U.S. deploys more than 43,000 unfit for combat

WASHINGTON — More than 43,000 U.S. troops listed as medically unfit for combat in the weeks before their scheduled deployment to Iraq or Afghanistan since 2003 were sent anyway, Pentagon records show.

This reliance on troops found medically "non-deployable" is another sign of stress placed on a military that has sent 1.6 million servicemembers to the war zones, soldier advocacy groups say.

"It is a consequence of the consistent churning of our troops," said Bobby Muller, president of Veterans For America. "They are repeatedly exposed to high-intensity combat with insufficient time at home to rest and heal before redeploying."

The numbers of non-deployable soldiers are based on health assessment forms filled out by medical personnel at each military installation before a servicemember's deployment.

According to those statistics, the number of troops that doctors found non-deployable, but who were still sent to Iraq or Afghanistan fluctuated from 10,854 in 2003, down to 5,397 in 2005, and back up to 9,140 in 2007.

The Pentagon records do not list what — or how serious — the health issues are, nor whether they were corrected before deployment, said Michael Kilpatrick, a deputy director for the Pentagon's Force Health Protection and Readiness Programs.

A Pentagon staffer examined 10,000 individual health records last year to determine causes for the non-deployable ratings, Kilpatrick said. Some reasons included a need for eyeglasses, dental work or allergy medicine and a small number of mental health cases, he said.

This is the first war in which this health screening process has been used, the Pentagon said.

Most of the non-deployable servicemembers are in the Army, which is doing most of the fighting in Iraq and Afghanistan. Between 5% and 7% of all active-duty, National Guard and Reserve soldiers slated for combat were found medically unfit due to health problems each year since 2003, according to statistics provided to USA TODAY.

Unit commanders make the final decision about whether a servicemember is sent into combat, although doctors can recommend against deployment because of a medical issue, Army spokeswoman Kim Waldron said.

"The commander consults with health care professionals to determine whether the treatment a soldier needs is available in theater," said Army Col. Steven Braverman of the Army Medical Command.

At Fort Carson, Colo., Maj. Gen. Mark Graham ordered an investigation into deployment procedures for a brigade deployed to Iraq late last year. At least 36 soldiers were found medically unfit but were still deployed, Graham told USA TODAY.

For at least seven soldiers, treatment in the war zone was inadequate and the soldiers were sent home, he said, and at least two of them should never have been deployed.

In testimony before the Senate Armed Services Committee in February, the panel's chairman, Sen. Carl Levin, D-Mich., asked Army leaders about an e-mail from the surgeon for the Fort Carson brigade that said medically "borderline" soldiers went to war because "we have been having issues reaching deployable strength."

"That should not be happening," Army Secretary Pete Geren told the committee. "I can't tell you that it's not, but it certainly should not be happening."

Meanwhile, soldiers with medical problems have also deployed to Iraq and Afghanistan from Fort Drum in New York and Fort Stewart and Fort Benning, both in Georgia, according to Brenda Farrell, who is leading an investigation into the practice for the Government Accountability Office.

A report from that investigation sought by members of the House Armed Services Committee is due in June.

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Drugmakers need to rein in ads, hearing told

By Susan Heavey

WASHINGTON (Reuters) - Pharmaceutical companies need to be more responsible in touting products to consumers or else face tighter controls from Congress, a top U.S. Democratic lawmaker said on Thursday.

Rep. Bart Stupak, at a hearing to discuss specific ads by Pfizer Inc, Johnson & Johnson, Merck & Co Inc and Schering-Plough Corp, said television commercials in particular use deceptive techniques to push products to potential patients and increase sales.

"It appears that we need to enforce significant restrictions on DTC (direct-to-consumer) ads to protect American consumers from manipulative commercials designed to mislead and deceive for the profit of pharmaceutical companies," said Stupak, head of the U.S. House of Representatives Energy and Commerce investigative panel.

The Michigan Democrat said Congress should consider whether ads promoting medicines should be allowed to continue to target consumers in the United States, the only country that allows such marketing except for New Zealand.

"Pharmaceutical companies should consider it a privilege to be allowed to air DTC ads in this country," he said. "We should make sure that pharmaceuticals companies conduct themselves responsibly."

Ruth Day, head of Duke University's Medical Cognition Laboratory, told lawmakers that drug companies use a variety of tactics to highlight a drug's benefits and downplay risks, including fast speech to visual effects.

For example, an ad for Schering-Plough's allergy drug Nasonex featured a bumble bee that flew around as side effects were listed, but simply hovered when benefits were discussed.

"All of these wing flaps and wing flashes and sparkly things essentially divided the attention of the viewers ... and thus led to decreased knowledge" of possible risks, Day said.

At the hearing, lawmakers focused on TV ads for Merck and Schering-Plough's controversial Vytorin cholesterol drug, citing "food and family" as sources of cholesterol and urged patients to consider medication if diet changes alone did not help.

Deepak Khanna, senior vice president and general manager of the companies' joint venture, defended the spots, saying they were reviewed by the U.S. Food and Drug Administration and backed by research.

"Our consumer research has consistently shown that the information about the two sources of cholesterol is getting through," Khanna said.

Merck and Schering-Plough ran the spots from September 2004 until January, when a study found Vytorin failed to keep neck arteries any clearer than Zocor, which is available as a cheaper generic. Stupak's panel is also investigating whether the companies withheld data from the Vytorin study.

