- SAN DIEGO (UPI) --
A Naval Reserve commander who volunteered for the Iraq war says the military
doctored his medical file to eliminate all traces of an anti-malaria drug
that he believes made him severely ill, suicidal and aggressive - and that
he has the before-and-after evidence to prove it.
- "I was given Lariam. I got sick from Lariam,"
said Cmdr. William Manofsky, 44, who is based at the Naval Air Warfare
Center in China Lake, Calif. "The Navy does not want to talk about
Lariam. There is no mention of it in my medical record. I'm pretty upset."
- Manofsky said there is no indication in his file of ever
being prescribed the drug, although the Navy handed it to him last November;
that a page is missing on which "Took Lariam" was written; and
that a reference to the drug during an emergency clinic visit on May 13
has mysteriously vanished from the page - even though he has a copy that
clearly shows it written there.
- Manofsky and his wife, Tori, believe the military is
covering up problems with the drug - the Navy's main concern so far, they
said, is to try to get the medical records back. A spokesman for the Navy
Bureau of Medicine and Surgery would only say that it provides quality
care and is working "to resolve the issue."
- "The military created the drug," Tori Manofsky
said (it was developed by the Walter Reed Army Institute of Research and
licensed to Roche). "There is a lot of money involved in the drug.
I think there are a lot of careers at stake. Anything that shows a problem
with Lariam has to be hidden or covered up somehow by the military. If
all these people came back and it was clearly Lariam, there would be lawsuits
up the kazoo."
- Lariam is the drug that at least two of the soldiers
who killed their wives at Fort Bragg last summer took while serving in
Afghanistan. Both those soldiers - and a third who apparently had taken
the drug - subsequently killed themselves. The drug's label warns of psychosis,
aggression, hallucinations and reports of suicide that can occur "long
after" someone stops taking it. The Food and Drug Administration this
year ordered that everyone prescribed the drug be handed a written statement
listing those dangers and warning them to quit taking it if they experience
- The government and the company that makes Lariam, Swiss
drug giant Hoffmann-La Roche, say the drug is safe and effective. The FDA
says it doesn't know whether the drug can trigger suicide. Roche says there
is no reliable evidence it can trigger violent behavior. The Pentagon says
side effects are generally rare and mild and are outweighed by the risk
of getting malaria.
- Manofsky, who never took Lariam before being deployed
to Kuwait last December, became suicidal after returning to California
this spring and nearly slugged his wife in a bizarre rage about the way
she cast her fishing line. He also suffered seizures, balance problems
so severe he sometimes could not stand, panic attacks and depression.
- Tori Manofsky became convinced Lariam was the culprit
after researching on the Web the medications her husband was taking. On
June 26, after several visits to the China Lake clinic in which they raised
the Lariam issue but felt they were being ignored, Bill Manofsky went to
the clinic to pick up his records on his way to see a neurologist. He flipped
through them to make sure Lariam was documented.
- "The first thing I noticed was a sheet missing,"
he said. "Both Tori and I had seen the sheet. Someone had written
on an angle, 'Took Lariam' and it was no longer there. There was no entry
for being issued Lariam."
- Manofsky flipped more pages, looking for the record of
a May 13 visit to the clinic. That day, his wife had insisted a Navy doctor
write the drug on that record and both had watched him do it. He found
the page on which he felt certain that note had been written.
- Manofsky knew his memory was shot, that he was acting
strangely, and there was no reason for anyone to believe him. But he had
a backup. Tori Manofsky - suspicious that Navy doctors were ignoring the
drug - secretly photocopied the page after the doctor wrote down "Lariam"
on the May 13 visit and briefly left the room.
- Tori's copy clearly shows the reference, "Lariam
for anti malaria" Underneath that, four other medicines Manofsky was
taking also are gone; they are mentioned elsewhere on the visit.
- Two independent document examiners consulted by UPI concluded
that unless the Manofskys themselves faked the doctor's writing and created
bogus copies, only the Navy can explain the omission.
- The document experts could find no evidence that writing
had been erased from the May 13 record. One of the experts - a former head
of an FBI questioned documents office - told UPI that the likeliest scenario
is that the clinic made a copy of the May 13 page while the Manofskys were
still there, and the doctor wrote "Lariam" on that copy after
Tori insisted. That sheet never made it into his medical file.
- While such a chain of events could theoretically be accidental,
Tori Manofsky believes the Navy knows it has a problem with the drug, and
was keeping two sets of records and recording Lariam problems on only one.
- UPI contacted the doctor who saw Manofsky on the May
13 visit and asked if he knew anything about changes in the medical record.
He declined to comment and said he had been told to refer questions to
Twentynine Palms Marine base, which forwarded them to the Navy Bureau of
Medicine and Surgery in Washington. Spokesman Brian Badura issued this
- "Successful medical treatment relies on accurate
information, close cooperation and communication between provider and patient,
and follow-up by all parties involved. Navy Medicine makes a concentrated
effort to meet the needs of each patient. Due to the number of circumstances
surrounding the Manofsky case and the ongoing efforts by Navy Medicine
to resolve this issue, we cannot offer additional input at this time."
- Several other service members who served in Iraq have
told UPI they had serious problems with the drug - including one who says
he was afraid of harming his wife and that there was no record of him being
prescribed Lariam, either. At least two soldiers were medically evacuated
from Iraq with suspected Lariam problems, one an Army officer in charge
of 300 soldiers, the other a soldier who felt the way he was treated suggested
the Army was "avoiding the Lariam diagnosis." The Army is now
- The Washington Post reported in July that the military
is investigating at least seven suicides among troops in Iraq, among a
larger number of deaths classified as "non-combat weapons discharge"
or "non-combat related."
