perspective on risk. Would it surprise us all if State/MED doesn’t want to take any? State/MED’s mission is “to safeguard and promote the health and well-being of America’s diplomatic community.”  Does that mean keep everyone with the slightest issue inside the United States instead of sending them on overseas assignments? Bad things can happen just the same in the United States – but of course, MED won’t be responsible when employees are on domestic assignments. It is responsible once employees/family members are overseas. So again, what is State/MED’s perspective on risk, and how much does this inform its decision on the medical clearances issued to FS employees, spouses and their kids?

FP’s Robbie Gramer recently had a lengthy piece on FS families in State’s medical labyrinth. It is quite a read, and don’t miss the quotes.

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US Embassy Cuba: New Mechanism For Brain Injury From an “Exposure of Unknown Origin”

Posted: 12:39 am ET

 

The University of Pennsylvania’s Center for Brain Injury and Repair was selected to coordinate the evaluation, treatment and rehabilitation of 21 government personnel (11 women and 10 men) identified by the State Department and evaluated an average of 203 days following exposure to reported sound (described as “buzzing,” “grinding  metal,” “piercing squeals” or “humming”) and sensory phenomena (described as pressure-like or vibrating and likened to air “baffling” inside a moving car with the windows partially rolled down) at the US Embassy in Havana, Cuba in late 2016.

“It’s like a concussion without a concussion.”

“Of the 21 individuals assessed at Penn, 17 reported cognitive or behavioral problems such as difficulty remembering, concentrating, or both. “It’s not that any patient can’t do a given task, but it requires way more effort,” said coauthor Randel Swanson, DO, PhD, a brain injury rehabilitation specialist at the University of Pennsylvania’s Center for Brain Injury and Repair. “They don’t have as much cognitive reserve.”

The author and his coauthors signed a nondisclosure agreement with the State Department, “so they cannot discuss whether they know more about what happened in Havana than has already been made public.”

The study concludes that “The unique circumstances of these patients and the clinical manifestations detailed in this report raise concern about a new mechanism for possible acquired brain injury from an exposure of unknown origin.”

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