How the VA failed to report bad providers who were still working - We Are The Mighty
MIGHTY TRENDING

How the VA failed to report bad providers who were still working

The U.S. Department of Veterans Affairs failed to report a number of medical providers, whose privileges were revoked, to national databases, according to a Nov. 27 report by the independent Government Accountability Office (GAO).


The GAO reviewed five of the VA’s 170 Medical Centers “after concerns were raised about their clinical care.” It found that VA officials did not report eight of nine doctors it found should have been reported.

The GAO report examined 148 providers from October 2013 to March 2017 and found that more than half didn’t provide documentation of reviews to the National Practitioner Data Bank or state licensing boards, as required by VHA policy. Also, the medical centers did not start the reviews of 16 providers for months to years “after the concerns were identified.”

Also read: It’s high time veterans have access to weed

“Depending on the findings from the review, VAMC officials may take an adverse privileging action against a provider that either limits the care a provider is allowed to deliver at the VAMC or prevents the provider from delivering care altogether,” the GAO report said.

How the VA failed to report bad providers who were still working
Marines, veterans, and care providers watch as the American flag is walked to the flagpole at the Carl T. Hayden VA Medical Center in Phoenix, AZ. (Photo by Sgt. Justin Boling)

At the five unidentified hospitals, providers weren’t reported because VA officials “misinterpreted or were not aware of VHA policies and guidance related to the NPDB and SLB reporting processes,” the report said.

“At one facility, we found that officials failed to report six providers to the NPDB because the officials were unaware that they had been delegated responsibility for NPDB reporting.”

Related: The VA might actually be getting its act together

The report found that two of four contract providers — whose privileges were revoked and were not reported — continued to provide outside care to veterans.

“One provider whose services were terminated related to patient abuse subsequently held privileges at another VAMC, while the other provider belongs to a network of providers that provides care for veterans in the community,” the report said.

Nearly 40,000 providers hold privileges in the centers.

How the VA failed to report bad providers who were still working
In the last few years, the VA is undergoing a string of reforms, aimed a ultimately providing better services to our nation’s veterans. (Photo courtesy of VA.)

GAO is making four recommendations for the Veterans Health Administration: To document reviews of providers’ clinical care after concerns are raised, develop timely requirements for reviews, to ensure proper oversight of such reviews, and perform timely reporting of providers.

The GAO said the VA agreed with its recommendations.

The Nov. 27 report is the latest in a string of reforms aimed in recent years at the Veterans Affairs Department.

In October, a USA Today investigation that found the VA had concealed medical mistakes and misconduct by health care workers.

After the newspaper report, Rep. Phil Roe, R- Tenn., chairman of the House Veterans Affairs Committee, asked GAO to investigate. A hearing on the findings is scheduled for Nov. 29.

In 2014, lawmakers spurred reform after it became known that some veterans had died while awaiting care at a medical center in Arizona.

Articles

Congresswoman gives the best description of flying the legendary A-10

“A badass airplane with a big gun on it.”


That’s how Republican Congresswoman Martha McSally described the A-10 Warthog to President Donald Trump, as she told the Center for Strategic and International Studies on Tuesday.

McSally, the first female fighter pilot and a veteran of Iraq and Afghanistan, told the crowd at the CSIS event about her experiences as an A-10 pilot laying down close air support for US troops during the 2000s.

“It’s an amazing airplane to fly, but it’s really cool to shoot the gun,” said McSally. “The folklore as A-10 pilots that we pass around is that we built the gun, and told the engineers ‘figure out how to fly this gun.'”

Related: The ‘Chopper Popper’ scored the A-10’s first air-to-air kill…against an Iraqi helicopter

“The gun, 30 millimeters is just amazing.” said McSally. “When you shoot the gun, the whole airplane shakes. The first time you shoot the gun, you think the airplane’s breaking up.”

Perhaps better known is the iconic “BRRRT” sound of the A-10’s 30 mm, 1,174 round gun as heard from the ground, a sound that US infantrymen have come to equate with salvation and safety.

How the VA failed to report bad providers who were still working
The GAU-8/A Avenger Gatling gun next to a VW Type 1. Removing an installed GAU-8 from an A-10 requires first installing a jack under the aircraft’s tail to prevent it from tipping, as the cannon makes up most of the aircraft’s forward weight. | US Air Force photo

In practice, the A-10’s gun is actually more precise than even the newest, most accurate GPS or laser-guided bombs, which can often cost up to a million dollars each.

“In Afghanistan … we used mostly the gun,” said McSally, “It’s a very precise weapon and it allows for minimizing collateral damage and fratricide because the weapon’s footprint is so tight. We can roll in and precisely go after the target while it keeps Americans safe.”

MIGHTY SURVIVAL

The Chinese military’s exploitation of the coronavirus pandemic

In Davos in 2017, Xi Jinping painted a vision of a China-led globalist world. The Chinese Communist Party’s handling of the COVID-19 pandemic gives us a taste of Chinese global leadership: it includes a breathtaking degree to which other nations, desperate for transparency and reciprocity in the form of detailed information and medical supplies, have been left in a lurch, and therefore vulnerable to Chinese coercion. This is not an opportunity for cooperation with China. This is not a moment for a reprieve in America’s competition against the communist regime; it is a harrowing foreshadowing of what is at stake if we lose.