Lawmakers also looked at ads for Pfizer's cholesterol drug Lipitor featuring artificial heart inventor Robert Jarvik, who had prompted some concern for appearing to be offering medical advice without being a practicing physician.

James Sage, a Pfizer senior director, said ads are necessary because companies cannot sell prescription products directly to consumers. Such patient-targeted spots "motivate them to seek additional information ... consult their physicians ... and follow treatment plans," he said.

Although ads for both drugs were suspended, several Republicans agreed with the companies, saying commercials prompt patients to seek therapy for their high cholesterol, a widespread chronic condition that can cause heart disease.

Ranking Republican John Shimkus of Illinois said it was too soon for lawmakers to intervene, citing new FDA powers to crack down on drug ads that went into effect earlier this year.

"We gave the FDA power to act and we haven't really given them time to really impose civil fines on false and misleading ads," said Shimkus, noting ads by the four drugmakers ran before the agency could use its new tools.

Thursday's hearing comes a week before the FDA holds its own meeting on direct-to-consumer ads.

The FDA reviews print and television ads and can send warnings or impose fines for false or misleading claims. Staff is limited, however, and the agency cannot review all ads.

A report by the Government Accountability Office released at the hearing found the agency still does not have a system in place to prioritize materials that need FDA review or keep track of which ads it had already reviewed.

Kim Taylor, president of Johnson & Johnson's Ortho Biotech Inc unit, which makes Procrit, told lawmakers the company worked with the FDA to develop ads for its anemia therapy that were "true, responsible and substantiated by scientific studies."

The ads ran from 1998 to 2005. Among other uses, Procrit is approved to treat anemia in cancer patients receiving chemotherapy, but Stupak said commercials featuring healthy- looking, energetic patients did not reflect the reality cancer patients face, including hair-loss and fatigue.

(Additional reporting by Lisa Richwine, editing by Gerald E. McCormick; Editing by Andre Grenon)

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E-Mail Shows Racial Jokes by Secret Service Supervisors

WASHINGTON — Secret Service supervisors shared crude sexual jokes and engaged in racially derogatory banter about blacks, and passed around an anecdote about a possible assassination of the Rev. Jesse Jackson, according to internal e-mail disclosed in a federal court filing on Friday by lawyers for black Secret Service agents.

The filing includes 10 e-mail messages that were among documents the agency recently turned over to lawyers for the black agents as part of an increasingly bitter discrimination lawsuit. The messages were written mainly from 2003 through 2005, and were sent to and from e-mail accounts of at least 20 Secret Service supervisors.

The messages offer a glimpse into the darker recesses of an agency known for protecting presidents and other dignitaries but whose culture is regarded as one of the most insular in federal law enforcement.

The disclosure of the messages follows an incident last month in which a noose was found in a room used by a black instructor at a Secret Service training facility in Beltsville, Md. Agency officials said that episode was under internal investigation.

Eric Zahren, a spokesman for the Secret Service, said he would not comment directly on the e-mail but said the agency deplored racially insensitive jokes.

“We are deeply disappointed by any communication or action on the part of our employees that exhibits racial or other insensitivity,” Mr. Zahren said.

Mr. Zahren said the messages were the result of a search of 20 million electronic documents over 16 years. He said that an internal inquiry had been opened and that the inspector general at the Department of Homeland Security, which oversees the Secret Service, had been alerted.

In some of the court documents, the senders of the e-mail messages are identified only by the jobs they currently occupy and the rank they held when the messages were sent. For example, an Oct. 9, 2003, message referring to a “Harlem Spelling Bee,” ridiculing black slang, was sent by Thomas Grupski, then assistant director for protective operations, who, according to the filing, now heads the Office of Government Liaison and Public Affairs.

A March 3, 2003, message describing Mr. Jackson as the “Righteous Reverend” was passed among several Secret Service supervisors. The message, about a missile striking an airplane in which Mr. Jackson and his wife were traveling, concludes, it “certainly wouldn’t be a great loss and it probably wouldn’t be an accident either.”

Another message contains what one Secret Service official said was a joke referring to interracial sex. The joke circulated in February and March 2003. It was sent, according to the lawsuit, by Donald White, who heads the Presidential Protective Detail, to Kurt Douglass, an agent in charge of the Secret Service office in Cincinnati.

The legal skirmishing in the discrimination suit has heated up in recent months, with Magistrate Judge Deborah A. Robinson rebuking the Secret Service for failing to produce documents and for destroying relevant records and e-mail.

Judge Robinson had ordered the agency to turn over the documents by late March, but the e-mail disclosed in the court filing on Friday was not turned over to lawyers for the agents until late April.

E. Desmond Hogan, a lawyer for the black agents, said the agents were “shocked but not surprised by the late production of significant evidence of racism at high levels in the Secret Service.”

“The government’s delay,” Mr. Hogan said, “follows a pattern of the Secret Service stonewalling plaintiffs and ignoring court orders, depriving African-American agents of the fundamental evidence of race discrimination that is key to their claims.”

The lawsuit, which has dragged on through years of litigation, was filed in 2000 by 10 black agents who charged that they were unfairly denied promotions. The agency employs about 3,200 agents, about 10 percent of whom are black.

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