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Bad Care

As I mentioned in my last post, from time to time I’ll post about some of the bad care that I see as a Quality Assurance Auditor. Our goal where I work is not to punish providers, but to use cases that are not up to the standards set for quality care as educational purposes.

During the meetings with the paramedic, we go over the deficiencies we find and point out better ways to provide care. In most cases, the paramedic takes our suggestions and we see steady improvement in both their care and their documentation.

So here is the carefully redacted report, or at least the parts that are pertinent. I’ll add notes below the image.

The patient was a 74 year old male.

Here are the things that I noted as deficient in this report.

  1. The crew performed a 12 lead EKG, which was good. Unfortunately, the medic who wrote the report (the tech) didn’t attach a copy. That’s actually a minor lapse, but it’s important for down stream readers including doctors and nurses at the hospital to have an EKG to refer to when they do their own EKG. That way they will be able not only to see what the medics saw, but to compare it for changes in the EKG which would indicate if the patient was getting worse or better.
  2. The medic did not document the patient’s Past Medical History, Medications, or Allergies. Since   the patient may not remember any of that, it’s important to note as the hospital doesn’t want to give the patient a medication that might harm him.
  3. There is no physical exam of the patient. That includes skin condition, respiratory condition, lung sounds, evaluation of peripheral edema, respiratory rate, or even if the patient currently has chest pain.
  4. The doctors office may have started an IV, given Aspirin, or treatment for the chest pain. We’ll never know since none of that was documented in the report. There are also no vital signs as obtained by the doctor’s office, so there is no means of comparing them with what the providers obtained.
  5. The heart rate is pretty fast, which should be of concern as there are a number of reasons, none particularly good, for tachycardia. The medic notes the EKG rhythm as being “NSR” which is “Normal Sinus Rhythm.” Clearly this is not as it’s above the upper limit for NSR which is 100 beats per minutes.
  6. The patients respiratory rate is also a bit above the normal range. The CO2 level is a bit below the normal range. Both of those, along with the tachycardia, should be of concern.
  7. The patient reports chest pain and increased Work of Breathing (WOB) on exertion. Since we don’t know his medical history or medications, there is no way to know if this is typical for him or a change in his condition.
  8. The term “non diagnostic” means that there are no changes to the EKG that would indicate a cardiac event. One of the things auditors do is “overread” the EKG to confirm the medics impression. Mostly paramedics are pretty good at interpreting EKGs, but still it’s important to confirm that.

I will note that the crew did transport to the appropriate facility, which is sometimes an issue, but not here,

Since the medical record is at best incomplete, we can only work on the premise that the care was also incomplete. There is more than a bit of likelihood that the patient may have suffered some harm as necessary treatment was not administered by the paramedics on the call and responsible for providing care.

There is always the possibility that proper care was delivered, but there is no way of determining that from the report.

The EMS Coordinator for the agency will likely have a sit down with the medic who was the tech and discuss the report and the lapses in care.

It sounds harsh, but as I said, the goal is not to punish or embarrass the provider, but to provide education to improve both his delivery of care and the documentation of that care.

 

 

Journal of Iatrogenic Medicine

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I mentioned that I’m going to add a category “Journal of Iatrogenic Medicine”, and this is the introduction.

Iatrongenic is harm induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures. In other words, by accident. The provided, whether doctor, nurse, EMS provider, or anyone else didn’t mean to cause harm, but they did.

In EMS when we see it we find that very often it is done by a provider who failed to recognize what was wrong with the patient, or the cause, or the correct course of action to treat the problem. That can be either using the wrong medication, device, or diagnostic procedure. It can also be an incorrect dose of a medication, or placing a piece of equipment incorrectly.

No matter what the cause, the patient suffers some degree of harm. Examples are giving a patient a medication to which he or she is allergic, or one that is incompatible with a medication the patient already takes. Or placing an endotracheal tube in the esophagus instead of the trachea.

It can even be a simple error such as sitting a patient with low or no blood pressure into a “stair chair” to move them out to the ambulance. The risk there is that they will lose what little blood pressure they have and pass out or worse.

Or not interpreting patient breath sounds correctly and giving an incorrect or no treatment.

