Three Months after Latif’s Death, “Transparent” Gitmo Reveals Acute Pneumonia
Roughly 11 years to the day after he was captured by Pakistanis to be sold for bounty and over 3 months after his death, Adnan Latif has returned to Yemen, a partly-decayed corpse.
In the statement announcing his remains have been repatriated, Gitmo revealed a new detail about how he died.
The medical examiner also concluded that acute pneumonia was a contributing factor in his death.
You gotta ask why a guy with acute pneumonia was put in solitary. I also wonder whether years of forced feeding contributes to pneumonia?
Not to worry, though, because Gitmo says they take care of detainees. Here’s the last paragraph of the statement:
Joint Task Force Guantanamo continues to provide safe, humane, and lawful care and custody of detainees. This mission is being performed professionally, transparently, and humanely by the men and women of Joint Task Force Guantanamo. [my emphasis]
It took two and a half months to learn Latif committed suicide. We’re only now learning he suffered from acute pneumonia. And we still do not officially know how badly his head injury–the one the government claims didn’t really exist so they could keep him detained–expressed itself while at Gitmo, much less the drugs he was being given, ostensibly for that and mental health problems.
Don’t worry though. Gitmo operates transparently.
May you rest in peace, Adnan.
Acute pneumonia, at least obvious signs of it, would be readily apparent from the most cursory examination. Criminal neglect comes to mind, or was this simply murder. Glad we are doing such a stellar job keeping the world safe for democracy.
Suicide and “acute pneumonia”. Ah, the story keeps getting murkier and murkier. I’ll have more to say shortly.
As to the question about whether forced feeding can cause pneumonia: http://www.aclu.org/human-rights/aclu-calls-end-inhumane-force-feeding-guantanamo-prisoners
As I noted in one of my reports, Latif was held in an area of the detention hospital where other prisoners were on a hunger strike, which indicates that he was engaged in another hunger strike (although I have been unable to obtain confirmation about that from JTF GTMO).
‘Acute pneumonia’ is something I would have expected competent doctors to have noticed and treated effectively and quickly.
What else are they lying about?
Couldn’t help but notice that pneumonia was stated to be a contributing factor, but not the cause of death. What little I know tells me that pneumonia is a condition of fluid buildup in the lungs that prevents adequate breathing. If it only contributes to death, something else helped the breathing to stop. (Now how could someone in a place like GITMO get fluid in their lungs?) Also, it’s noteworthy that the professional level of detainee care continues.
PS A quick check at WikiP indicates to me that an accurate diagnosis could be difficult at postmortem; this causes me to suspect there’s more to this than has been disclosed (slight understatement?).
So, now our own doctors and scientists are acting rather like those who worked for the Nazis?
So here’s my take, at FDL’s The Dissenter:
Gitmo Detainee’s Body Returned to Yemen, New Details on His Death Revealed
Here’s a link to a morbidity and mortality report about a nasogastric tube by the US Department of Health and Human Services
It highlights the complication (pneumonia) that nasogastric tubes cause when the tip is not correctly positioned in the stomach. Putting the tube up the nostril and then snaking it down into the stomach is a blind procedure done at the bedside. An xray is usually performed in the hospital to confirm the tip of the nasogastric tube is in the stomach (all nasogastric tubes show up on X-rays), and the tube is repositioned before any feedings take place if the tip is not in the correct site.
If the nasogastric tube accidentally snakes down into the wind pipe and it is not pulled out and repositioned before feeding starts, then the liquid nitrution is forced directly into the lungs.
If the tip of the tube goes down the esophagus correctly but never makes it into the stomach, this too can cause liquid nutrition to reflux and be aspirated into the windpipe and lungs.
Even having a correctly placed nasogastric tube can increase the risk of aspiration of the liquid nutrition into the lungs, but more risk obviously with the above scenarios. Wonder if the military performs xrays on force fed prisoners.
There are percutaneous gastric feeding tubes (puncture through the abdominal skin and muscles into the stomach) which skips the nose and esophagus altogether. Percutaneous G-tubes, as they are called, are used for people who will be fed longer than a few weeks. But even G tubes do not decrease the risk of aspiration pneumonia.
@pdaly: At my article over at The Dissenter, I note that in Southcom’s statement by Capt. Durand, reported by Jason, Latif had been “medically cleared” prior to being taken to Camp 5. This, of course, raises even more questions.
H/t Jason for that.