Competition with China spans the spheres of economics and diplomacy, but undergirding the entire effort is American hard power. It is our military, both our military capabilities as well as our willingness to employ them, that keeps Chinese territorial expansion at bay. And even during a global pandemic of Beijing’s making, Beijing’s military has been very busy. It is why the United States must follow through with the Pentagon’s plans to recapitalize our strategic deterrent and other military plans meant to deter Chinese aggression.


How the VA failed to report bad providers who were still working

The COVID-19 pandemic has prompted the United States and its partners to pause wargaming exercises that are meant to reassure allies and bolster readiness to protect the health of its military members. In contrast, China has not slowed down provocative, offensive military maneuvers. Beijing just days ago conducted naval drills near Taiwan’s shores, has continued to buzz Taiwan’s airspace, it sank a Vietnamese fishing vessel in international waters, and according to State Department spokesperson Morgan Ortagus, the Chinese government has continued to make developments on military bases China built on reefs and islands on which it erroneously claims sovereignty.

Defense officials have repeatedly warned that the first island chain is vulnerable to Chinese aggression. Nested in that first island chain are Taiwan and Japan, valuable allies, and who will be critical allies in the U.S. effort to weaken China’s leverage and expose its malign behavior. They are among others in the larger Indo-Pacific region to include India and Australia that will anchor our cooperative efforts to defend national sovereignty against CCP authoritarianism.

Defense Secretary Mark Esper has said the Pentagon is committed to mission readiness during the pandemic. He also told Congress in February that the “highest priority remains China, as its government continues to use — and misuse — its diplomatic, economic and military strength to attempt to alter the landscape of power and reshape the world in its favor, often at the expense of others.”

While deterring China and assuring allies entails much more than our strategic deterrent, the cornerstone for deterring military aggression of the worst kind is our nuclear arsenal. The nuclear modernization strategy laid out in the Trump Nuclear Posture Review must continue to move forward on time, and the COVID-19 pandemic cannot be a pretext for delays.

The cost of the entire nuclear enterprise is roughly 5 percent of all national security spending devoted to the recapitalization, sustainment, and operations. The Obama administration began the modernization effort, and the Trump administration has determined to carry it through while adapting it based on the actions of China as well as Russia.

Defense officials have warned that in addition to Russia, China presents formidable nuclear challenges, and the trends are not headed in the right direction. Although China refuses to be transparent about its nuclear program, the United States knows China has significant capabilities that leverage cutting edge technology and assesses China is likely to at least double the size of its nuclear arsenal by the end of the decade. Additionally, China’s nuclear weapons are central to China’s military plans and intentions.

Despite the significant continuity between administrations about nuclear modernization, there will be efforts to cancel or delay some components of the force, and dealing with pandemics will be used as a pretext. For years, ideologically motivated groups have focused on the intercontinental ballistic missiles, or “land-based leg” of the triad, specifically, as an opportunity to find financial savings. Some have argued against eliminating the leg altogether while some argue it makes more sense to continue to extend the life of the current fleet, the old Minuteman IIIs with Cold War era technologies, rather than pursue its replacement called the Ground-based Strategic Deterrent (GBSD). But military leaders have repeatedly warned that the decades’ old Minuteman IIIs would have trouble penetrating future air defenses, and the cost to pursue GBSD will not be more expensive than another life extension program that would leave the United States underprepared. Now is not the time to delay the next generation of our nuclear weapons.

Conventional weapons are also necessary to deter Chinese aggression. Remember, the aim is to deter the aggression in the first place, rather than respond once China decides to act on its malign intention to attack U.S. bases or territory of a sovereign nation. The United States can do this if it convinces Beijing it has the will and capability to retaliate defensively in response to an offensive act of aggression such that Beijing will regret the decision.

How the VA failed to report bad providers who were still working

So, in addition to the nuclear program, there are meaningful changes underway. For example, the U.S. Marine Corps is focused on deploying a force in the Indo Pacific theater in cooperation with our allies, which is inside the range of China’s massive missile force. This force would be so formidable and with so many targets distributed throughout the region that it allows the U.S. military a high degree of resiliency. The USMC also wants offensive long-range missiles, drones, and rocket artillery, and lots of them. Notable, now that President Trump withdrew from the dated INF Treaty due to Russian cheating, the USMC can have the range of missiles it needs. The United States will also need a mix of defensive systems with the ability to intercept the first rounds of missile attacks to preserve the U.S. ability to respond and with more options at its disposal. This offense-defense mix that includes passive and active defenses will complicate Beijing’s calculations and will dissuade an initial move and preserve peace.

The current COVID-19 pandemic will impact all areas of the U.S. government and reshuffle initiatives and divide attention. But it’s vital to appreciate the severity of China’s actions, that China is the cause of this historic crisis, and that its military is exploiting it to gain an advantage over the United States in the near and long term. The United States must work to ensure they fail.

This article originally appeared on Real Clear Defense. Follow @RCDefense on Twitter.

MIGHTY TRENDING

The VA just expanded private care with a $5 billion spending bill

President Donald Trump signed a landmark bill on June 6, 2018, to replace the troubled Veterans Choice Program and expand private health care options amid a fight between the White House and Congress over how to pay for it.