- The Pentagon hasn't identified any deaths as suicides
since the war started.
- Earlier this year, two more soldiers deployed out of
Fort Bragg who took Lariam in Afghanistan committed suicide after returning
home - bringing the number of suicides after that war to at least five.
In one case, the soldier's father said he asked Fort Bragg officials if
the Lariam given to his son could have played a role. "They have no
comment," he told UPI.
- The Pentagon insists that there have been few problems
with the drug, prescribed to soldiers around the world to prevent malaria.
More 25 million people have taken it worldwide, according to the manufacturer,
5 million of them in the U.S.
- Assistant Secretary of Defense Dr. William Winkenwerder,
Jr., wrote a U.S. congressman last fall that any possible side effects
are "greatly outweighed by the drug's effectiveness in preventing
the severe consequences of malaria infections" among troops.
- In the Fort Bragg homicide-suicides, a team of experts
dispatched by the Army Surgeon General's office concluded that Lariam was
an "unlikely" explanation for the entire cluster of deaths but
acknowledged it had not investigated it in any single case. It blamed the
deaths on marital problems.
- At the time, critics said some of the Fort Bragg deaths
should have been investigated as possibly drug related, especially because
there was no history of domestic abuse and all three of the soldiers who
had been in Afghanistan killed themselves - both unusual in domestic homicide
- A former Roche employee said that Lariam, known generically
as mefloquine, is a member of the quinolone family of drugs that can produce
severe psychiatric problems in some users.
- "Any drug with a quinolone base to it, which includes
Lariam, is likely to do this," said Dr. Donald H. Marks, former associate
director of clinical research at Roche who now consults with attorneys
suing drug manufacturers. "These types of drugs can induce a temporary
homicidal or suicidal rage."
- The Army puts the rate of severe side effects at 1 in
13,000. A widely reported British study completed in 1996 found that one
person in 140 had such serious problems that they temporarily couldn't
carry out the function for which they were traveling.
- The Manofskys said they were willing to take on the Navy
publicly because they are convinced the truth is not being told, and concerned
that other soldiers returning from deployments overseas are getting the
- They showed UPI Bill Manofsky's complete medical file
and Navy service record; e-mails from the Navy psychiatrist who treated
him before he decided not to work with the Navy any more; a log Tori kept
of Bill's symptoms, and all the medicines he was taking including remaining
Lariam pills. They gave interviews in California and Washington in which
they went over the events almost minute by minute.
- The Manofskys outlined this sequence of events.
- A 17-year veteran of the Naval Reserve, Manofsky was
handed Lariam last November at China Lake before being deployed. There
was no prescription written or warning given of possible side effects,
and Tori Manofsky said she has since been told by a base medical worker
that there were "special instructions for dispensing and documenting"
- Bill Manofsky served active duty at an air base in Kuwait
during the war, using his top-secret clearance on a targeting system. But
he suffered what he now says were bad Lariam side effects that started
in Kuwait and got worse when he got home and kept taking his pills as directed.
He's had uncontrollable vomiting and vertigo, depression and anxiety attacks
requiring hospitalization. His hands tremble. He stutters and repeats himself.
He has frightening seizures.
- After 11 years of marriage, Tori said that after taking
Lariam, Bill's personality changed drastically from the gentle husband
- The drug is taken weekly while deployed and for four
more weeks after a person returns, so Manofsky was still taking the pills
when he got back.
- Tori kept a journal documenting her husband's problems.
An entry for May 2 described his symptoms as "balance off, angry,
moody, coping poorly, sad, depressed. What really bothers me is 'aggressive
- highly aggressive.'"
- The couple tried to go fishing in early May in an effort
to relax. But Bill got so angry he scared his wife. When she cast her line
in the water, "Bill came over and said, 'Do it this way,'" she
wrote in the journal documenting his problems. "He kept saying it
over and over - extremely angry!!!"
- After she told him she was upset and wanted to stop fishing,
"he leaned over me like he was going to slug me in the head and said,
'If you don't do it this way I'm going to ...'" He stopped in the
middle of the sentence and backed off. She said that a few hours later
he had no memory of the incident.
- Bill Manofsky told UPI later that, "I was trying
not to pull a Fort Bragg."
- "I wanted to make sure Bill had the proper care
with Lariam toxicity," Tori said, describing the May 13 visit to the
China Lake clinic. The symptoms I read on the Internet matched up with
Bill's to a tee. I told the doctor that I thought that Lariam was responsible
for his symptoms. I said, 'Doctor, would you write Lariam down.'"
- "He wrote everything down and put the clipboard
on the bed near Bill's legs. I leaned over and I said, 'Bill, I need to
copy this.' They had a copy machine down the hall. I went down and copied
it and did not say anything to anybody about it."
- Later in May, Manofsky became suicidal. On May 31, Tori
said that while she was driving them to a restaurant, "Bill's panic,
anxiety and distress became so acute that he proceeded to try and claw
his way out of the truck so he could jump out. I kept telling him, 'Bill,
it's gonna be OK, it's gonna be OK.' He said he was crawling out of skin,
he had to get out of there."
- At the restaurant, "Bill went to the bathroom and
began vomiting, he then sat on the floor and said repeatedly that he was
going to blow his brains out.
- The Manofskys say that Bill was referred to a Navy psychiatrist
who also seemed to resist the idea that a drug prescribed by the Navy could
be causing his problems. She diagnosed him with anxiety and "narcissistic"
and "histrionic" personality traits.
- Then, on June 26, Bill Manofsky discovered the changes
in his medical record.
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