Unrelated to tube feeds, if someone is in a comatose state (from a drug overdose for example), the hospital normally intubates that person “to protect the airway” –else if the person vomits, the person is not able to wake up enough to cough and instead suffocates on his own vomit.
Was just reading that. Agree.
@pdaly: Sure. But there was never a period when he was comatose. They found him dead.
After such as patient has been intubated (tube in the wind pipe), a chest x-ray is obtained to confirm the tip of the tube is in the mainstem of the windpipe. After a short distance, the windpipe branches into a left and right bronchus, so, if by accident, the tube is advanced too far, only one lung will be intubated and be receiving air. The other lung will not be receiving air and it will also be at risk of aspiration/pneumonia.
Another bad scenario:
Occasionally the person placing the breathing tube misses the windpipe entirely and then the breathing tube is in the esophagus. Neither lung receives air, the esophagus and stomach fills with air blown in, and this eventually causes aspiration into both lungs.
Chest X-rays for all.
I was remembering what hcgorman was writing in an earlier post: that the government reminded us what the protocol for checking on the detainee was, but no actual reports on the record of doing just that.
Perhaps Latif had time to be comatose?
@emptywheel: Well… did they? The statement from Durand said Latif was found “motionless and unresponsive.” We do not have a time of death.
They’ve been quite oblique about every fact all the way through. Even still, they’ve gotten caught up in some contradictions.
Btw, it’s interesting to me that the sources for Savage on the autopsy never picked up or said anything about the “acute pneumonia”.
What comes to mind about the pneumonia is the likelihood that Latif’s immune system was very possibly compromised, by stress, by drugs, by diet (the hunger strikining), and possibly by other factors.
@Jeff Kaye: @pdaly:
Fair point, both of you. Interesting question.
@pdaly: But how long would the patient need to be intubated and/or comatose for him to get acute pneumonia to happen? Cause IIRC he was dead that day.
I admit we have no evidence that Latif was being force fed or intubated.
Hypothetically speaking, if Latif had been force-fed days earlier, aspirated during those feeds, but then he was medically cleared without an x-ray and placed in solitary, I imagine he could develop a pneumonia over the span of a day or two without medical intervention.
A sudden “aspiration” may be indistinguishable from an actual pneumonia if the diagnosis is by X-ray only.
Both could appear as white hazy areas in the lungs on x-ray. Healthy lungs mostly appear “black” on x-ray.
So you could vomit and aspirate and have a same day “pneumonia” on X-ray.
An autopsy performed at the time of death could easily distinguish between tube feed fluid in the lungs/vomit vs. pus from a bacterial pneumonia, however.
Latif was pronounced dead in the mid-afternoon at the detentiom hospital. They found him in his cell about 30 mins before he was transferred there.
On one of the previous Latif threads, I mentioned fluphenazine (or any of the phenothiazines) which would fit the criteria of monthly ‘zombie drug’ and has a history of use in institutionalized patients as a long-acting anti-psychotic to reduce self-harming behaviours.
Fluphenazine also has a history of the occasional death by unexplained asphyxiation. The NIH page on fluphenazine notes, under Adverse Reactions: ‘Autopsy findings have usually revealed acute fulminating pneumonia or pneumonitis, aspiration of gastric contents, or intramyocardial lesions.’
From your sentence, you are suggesting he was unresponsive and the military waited 30 minutes before getting him to the hospital?
Or was the hospital 30 minutes away?
How soon after arriving at the hospital was he pronounced dead? Dead on arrival?
That last one ” intramyocardial lesions” is kind of weird. Wonder if any explanation is offered why a psych drug would cause lesions in the heart muscle.
@pdaly: He was hunger striking, so it’s probably safe to assume he was being tubally fed.
Doesn’t matter. He was killed by his environment, of his environment.
@pdaly: this was the statement JTF GTMO gave me in early November regarding that.
@passepartout: Interesting, thanks.
@passepartout: Yes, I remember you saying that. I speculated as much to Jason in some emails. The drug is also known as Prolixin. Along with Haldol, which is also used in injectable form (Haldol decanoate — and I will reveal here that I have a very good source who says the latter was used at Guantanamo), fluphenazine was researched as a chemical incapacitant at Edgewood Arsenal. Neither was selected for battlefield use, but they certainly fit the bill as zombie drugs.