The bill, the VA Mission Act, would also expand caregivers assistance to the families of disabled veterans and order an inventory of the Department of Veterans Affairs‘ more than 1,100 facilities with a long-term view to trimming excess.


“This is a very big day,” said Trump, who made veterans care one of the signature issues of his run for the White House. “All during the campaign, I’d say, ‘Why can’t they just go out and see a doctor instead of standing on line?’

“This is truly a historic moment, a historic time for our country,” he continued, before signing the bill at a White House Rose Garden ceremony. “We’re allowing our veterans to get access to the best medical care available, whether it’s at the VA or at a private provider.”

In his remarks, Trump did not mention that funds to pay for the bill have yet to be identified, or that the White House and Congress are at odds on funding mechanisms. The bill’s projected costs over five years are also in dispute.

At a Senate news conference in May 2018, Sen. Johnny Isakson, R-Georgia, chairman of the Senate Veterans Affairs Committee and a key sponsor of the bill, and Sen. Jon Tester, the ranking member of the committee, put the total costs at $55 billion, although other estimates have it at $52 billion.

How the VA failed to report bad providers who were still working
Sen. Johnny Isakson

Isakson acknowledged that the bill isn’t paid for but said he is working with Sen. Richard Shelby, R-Alabama, chairman of the Senate Appropriations Committee, to add funding for the bill that would likely balloon the deficit. The White House has argued for funding the bill by cutting other programs.

A White House memo obtained by The Washington Post said that simply adding funding is “anathema to responsible spending” and would lead to “virtually unlimited increases” in spending on private health care for veterans.

Shelby said on June 5, 2018, that going along with the White House would result in cuts of $10 billion a year to existing programs, including some at the VA.

“If we don’t get on it, we’re going to have a hole of $10 billion in our [appropriations],” said Shelby, who predicted “some real trouble” in reaching agreement, according to a Washington Post report.

Critics of the bill have warned that over-reliance on private-care options could lead to the “privatization” of VA health care, but Trump said, “If the VA can’t meet the needs of the veteran in a timely manner, that veteran will have the right to go right outside to a private doctor. It’s so simple and yet so complicated.”

In his remarks at the ceremony of less than 20 minutes, Trump also noted that it was the 74th anniversary of the D-Day landings in Normandy when U.S. troops “stormed into hell.”

How the VA failed to report bad providers who were still working
A LCVP (Landing Craft, Vehicle, Personnel) from the U.S. Coast Guard-manned USS Samuel Chase disembarks troops of Company E, 16th Infantry, 1st Infantry Division wading onto the Fox Green section of Omaha Beach on the morning of June 6, 1944.

“They put everything on the line for us,” he said and, like all veterans, “when they come home, we must do everything that we can possibly do for them, and that’s what we’re doing.”

The issue of funding has plagued the existing Veterans Choice Program since it was enacted in response to the wait-times scandals of 2014 in which VA officials were caught doctoring records to show better performance.

The Choice program allowed veterans who lived more than 40 miles from a VA facility or had to wait more than 30 days for an appointment to have access to private care, but the program was time limited and Congress has struggled to come up with money for extensions.

The program was again due to run out of funding May 31, 2018, but the VA said there was enough money remaining to keep it in operation until Trump signed the VA Mission Act.

The new bill called for $5.2 billion in funding to keep the existing Choice program in operation for a year while the VA worked through reforms to consolidate the seven private-care options into one system while eliminating the 30-day, 40-mile restrictions.

However, a Government Accountability Office report on the Veterans Choice Program released June 4, 2018, cast doubt on the VA’s ability to implement the reforms called for under the VA Mission Act.

The GAO said veterans could wait up to 70 days for private-care appointments under the Choice program because of poor communication between the VA and its facilities and “an insufficient number, mix, or geographic distribution of community providers.”

Trump touts ridding VA of corruption, poor performers

Ahead of the signing ceremony, the White House put out a statement citing Trump’s accomplishments in his first 500 days in office. Veterans programs topped the list.

Trump “worked with Congress to forge an overwhelming bipartisan vote of support” for the VA Mission Act, the statement said. The vote in the House was 347-70; the Senate vote was 92-5.

The VA Mission Act and other veterans legislation will “bring more accountability to the Department of Veterans Affairs and provide our veterans with more choice in the care they receive,” the White House statement said.

In his remarks, Trump hailed passage of the VA Accountability Act, which is aimed at getting rid of poor performers, and lashed out at civil service unions for opposing reform.

“Four years ago, our entire nation was shocked and outraged by stories of the VA system plagued by neglect, abuse, fraud and mistreatment of our veterans,” he said in a reference to the wait-times scandals.

How the VA failed to report bad providers who were still working
World War II veteran, Sgt. Maj. Raymond Sylvester.
(Photo by Staff Sgt. Felix Fimbres)

“And there was nothing they could do about it. Good people that worked there, they couldn’t take care of the bad people — meaning ‘You’re fired, get the hell out of here,’ ” Trump said.

More accountability “made so much sense but it was hard,” he said. “You have civil service, you have unions. Of course, they’d never do anything to stop anything, but they had a very great deal of power.

