Forces’ medicine use could face challenge in legal actions

The Defence Forces feared new medical instructions on the use of anti-malaria medicines by troops would be used in legal actions being taken by serving and former soldiers over side effects from the drug Lariam.
Forces’ medicine use could face challenge in legal actions

The Defence Forces feared new medical instructions on the use of anti-malaria medicines by troops would be used in legal actions being taken by serving and former soldiers over side effects from the drug Lariam.

Internal emails reveal that the director of the Defence Forces’ legal services warned they could expect a “significant amount of detailed cross-examination” about the move.

Earlier this year, the Department of Defence announced a change of policy allowing troops a choice of three different anti-malarial drugs for missions in sub- Saharan Africa.

The State is already facing more than 160 compensation claims from soldiers, who claim they suffered serious side effects from the use of Lariam — the default option available up until then.

Side effects reported by some of them include depression, anxiety, insomnia, suicidal thoughts, and other mental health issues.

The policy change raised significant concerns within the Defence Forces and Department of Defence however, records show.

The director of the Defence Forces’ legal services, Colonel Jerry Lane, wrote in one email to colleagues: “I agree that we should expect scrutiny in the form of parliamentary questions, solicitors’ queries, and general press queries.

“However, I am more concerned that we are likely to face a significant amount of detailed cross-examination in court [case dependant] [and probably Director Medical Branch being called] and we also need to have that in mind as we move ahead with this.”

The records, obtained under FOI, also show the Department of Defence quickly alerted the State Claims Agency to the policy change.

The department’s head of litigation branch wrote: “I will provide the State Claims Agency with a copy of them in the context of the on-going claims so that our counsel is alerted to the changes and can be prepared for this issue if or when it may arise in the context of any specific Lariam case.”

The new instruction issued to troops and said if Lariam was being used, it should “if possible, be started four weeks prior to deployment” to determine how tolerable it was for the individual solider.

A brief prepared for minister of state with responsibility for defence, Paul Kehoe, explained that Lariam was not being removed as a treatment option for the Defence Forces.

It said: “[This change in medical policy advice] makes no commentary as to whether the medications are ranked for usage as first, second or third line use.

“The decision on which medication to prescribe will be made by the medical officer following consultation with the individual during their overseas deployment medical assessment.”

Mr Kehoe was told that the new instructions came about as part of consideration of a “risk/benefit analysis perspective” on the use of anti-malarials.

A Department of Defence spokeswoman said three anti-malarial drugs — Lariam, Malarone, and Doxycycline — were now available to members of the Defence Forces.

Asked about the internal emails raising concerns about the policy change being used in pending court cases, she added: “Given that there is litigation pending in relation to these matters, it would be inappropriate to comment further.”

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