I could probably write another 1,000 words just listing common medical errors, but I think you get the point. Except for putting a patient in a stair chair, doctors and nurses have done all of what I listed also.

Part of my job is to read patient care reports to look for errors large and small. Small errors are corrected during periodic reviews. Larger errors are reported to the system medical director and he determines if he or she considers it a large error and what action is needed.

Every EMS system in the country has a set of protocols for providers to follow when examining, diagnosing, treating, and transporting patients. Some states impose one set of protocols on every EMS system, some do it by county, and a couple allow each EMS system medical director to determine their own protocols.

My job entails reading reports and determining if the provider understood what was going on with the patient, what the correct course of treatment is, providing that treatment correctly and safely transporting the patient to the most appropriate facility for further treatment.

Then they have to write a report that explains all of that.

The approach I take, because it’s the approach the owner of the company wants, is to treat all of this as educational.

Which is all I’ll say about that since I don’t want my readers to fall asleep.

Because I read a lot of reports I come across some real doozy’s from time to time. Those are the reports that I’ll feature in posts about Iatrogenic Medicine.

In case anyone is worried, I will carefully vet each report that I write about so that there is no Protected Health Information revealed. When I quote text, all identifiers will be removed.

I’ll dissect the reports, what was done wrong, what the correct course of action was, and anything else I think is valuable.

That’s it in a nutshell. I should get the first post up in a day or so.

Time Marches On

It’s now almost nine years since I retired from active work in EMS. When I retired, I thought that the 35 years I spent in EMS with one agency had gone by quickly. It had, but it was nothing compared to the time since I took off my uniform for the last time, emptied my locker, and turned in my gear.

I’ve managed to stay close to EMS as a teacher, consultant, and Quality Improvement advisor. It’s not quite the same as being on an ambulance, but it also doesn’t involved nights, weekends, holidays, wolfing down meals, and always being tired from working and trying to have a “normal” life.

Life is just a series of trade offs, I guess.

Up until the hysteria of the pandemic gripped the world, I also managed to keep in touch with many of my co workers. There would be retirement parties, informal get togethers, and as a retired department member I was able to attend training for free.

The last meant that in addition to getting my recertification requirements out of the way for free, I’d be able to see other retirees and many still active EMTs and paramedics. I also met many of the people who have been hired over the years.

I don’t know if that benefit will resume next year when I again need a refresher course, but I hope so.

What brought all of this into sharp focus was looking at my former agency’s Facebook page over the last few weeks and seeing half a dozen former co workers retire. Some of them, about half, were people that I trained when they were new department members. Talk about feeling old.

In the years just before and after I retired many of the people I started working with in the late 1970s also retired. Then it slowed down for a few years as the next cohort didn’t have enough time in to retire with their pensions intact.

This makes me melancholy, but it’s the way of the world.

The late blogger “Neptunus Lex” posted about this back in 2008 before I was thinking seriously about a retirement that still seemed years away.

The post is called Milestones and you can read it thanks to some of his regular readers who downloaded his posts before they disappeared when it was shut down some time after his untimely death.

It’s well worth the read, but here is the passage that has stuck with me since I read it thirteen years ago.

There are no irreplaceable men. If you want to know the hole you leave behind when you go, put your fist in a bucket of water. Now pull it out. There. That’s the hole.

As much as we might flatter ourselves, agencies are organisms and will continue off after shedding individual shells.

The cohort of people hired in the mid to late 1980s are starting to retire and leave the service. In another few years there won’t be many people left with whom I ever worked. At best I’ll be a name that some now retired guy mentioned a few times when telling stories about the old days. Or something like that.

When I retired I had to decide what I wanted to do for the rest of my life. I worked with guys who filled their post retirement days with work not remotely related to what they had done before. Others did nothing. I don’t know how you go through your late 50s and 60s doing nothing all day. I couldn’t contemplate doing that, so I found a job that entailed some teaching, some reading of reports, and some counseling EMTs and paramedics when their performance was sub optimal.

Or maybe the job found me. My last partner and I were discussing my impending retirement and he said that my natural niche would be teaching providers the things they don’t teach you in the book. Which is a good part of what I do. I don’t tell “war stories” I use “illustrative anecdotes” that just happen to contain stories from the old days.