“So we passed something that hasn’t been that recognized, and yet I would put it almost in the class with Choice. Almost in the class with Choice. VA Accountability — passed. And now, if people don’t do a great job, they can’t work with our vets anymore. They’re gone,” Trump said.

The VA has more than 360,000 employees serving the health care needs of about nine million veterans annually. Most of them are represented by the American Federation of Government Employees, which opposed the VA Mission Act.

The AFGE said that the act amounts to “opening the door to privatization of the country’s largest health care system.”

The major veterans service organizations (VSOs) also initially feared privatization but came round to backing the VA Mission Act as a catalyst for improving care while preserving the VA’s role as the main provider of health care.

In a statement after the signing ceremony, Keith Harman, national commander of the 1.7 million-member Veterans of Foreign Wars, said, “The VFW and other veterans service organizations worked closely with Congress and the White House to help create a carefully negotiated bipartisan deal with the fingerprints of veterans who rely on the VA all over it.”

Bill also addresses caregivers, excess VA facilities

In addition to expanding private-care options, the bill would also address long-time concerns of the VSOs on the restrictions in the current program to provide small stipends to family members who care for severely disabled veterans.

The program has been limited to post-9/11 veterans, but the bill was aimed at expanding caregivers assistance over two years to veterans of all eras.

Advocates had argued that caregivers assistance saves the VA money by allowing disabled veterans to remain at home rather than relying on more expensive in-patient treatment.

“The more veterans and their caregivers who are eligible for support, the closer we are to fulfilling our promise to care for those who’ve sacrificed so much on our behalf,” Sen. Patty Murray, D-Washington, a chief sponsor, said in a statement.

The Congressional Budget Office has estimated that more than 41,000 caregivers could be added to the rolls under the new bill over the next five years at a cost of nearly $7 billion.

How the VA failed to report bad providers who were still working
Omaha VA Medical Center

In reference to the caregivers section of the bill, Trump said, “If you wore that uniform, if at some point you work that uniform, you deserve the absolute best and that’s what we’re doing.”

In a statement, Delphine Metcalf-Foster, national commander of the Disabled American Veterans and herself a former caregiver to her late husband, said in a statement:

“This new law will not only extend support to thousands more deserving family caregivers that severely injured veterans rely on, but also make a number of reforms and improvements to strengthen the VA health care system and improve veterans’ access to care.”

The bill also ordered up a VA asset review in which the president would set up a nine-member Asset and Infrastructure Review (AIR) Commission, with representatives from VSOs, the health care industry, and federal facility managers.

Opponents have likened the commission to the Base Realignment and Closure Commission (BRAC) at the Pentagon on the hot-button issue of base closings.

The panel would meet in 2022 and 2023 to issue recommendations on “the modernization or realignment of Veterans Health Administration facilities.”

At a Senate news conference in May 2018, Carlos Fuentes, the VFW’s National Legislative Services director, said comparing AIR to BRAC is misleading.

“Under BRAC, DoD moves its assets, including service members and their families. VA can’t force veterans to move,” Fuentes said.

At a panel discussion last month in the House, Rep. Phil Roe, R-Tennessee, chairman of the House Veterans Affairs Committee, said that the average age of a building at the VA is more than 50 years.

He said the VA has more than 6,000 buildings in its inventory, and about 1,100 “are not even utilized. So we’re paying millions of dollars to keep up empty buildings — makes no sense.”

This article originally appeared on Military.com. Follow @military.com on Twitter.

MIGHTY CULTURE

7 acronyms the military should use, but doesn’t

It’s no secret the military is full of soup. Even an FNG could tell you that. There are even more specific alphabet soup acronyms within each branch: the Air Force has OTP, and the Marines have OSM (semi-respectively).

Here’s a couple of acronyms we made up that aren’t in use, but should be.


S.R.O.O.R.T

“Sergeant ran out of real tasks.”

This acronym is used to explain why you are: measuring the length of floor tiles, power washing a lawn chair, or cleaning an actual pile of garbage with Windex. We don’t ask why. We know.

Example: I know we’re outside in the desert, but S.R.O.O.R.T. so now we all have to sweep the dirt.

How the VA failed to report bad providers who were still working

Images From The Korengal Outpost – The Far Side.

O.D.T.W.O.D.

“Only dipping tobacco while on deployment.”

This acronym is the lie you tell yourself while on deployment. It soon warps into the closely related acronym “O.D.T.B.O.D.” which is “Only dipping tobacco because of deployment.”

Example: Yeah, I never used to chew Cope, but I’m O.D.T.W.O.D.

G.P.O.G.

“Good piece of gear.”

This acronym is used to describe a fully functional piece of gear in the military.

Example: *N/A, no plausible use*

How the VA failed to report bad providers who were still working

“Dinner” aboard the USS Green Bay.

(Sgt. Branden Colston/ USMC)

W.D.I.E.G.A.F

“Why did I even grab a fork?”

This acronym is used to describe the fine delicatessen cuisine service members enjoy on a ship. It’s food so sparse, so understated, so daringly simple, it begs the question: why did I even grab a fork?”