Dr. Ketchum, who was at Edgewood, discusses it in his book, Chemical Warfare Secrets. Haldol was known then as experimental substance 30234. They studied their cognitive effects. The drugs are both types of synthetic butyrophenones.
The drugs caused “dysphoria, reduced activity and decreased motivation” in non-psychotic volunteers. While the drugs caused significant cognitive slowing in those it was given, it was not considered “potent” enough for battlefield use (for which they were considering it), as they didn’t make the subjects “confused” enough, and it was thought that with sufficient survival stress, it’s effects wouldn’t be debilitating enough.
They also noted that they caused dystonias.
But there’s been a lot more information on these drugs now in the public domain. — I did already formally ask DoD if fluphenazine was used at Gitmo. They did not even reply.
Thanks. That statement is fuzzy, though.
If the hospital took over from the corpsmen, and performed “extensive lifesaving measures” then there would be presumably evidence of life–heart rhythm? blood pressure?, pupillary response?
So then time of death WOULD be the time when the physician pronounces the patient dead and ceases further resuscitation attempts.
However, the statement “part of the investigation will be to determine the estimated time of death, based on forensics” implies that Latif was dead on arrival, and that the “extensive lifesaving measures” were performed only by the corpsmen following the discovery of Latif’s body by the guardsman.
In that case, why wouldn’t JTF GTMO simply state, unequivocally, that the corpsmen tried to revive Latif but were unsuccessful and that Latif was declared “dead on arrival” to the hospital by the on-duty physician? (Unless Latif wasn’t quite dead, yet?)
BTW, if Latif had a fever with his pneumonia, I assume this allows a longer period of time for his core body temperature to reach room temperature (and thus allows more time to reach the emergency room in a semi-warm state) depending on how high a fever the investigators choose for Latif at the true time of death.
I write “assume”, and I’ll defer to someone familiar with forensics.
Potentially confusing the issue for me, I recall wrt to making ice, at least, that the opposite might be true.
There are anecdotes that previously heated water sometimes freezes “faster” than cold water.
“Humane” treatment, my ass.
It was in 2008, following legal challenges by the ACLU and others, that the courts ruled that Haldol couldn’t be given to ICE detainees without a court order. I don’t know if this ruling applied to all detainees in US custody but amid the FOIAs and new laws, Haldol use all but dropped off the map for detainees. This is one of the reasons I brought up fluphenazine — there was already a trail of breadcrumbs/FOIAs for Haldol and a reason for deniability: ‘No detainee is given Haldol without a court order…’
Also, pneumonia kills so many people because quite often it sneaks up on you. You compensate until you don’t. You’ll have a patient whose chief complaint is his ribs hurt, and then suddenly he’s not ventilating at all. It’s even worse with kids.
@passepartout: Seems ICE stopped the Haldol under threat of a lawsuit, but there was no court order. It was ICE who said they would forfend from using Haldol unless they had a court order. I don’t see how the issue spread to DoD, and know of nothing to suggest it did. That doesn’t mean it did not, but we just don’t know about that.
For readers who may have tried to reference my Dissenter/FDL article on this latest news, it appears FDL may be down, or has been for awhile. Here’s some alternate links: try http://pubrecord.org/world/10661/gitmo-detainees-returned-yemen/ or http://valtinsblog.blogspot.com/2012/12/gitmo-detainees-body-returned-to-yemen.html
@Jeff Kaye @passepartout: Interesting. I wonder if the govt wanted to avoid a court ruling against Haldol generally.
@emptywheel: Sure comes off looking that way. Re Gitmo, we’d have to have a timeline of actual drug practice, something we are unlikely to get.
I find it disingenuous that you all seem so very concerned for someone none of you knew. So, then I must assume you are all humanists. As such, you should then feel compassion for ALL human beings, including those who wear a uniform, and then find themselves caring for people who more than likely if given the chance would kill them. The courage and dedication it takes to care for Gitmo detainees, especially those like Adnan Latif, amount to an emotional train wreck for those who served to protect and, yes, care for him. You are talking about answers in search of a question, and you won’t find it because you are only considering one side of the human coin you pretend to respect and care about.
Well, one underlying motivation for many people is that we don’t want to see ANYBODY mistreated, and that absolutely includes soldiers whom are caused to do things that damage their minds, as well. That’s not to say there aren’t those that simply don’t have any real ethical motivation, but let’s hope that bunch is a small minority. There are indeed those among us that pray for those that harmed us.