Medical Aspects of Chemical Warfare (2008) - The Black Vault

History of the Medical Management of Chemical CasualtiesEXHIBIT 3-8A CASE OF ACCIDENTAL EXPOSUREAETV-TF-CC 10 June 1991MEMORANDUM FOR RECORDSUBJECT: Chemical Casualty Occurring During “Bunker Search andEquipment Destruction Mission” Within the 3AD Area of Operation.1. On 01 Mar 91, PFC David A. Fisher . . . , a 19D cavalry scout assigned to the 4/8th Cav, 3AD was performing a searchand destroy mission of Iraqi equipment and bunker complexes. Somewhere among the several complexes he visitedhe brushed against an unknown surface which deposited a chemical agent upon his flack jacket and his Nomex suit.He was unaware of the contact with the chemical agent.2. PFC Fisher returned back to his unit still unaware of any contact. He was assigned to morning guard duty at 0100hrs on 02 Mar. He noticed a redness associated with skin irritation on his upper left arm which felt like a “spiderbite”. By 0400 the same day, blisters appeared. The blisters were in the area of his polio-immunization site. The blistersize was 1/4” x 1/2”. Later that morning he reported to sick call to get treatment. He was not treated for a chemicalinjury at that time.3. Later that day his signs and symptoms did not go away. His blisters spread to his lower arm. He returned to sickcall where he underwent skin decontamination. At this point he was processed as a chemical agent casualty andtreated as such.4. Chemical RECON (FOX) vehicles were dispatched to “sniff” the articles of clothing and to search bunkers in the AOfor signs of chemical contamination. The FOX mass spectrometer tapes indicated the presence of an H-series blisteragent. On 03 Mar 0940, HD chemical blister agent was reported to be found in a bunker at location QU 050072.5. Clinical confirmation came from Col Dunn M.D., Commander of the US Army Medical Research Institute of ChemicalDefense. Col Dunn stated that PFC Fisher showed a sufficient clinical history and syptomotology to classify himas a classical Mustard agent (blister) casualty. Col Dunn, further stated that if a positive urine test for thiodiglycol, abreakdown products of mustard agent, could be gathered, then the clinical diagnosis was sound. A urine specimenwas taken.6. . . . 3AD Division Surgeon, confirmed that the urine test was positive. PFC Fisher was confirmed to be a chemical“mustard blister agent” casualty. The clothing, flack jacket, and fluid from the blisters were secured from 2d BDE by. . . and 513th MI personnel for further analysis and control.. . .Assistant Division Chemical Officer 423Data source: Chemical Casualty Occurring During “Bunker Search and Equipment Destruction Mission” Within the 3AD Area of Operation.US Department of the Army, Third Armored Division; 1991. Memorandum, 10 June 1991. Available at: http://www.gulflink.osd.mil/fisher_ii/fisher_ii_refs/n45en062/970725_sep96_decls26_0001.htm. Accessed April 15, 2008.and Biological Casualties Course (taught by US ArmyMedical Research Institute of Chemical Defense) andwere confident of their suspicions.The value of chemical casualty management liesin staff coordination and communication of medicalinformation. Russia’s 2002 use of nonlethal gas againstChechnyan terrorists at a Moscow theater (see Chapter 2)provides an example of unsuccessful chemical casualtymanagement. Had Russian special operations personnelindicated to first responders and receivers the nature ofthe chemical weapon used, the judicious use of nalaxonecould have been easily planned. Instead, healthcareproviders thought they were facing a new nerve agentand were unable to respond appropriately.107