Example: Welcome aboard, today we will be serving delectable items from the W.D.I.E.G.A.F. cuisine: our first course is a handful of hard white rice, followed by two triangles of cardboard garlic bread, accented with a chalice of warm water. Served sea side. Bon Appetit.

N.O.E.F.B.O.F.A.C

“Not old enough for beer, only for armed combat.”

This is a much needed acronym for the millions of 18-to 21-year-olds in our military who cannot legally buy beer but can legally be trusted with billions of dollars of equipment and the lives of men who are old enough to buy beer. Granted, this one doesn’t really roll off the tongue—but neither does explaining the ancient logic behind this law.

Example: I’ll take an automatic rifle, a crate of C-4 explosives, and a Shirley Temple to drink, sorry I’m N.O.E.F.B.O.F.A.C.

How the VA failed to report bad providers who were still working

Y.M.C.A

“You make comm awful.”

This is for anybody who never shuts the hell up over comm. They add useless information, make bad jokes, clog up the line, and all kinds of other annoying things.

Example: You don’t have to mouth breath for 3 seconds before saying what you need to say. Y.M.C.A. Over.

B.O.O.B.S

“Boy, our operation’s boring, Sgt.”

Sometimes you have said all you need to say. You’ve been in a foreign place with the same 6 dudes for months. You can only talk about how bad the Cleveland Browns are, or what kind of food you wish you could eat, for so long… Sometimes, when you’ve been away for months and don’t have anything to talk about, you just talk about B.O.O.B.S.

Example: …Ahem…*idle whistling*….*clearing throat cough*…B.O.O.B.S…

Articles

This is why it’s better to be shot by an AK-47 than an M4

Admittedly, I’d rather not be shot with either, but if I had to choose, I’d take a round from the AK47 over the M4 any day of the week. To understand why, it’s important to have a very basic look at the physics behind terminal ballistics, in this case being the science of what happens when a penetrating missile enters a human body. The first place to start is the Kinetic Energy Equation:


KE = ½ M (V12 – V22)

Breaking this equation down into its components, we have Kinetic Energy (KE) influenced by the Mass (M) of the penetrating missile, as well as the Velocity (V) of the missile. This make sense, and it is logical that a heavier, faster missile is going to do more damage than a lighter, slower missile. What is important to understand is the relative influence that Mass and Velocity have on Kinetic Energy, as this is key to understanding why I’d rather be shot by an AK than an M4.

You’ll notice that the Mass component of the KE equation is halved, whereas the Velocity component is squared.

For this reason, it is the Velocity of the projectile that has far more bearing on the energy that it dissipates into the target than the mass.

How the VA failed to report bad providers who were still working
Bang. (U.S. Air Force photo by Staff Sgt. Levi Riendeau)

The V1-V2 component of the equation takes into consideration that the projectile might actually pass straight through the target, rather than coming to rest in the target. In this instance, the change in the Velocity of the projectile as it passes through the target (V1 being its velocity as it enters, and V2 being velocity on exit) is the factor that is considered when calculating how much energy the missile delivered into the target.

Naturally if the projectile comes to rest in the target (ie: no exit wound) then V2 equals zero and the projectile’s velocity as it entered (V1) is used to calculate the KE.

That’s enough physics for now, but you get the concept that the optimum projectile to shoot someone with is one that has a decent mass, is very, very fast, and is guaranteed to come to rest in your target, as to dissipate as much energy as possible into them, and hence do maximal damage.

How the VA failed to report bad providers who were still working
M4 Carbine. (U.S. Air Force photo)

The next concept to grasp is that of permanent cavitation versus temporary cavitation. Permanent cavitation is the hole that gets left in a target from a projectile punching through it. You can think of it simply like a sharp stick being pushed through a target and leaving a hole the diameter of the stick. The permanent cavity left by a bullet is proportionate to the surface area of the bullet as it passes through the tissue.

For instance, if an AK47 round of 7.62mm diameter at its widest point passes cleanly through a target, it will leave a round 7.62mm hole (permanent cavity). If this hole goes through a vital structure in the body, then the wound can be fatal. However, if the bullet passes through soft tissues only, then the permanent cavity can be relatively benign.

This is a slight oversimplification of the concept, as bullets will rarely remain dead straight as they pass through human bodies, as they have a tendency to destabilize, and the heavier back-end of the bullet will want to overtake the front.

This concept, known as yaw, increases the frontal surface area of the bullet as it passes through tissue, and hence creates a larger permanent cavity.

How the VA failed to report bad providers who were still working
(U.S. Marine Corps photo)

Far more damaging than the permanent cavity left by a projectile is the temporary cavity that it creates. Anyone who has ever watched the TV show MythBusters will have some familiarity with this concept, and it is best demonstrated using slow motion video imagery of bullets being shot into special jelly known as ballistic gelatin, which is calibrated to be the same density as human soft tissues.

What can be seen in these video images (below) is the pulsating dissipation of energy that emanates out from a bullet as it passes through the gelatin.

Also read: This is perhaps the fastest shotgun in the world

This is a visual illustration of the concept of temporary cavitation, and it allows the viewer to begin to appreciate the devastating effect that a high velocity missile can have once it enters a human body. The temporary cavitation is the transfer of Kinetic Energy from the projectile into the tissues of the target, and as we learned above, is relative to the mass and, more importantly, the velocity of the projectile.

