COUNTERING MILITARY RECRUITMENT
Articles: Military Service: Casualties
Army colonel draws fire for stress study
ALISON YOUNG, The Atlanta Journal-Constitution
September 3, 2007
Columbus — As a combat surgeon in Afghanistan, Col. Richard Gonzalez
earned a Bronze Star and Army accolades for his self-sacrifice.
Now Gonzalez is fighting to save his military career, accused of
discrediting his uniform as leader of a scientific study at Fort
Benning.
The Army has halted the study, which was examining the debilitating
impact of stress on recruits, and ordered results kept secret.
Gonzalez was demoted and is under investigation for arranging a
researcher's no-bid contract and conducting an unapproved study. The
Army is also looking into possible violations of consent and medical
privacy procedures.
But Army documents show the research board that first approved the
study — and is now investigating Gonzalez's team — shares blame for
miscommunications and mistakes.
The board did not explain study requirements or properly supervise
Gonzalez, a first-time researcher, an Army audit found. Nor did it
forward his proposal for a required command-level review. The board
even lost track of what study plan it had approved.
Shutting down the study may have violated soldiers' trust in more
fundamental ways. Each of the 330 recruits volunteered on the
promise that the project might save others from physical and mental
injuries. They spent hours sharing intimate details about the most
stressful events of their lives.
In the wake of the investigations, without Gonzalez's knowledge, the
Army removed the recruits' private files so it could turn his locked
study office into an employee break room.
While Gonzalez later found paper files in a "disheveled" state, the
Army wouldn't tell him where the study's computer was, records show.
The incident has raised serious questions among researchers about
whether intensely private details — such as recruits' accounts of
childhood abuse and molestation — have been disclosed.
Several Army commanders, citing ongoing investigations, declined
requests for interviews. An Army spokeswoman said the files and
computer are secure.
While blame is heaped upon Gonzalez, others are avoiding
responsibility, a researcher said.
"We're the fall guys," said Roger Bannon, a retired Army major and
Gonzalez's study manager until he was fired in July.
"The easiest thing for them to do," Bannon said, "is to pick the
weakest target at the lowest level and that's Colonel Gonzalez and
me."
Proposal impressed CDC
Many thought the study held great promise when Gonzalez pitched it.
The idea drew support from top scientists at the Centers for Disease
Control and Prevention and won $250,000 in an Army research
competition.
"Dr. Gonzalez' study is one of the best organized [conceptually and
operationally] that I have been privileged to collaborate on," the
CDC's Dr. William Reeves wrote this summer to Gonzalez's commanders.
In Afghanistan, Gonzalez had seen constant fatigue among soldiers.
He saw the same fatigue among recruits when he returned to Fort
Benning, he said last fall in an Atlanta Journal-Constitutio n
interview.
"I wanted to look at soldiers from the beginning, wondering about
stress-related problems," he said. Gonzalez wondered whether he
could predict which soldiers would break down from injuries, fatigue
or post-traumatic stress disorder.
Up to 15 percent of recruits don't complete basic training, a
problem as the Army struggles with enlistment goals. And veterans
are grappling with high rates of PTSD.
Gonzalez's commander named Bannon as his study manager, even though
Bannon also had no research experience. Reeves and his CDC team
joined the project after the researchers came across his work on the
role stress plays in chronic fatigue and Gulf War syndrome. CDC
declined interview requests.
All seemed well after the study began last September. But an Oct. 16
feature article in the Army Times sparked a cascade of questions
from the Army's surgeon general and others who had been unaware of
the project, e-mails show.
It turned out the Army had never fully approved the study. An Army
institutional review board in Augusta had signed off on the proposal
but failed to forward it for a required higher-level approval,
records show. Institutional review boards scrutinize plans for a
study to ensure rules are followed and research subjects are
protected.
IRB approval is usually all that's required in the civilian world.
The Army requires a second approval to protect soldiers from being
coerced into research. The study later got that second approval, but
researchers hit a new snag in May. An Army research expert
discovered Gonzalez's team had taken blood samples before recruits
signed consent forms. Fort Benning, as part of a mandatory intake
process, already takes blood from every recruit. The researchers had
them collect a little extra for their study.
Researchers only analyzed the blood if a soldier later signed a
consent form. But the adviser said consent must be obtained before
blood is taken. In the civilian world, this is not a major breach
because the blood was not tested without consent, bioethicists
said. "It doesn't constitute research at that point," said David
Magnus, director of the Stanford Center for Biomedical Ethics.
The IRB and the higher-level review office hadn't caught the problem
because the researchers said consent would be obtained prior to any
study procedures, Army officials said in a statement.
Richard Topolski, an Augusta State University professor and member
of the research team, said in hindsight the study's protocol was not
clear. But there was no intent to mislead, said Topolski.
Researchers wanted to eliminate the minor risk of a second needle-
stick, he said.
Contract scrutinized
Still, e-mails show the second phase of the study involving 1,200
recruits seemed to be on track for a June 20 launch, when the
commander of Fort Benning's hospital abruptly halted the project May
30.
Col. Margaret Rivera ordered Gonzalez and Bannon to report on their
preliminary findings and provide a financial audit and a copy of
Bannon's contract. Bannon retired May 1 from the Army but continued
work under a $72,000 contract.
With no experience with contracting, Bannon said he and Gonzalez
relied heavily on Fort Benning procurement officials who told them
it would be OK to give a sole-source contract to a Virginia firm
that then hired Bannon.
"If they told me I wasn't allowed to do this, then I never would
have done that," said Bannon, an occupational therapist. But
Rivera's staff concluded the researchers began the study without
proper approval and had made misleading statements to get Bannon's
contract.
The Army canceled the contract and is considering legal action
against Bannon. Gonzalez, once the hospital's chief of warrior care
and chief of orthopedics, was demoted to staff doctor. Fort
Benning's commander, Maj. Gen. Walter Wojdakowski, on July 26
reprimanded Gonzalez, saying his actions "demonstrate a complete
lack of judgment and bring discredit upon you, your unit, and the
United States Army."
Gonzalez, who was touted by Army publicists in 2004 for volunteering
for an extra year in Afghanistan, is close to qualifying for
military retirement benefits. He sold his private surgery practice
and converted from a National Guard officer to active duty Army
while in Afghanistan. Bannon said he fears the Army is laying the
groundwork to discharge Gonzalez and leave him with nothing.
Christopher Yukins, a government contract law expert at George
Washington University, said departing government employees are
supposed to be briefed on rules for future employment. And he said
prudent contractors will often ask an incoming employee for an
ethics letter from the government saying a contract job is OK.
Neither happened, Bannon said.
Data remain unpublished
While Bannon and Gonzalez admit mistakes, an audit by the Army's
Clinical Investigation Regulatory Office in July also blamed the IRB
for not monitoring the study properly.
The audit also called for the Fort Benning data to be analyzed and
put to use if it will help soldiers. But the IRB continues to tell
the researchers they may not publish the data.
It's put CDC's scientists in a bind: They have a manuscript they
want to send to a journal and still want to continue the research.
Army officials would not say whether disciplinary action was taken
against the IRB or its chairman, Lt. Col. Joseph Wood.
"Any communication and procedural problems from the IRB have been
recognized and are corrected," the Army said.
Since June, Bannon has asked the Defense Department's inspector
general, the Government Accountability Office and U.S. Rep. Sanford
Bishop (D-Ga.) for an independent investigation.
So far, he said, nobody's taken up the probe.
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