As the energy of the projectile is dissipated into the tissues of the target the temporary cavitation pulverizes structures adjacent to the bullet’s tract, including blood vessels, nerves, muscles, and any solid organs that may be in close proximity.

For that reason the high velocity projectile does not need to pass directly through a structure in the body to destroy it. The higher the Kinetic Energy of the projectile the further out from the permanent cavity the temporary cavity extends.

Below is a slow motion video of a 5.56x45mm round (same as the M4 fires) hitting ballistic gelatine in slow motion. After watching, the medical provider can begin to appreciate the damage that gets done to tissues by the pressure wave of the temporary cavitation.

https://www.youtube.com/watch?v=HRbAfdoU9vY

(Brass Fetcher | YouTube)

Another characteristic of the M4 round is the tendency for the bullet to disintegrate if it strikes tissue at a decent velocity. Despite being a jacketed round, owing to it being smaller, lighter, and faster than an AK47 projectile, it tends to yaw faster once it hits tissue and the shearing forces on the bullet once it is traveling at 90 degrees through the tissue often tears the bullet into pieces, thus creating multiple smaller projectiles and increasing the chances of all of the bullet parts remaining in the target, and hence dissipating more energy.

The AK47 round, being slightly heavier and slower than the M4 round will have a tendency to remain intact as it strikes tissue, and whilst it will penetrate deeper, it tends to remain intact and not yaw until it has penetrated much deeper than the M4.

More: This Marine tweaked his body armor to instantly treat a gunshot wound

The video below shows a soft point round being used, which theoretically should be more destructive than its full metal jacket counterpart, the video still illustrates nicely the significant penetration of the AK47 round without it yawing significantly or disintegrating.

I once saw a good case study illustrating this point nicely where a casualty had sustained an AK47 gunshot wound to the right lateral thigh and we recovered the intact bullet from the inside of his left upper abdominal wall. It had passed through approximately 1 metre of his tissues and shredded his small bowel, but the projectile hadn’t fragmented at all, and the temporary cavitation hadn’t done enough damage to be lethal. The casualty required a laparotomy to remove multiple sections of small intestine, but made a good recovery. That one is a story for another time.

(The Ammo Channel | YouTube)

Although an unpleasant injury to have, the fact that the AK47 round was travelling slower than an M4 at the same range would have been, coupled with the fact that the projectile remained intact and didn’t yaw significantly as in passed through him, meant the wound was nowhere near as devastating as the above-mentioned M4 injury in the same area.

It must be noted however that the comparison is far from perfect given that the M4 injury involved the bone, with the one immediately above passing solely through soft tissues.

So there it is, all things being equal, when all is said and done I’d rather be shot with an AK47 than an M4 on any day of the week. Naturally, as medical responders, it is always important to treat the wound and not the rifle that inflicted it, and I have certainly seen some horrendous AK47 wounds over the years and some relatively minor ones from M4s, so it all depends.

The main take home points for medicos are to be aware of the magnitude of damage that can be caused by the temporary cavitation resulting from high velocity missile wounds, and also if you find an entrance wound, there’s no telling where in the body the projectile might have ended up!

MIGHTY TRENDING

Watch the Royal Navy blow up a WWII-era bomb at sea

An unexploded World War II bomb that forced a London Airport to close was detonated at sea by the Royal Navy on Feb. 14, 2018.


The 500-kilogram, 1.5-meter-long tapered-end shell was blown up with high-grade military detonators off the coast of Essex, where the bomb was transported.

The explosion took place around midday. The navy released video footage of its bomb disposal experts blowing up the device with high-grade military detonators.

 

The device was first discovered buried in dense silt on Feb. 11, 2018 near London City Airport’s runway, located by the River Thames.

Also read: The world’s most expensive bomber traces its roots to World War II

The airport closed that night and all of Feb. 12, 2018 so Royal Navy bomb disposal experts could remove the device.

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A Royal Navy bomb disposal team return to the shore after destroying the bomb. (Crown Copyright)

Divers removed the ordnance with a lifting bag on Feb. 12, dragged it down the Thames overnight, and took it to Shoeburyness, a coastal town 60 kilometers east of the bomb’s original location.

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Royal Navy bomb disposal experts return after detonating the device. (Crown Copyright)

The area where London City Airport stands used to be an industrial center, and it came under heavy bombardment from German planes during the war. Unexploded bombs still occasionally turn up during construction work.

MIGHTY SPORTS

Korean War vet honored at Steelers football game

Korean War veteran Ed Portka, 90, was honored along with his stepson as the Pittsburgh Steelers hosted the Cincinnati Bengals on national television.

Former Maj. David Reeser, who commanded an Army diving company in Europe 28 years ago, accompanied his stepfather, a former first lieutenant, onto the field for the Steelers’ “Salute Our Heroes” recognition during a short break following the third quarter of the game.

“I’m excited about it,” Portka said about his upcoming recognition, just before the game, offering that he was “looking forward to it,” but a little hesitant.


Portka served as a platoon leader in an engineer unit under the 1st Cavalry Division in Korea. He was responsible for breaching minefields and other obstacles during offensive operations and installing minefields to protect U.S. defensive positions.

“We did a lot of dirty work,” Portka said. “It was specialized work.”

He said every chance they got, they detonated mines by firing their M-1 rifles at them rather than risking lives.

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Second Lt. Ed Portka, prior to deploying to Korea with an engineering unit under the 1st Cavalry Division, where he was responsible for breaching minefields.

(U.S. Army photo)

Portka served in Korea from 1952-53. One of his memories was of meeting Gen. Matthew Ridgway, 8th Army commander, during a battlefield circulation, just after Portka’s platoon finished clearing a minefield near Pusan, Korea.

“He was down-to-earth,” Portka said of Ridgway.

The Korean War armistice agreement was signed on Portka’s 24th birthday, July 27, 1953, just before he redeployed home. He said it was quite a birthday present.

After the war, Portka was an architectural draftsman with George M. Ewing Company in Washington, D.C. He later managed the firm’s Philadelphia office and was the project manager for the design of Veterans Stadium, home of the Philadelphia Eagles.

Reeser was stationed in Europe in the early 1990s, where he served as a platoon Leader and then as commander of a diving detachment. After leaving the military, he founded an engineering firm, Infrastructure Engineers, that performs underwater bridge inspections.

Reeser now lives in Florida and his stepfather in Atlanta, but said he returns to Pittsburgh every chance he gets to take his stepfather to Steeler games.

At the end of their recognition on the field, both veterans aggressively waved Pittsburgh Steeler “terrible towels.” The Steelers beat the Bengals 27-3.

This article originally appeared on United States Army. Follow @USArmy on Twitter.

MIGHTY TRENDING

Gunmen assault Afghan spy facility in Kabul

Gunmen have launched an attack on an Afghan intelligence training center in Kabul, officials say.

Police officer Abdul Rahman said on Aug. 16, 2018, that the attackers were holed up in a building near the compound overseen by the National Security Directorate in a western neighborhood of the Afghan capital.

He said the gunmen were shooting at the facility and it wasn’t immediately clear how many gunmen were involved in the assault.


Kabul police spokesman Hashmat Stanekzai said the attackers were firing rocket-propelled grenades and other weapons.

Interior Ministry spokesman Nasrat Rahimi later said three or four attackers took part in the assault and two of them were killed.

He said Afghan forces had cleared the building from the basement all to the fourth floor and were battling gunmen on the fifth floor during the early evening.

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A rocket-propelled grenade (on the left) and RPG-7 launcher. For use, the thinner cylinder part of the rocket-propelled grenade is inserted into the muzzle of the launcher.

There was no immediate word on the number of casualties among civilians and security forces nor any immediate claim of responsibility, which comes a day after a suicide bombing in a Shi’ite area of Kabul killed 34 people and wounded 56 others.

The Islamic State (IS) extremist group on Aug. 16, 2018, claimed responsibility for the bombing.

Afghanistan’s Western-backed government has been struggling to fend off the Taliban, the Islamic State, and other militant groups since the withdrawal of most NATO troops in 2014.

This article originally appeared on Radio Free Europe/Radio Liberty. Follow @RFERL on Twitter.

Articles

A deceased veteran was reportedly abandoned in shower for 9 hours

Staff at the Bay Pines Veterans Healthcare System left a deceased veteran in a shower room for over nine hours, increasing the risk of decomposition.


That is among the findings of a 24-page report issued by investigators into the incident, news outlets say.

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According to reports from the Tampa Bay Times and Fox13News.com, documentation concerning the post-mortem care was falsified to cover up the incident.

The report, heavily redacted by the Department of Veterans Affairs due to confidentiality rules, revealed massive failures in the incident.

Hospital spokesman Jason Dangel told the Tampa Bay Times “appropriate personnel action was taken” in addition to carrying out a combination of retraining staff and changing procedures. The report, while heavily redacted to protect the confidentiality of the staff who allegedy left the deceased veteran lying around for nine hours, did list the procedures that should have been followed.

How the VA failed to report bad providers who were still working
(Photo: VA)

In a lengthier statement released to Fox13news.com, an unidentified spokesperson with the VA hospital noted, “As reflected in the outcomes of our thorough internal reviews, it was found that some staff did not follow post mortem care procedures. We view this finding unacceptable, and have taken appropriate action to mitigate reoccurrence in the future.”

The staff will be retained, sign a written commitment to maintain VA core values and nurses will be on staff to make sure the procedures are followed, the official said.

“We feel that we have taken strong, appropriate and expeditious steps to strengthen and improve our existing systems and processes within the unit,” the official said.

In a stinging statement on the incident also delivered to Fox13news.com, Florida Republican Rep. Gus Bilirakis said, “I am deeply disturbed by the incident that occurred at the Bay Pines VA hospital, and even more distressed to learn that staff attempted to cover it up. The report details a total failure on the part of the Department of Veterans’ Affairs and an urgent need for greater accountability.”

“Unsurprisingly, not a single VA employee has been fired following this incident, despite a clear lack of concern and respect for the Veteran,” Bilirakis added. “The men and women who sacrificed on behalf of our nation deserve better.”

MIGHTY TRENDING

Russian destroyer sails into the line of fire during shooting drills

During a US and Ukrainian-led multinational maritime exercise, a Russian destroyer created a “dangerous situation” by sailing into an area restricted for live-fire drills, the Ukrainian Navy said in an statement.

On July 10, 2019, the Russian Kashin-class guided-missile destroyer Smetlivy purposefully sailed into an area reserved for naval gunfire exercises, part of the latest iteration of Exercise Sea Breeze, the Ukrainian Navy said in a Facebook post.


“The Russian Federation once again showed its true face and provoked an emergency situation in the Black Sea, ignoring international maritime law,” the post explains, according to a translation by Ukrainian media.

The Ukrainian frigate Hetman Sahaydachniy attempted to communicate with the Russian ship, but the latter is said to have feigned communication problems.

The Russian military, which has been conducting drills in the same area, says that the Ukrainian Navy is lying.

“The Ukrainian Navy’s claim that the Black Sea Fleet’s Smetlivy patrol vessel has allegedly entered a closed zone where Sea Breeze-2019 drills are held is not true,” Russia’s Black Sea Fleet said in a statement carried by Russian media. “Smetlivy acts in strict compliance with the international law.”

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Russian Kashin-class guided-missile destroyer Smetlivy.

A US Navy spokesman told Defense One that the Russian ship was present but declined to offer any specific details on the incident. “The presence of the Russian ship had no impact to the exercise yesterday and all evolutions were conducted as scheduled,” Lt. Bobby Dixon, a spokesman for the US Navy’s 6th Fleet, told the outlet.

He added, without elaborating, that “it can be ill-advised to enter an area given the safety hazard identified in a Notice to Mariners.”

The 19th iteration of Exercise Sea Breeze began on July 1, 2019, and will conclude July 19, 2019. The drills involved around 3,000 troops, as well as 32 ships and 24 aircraft, from 19 different countries and focused on a variety of training areas, including maritime interdiction operations, air defense, amphibious warfare, and more.

This article originally appeared on Business Insider. Follow @BusinessInsider on Twitter.

Articles

This is how many ISIS fighters America’s top commando says have been killed

During a discussion at the Aspen Security Forum on July 21, Army Gen. Raymond Thomas, head of US Special Operations Command, cited estimates saying that the US-led fight against ISIS had killed 60,000 to 70,000 ISIS militants.


It is not the first time US military officials have given estimates for ISIS body counts — Thomas himself cited a similar number in February — but those estimates have been made despite doubts among military leaders and government policymakers about their accuracy and usefulness.

When asked about the whereabouts of ISIS leader Abu Bakr al-Baghdadi, Thomas downplayed the ISIS leader’s influence and said that while Baghdadi’s fate is currently unknown, “we will get him eventually.”

To underline his point, Thomas elaborated on the damage done to ISIS’ personnel network.

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“I mean, everyone who worked for him initially is dead or gone. Everybody who stepped to the plate the next time, dead or gone,” Thomas said. “Down through a network where we have killed in conservative estimates 60,000 to 70,000 of his followers, his army. They declared an army, they put it on the battlefield, and we went to war with it.”

Those comments come several months after Thomas claimed that more than 60,000 ISIS fighters had been killed since the campaign against the group started in summer 2014.

“I’m not into morbid body counts, but that matters,” he said in February, speaking at the National Defense Industrial Association’s Special Operations/Low Intensity Conflict conference. “So when folks ask, do you need more aggressive [measures], do you need better [rules of engagement], I would tell you that we’re being pretty darn prolific.”

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Members of the 9th Iraqi Army Division, supported by Combined Joint Task Force – Operation Inherent Resolve, fire a heavy machine gun at ISIS fighter positions. Army photo by Staff Sgt. Jason Hull.

Body counts — which earned scorn during the Vietnam War — are considered a dubious metric by which to measure the success of a military campaign, particularly ones against groups like ISIS. It is typically hard to estimate how many fighters such groups have, and it is not always clear how many have been killed during military engagements.

In 2014, an observer group estimated the terror group had 100,000 fighters. The Pentagon said in summer 2016 that it had just 15,000 to 20,000 fighters left in Iraq and Syria.

The February number given by Thomas was not much higher than the 50,000 ISIS-dead estimate made by US officials in December. But the December number given by US officials was twice as high as the figure cited by UK Defense Minister Michael Fallon that same month.

And the figure cited by Thomas on July 21 was only slightly higher than what he said in February, despite the increased intensity of anti-ISIS operations in Iraq and Syria in the intervening months.

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US-led Coalition successfully executes a large scale, multinational strike on a weapons facility. DoD photo from Staff Sgt. Charles Rivezzo.

Air operations against ISIS in Iraq and Syria increased significantly after Trump took office in January, with military leaders emphasizing an “annihilation campaign” aimed at eliminating ISIS fighters.

But those air operations appear to have caused a considerable increase in civilian deaths.

The US government reversed its policy on body counts several times during the wars in Iraq and Afghanistan, and numbers given by the government have been undercut or criticized by civilian and military personnel alike.

“My policy has always been, don’t release that kind of thing,” Chuck Hagel, who served as secretary of defense from 2013 to 2015, told CNN in December 2016. “Body counts, I mean, come on, did we learn anything from Vietnam?”