I help providers write medical reports that will keep them out of trouble with their bosses and state regulators. The saying “If you didn’t write it, you didn’t do it.” predates my tenure in EMS. I l learned it in the early 1970s when I took my first EMT class. Reports were a lot shorter then because expectations for EMTs were pretty low and other than on TV there weren’t any paramedics in this part of the country.

Requirements for reporting now are much higher for clinical, financial, regulatory, and other requirements. Ironically, electronic Patient Care Reports (ePCR) make it harder to write good clinical reports in their quest to become good financial and data collection tools. As a result a half generation of providers don’t know how to write a medical narrative.

Which plays into my strengths in ways I never expected. I spend as much time teaching people how to write a report as I do teaching them how to improve their patient care.

Service chiefs even ask my advice on various things. It’s an odd feeling being called into the chief’s office and not getting yelled at for something.

It’s a nice way to supplement my not bad at all pension, meet new people, and keep current with what’s going on in EMS. It even gives me more to write about on this blog.

I’ve been saving some reports that are good teaching tools. Which means that they were poorly written and usually reflected sub optimal care. Informally those are known as “train wrecks.” I’ll be going through them and redacting protected health information and will be using them for blog posts in the coming months. Fortunately (for me) there are always a couple in each batch of reports I get to review.

Look for those in a new category named “Tales From the Journal of Iatrogenic Medicine.”

 

National Rifle Association

For the record, I have been a member for over twenty years and a Life Member for several years now. I’ve attended about half a dozen Annual Meetings and Exhibitions.

In other words, I’ve been a supporter for a while now. I even voted in the Board of Directors elections, even though it’s a rotten process.

Lately, I’ve been lately enthused about the actions of the Board of Directors and other management of the NRA. They seem to have lost their way as the premier defender of the Second Amendment. I have a sinking feeling that more money goes to things other than activities that defend our freedom.

Since their financial dealings are rather opaque, it’s a feeling not a conviction.

Gone Owners of American and Firearms Policy Coalition seem to be winning more cases in court than the NRA. While the NRA often files amicus briefs, they don’t seem to be the primary plaintiff in many cases recently.

Then there is the ongoing bankruptcy proceedings.

I won’t go into whether Wayne LaPierre should continue to be the face of the NRA or not. That’s up to the Board of Directors to decide.

The problem is that the Board of Directors seems to be disinclined to tackle the subject. That may be because the BOD is appointed by a nominating committee. From my experience with other non profit organizations, the nominating committee seems to work in the dark. What process they go through to select their “slate” of candidates can be daunting to discover.

They all seem to have a somewhat incestuous air to them, but that could just be me.

All of which brings me to the point of this post. With one exception, and because I know the good work he does at the local level, I am disinclined to vote for any of the current members the NRA Board of Directors. Oh, that member of the BOD is also completing his first term, so he’s probably still at least quasi independent.

In case you are a voting member of the NRA and reading this post, you’ll be doing all of us a favor to vote for Jim Wallace.

The other person I urge you to vote for is Gary F. LeGros, Jr. Jeanerette, Iberia Parish, Louisiana. Attorney LeGros is a shooter, hunter, and fisherman with solid Pro 2A credentials. I have confidence in his ability to ask questions that will make some people at NRA Headquarters rather uncomfortable.

Attorney LeGros is a write in candidate, so please write his name in.

Which is what the NRA needs right about now.

Balloting is open until August 15, so please don’t forget.

 

Child Abuse During The Pandemic

I hope the title got your attention. I’m not talking about the “traditional” definition of child abuse, but rather the practice of forcing children from about age 2 up to 18 to wear masks.

This is supposed to be protective, but no one quite specifies who is being protected and from what. That’s aside from the whole issue of what kind of masks people are wearing and that other than N95 medical grade and surgical masks, they are useless.

A quick review, a N95 mask protects the wearing from outside threats, although maybe not viruses. A surgical mask mask protect the outside world from the wearer. That’s why doctor wear them, to protect their patients from infection during operations, examinations, and other procedures. The same reason that doctors wear gloves, although gloves also protect the care provider.

Keep in mind that unless a child has some rare pre existing medical conditions they are pretty much immune from Covid 19. Even if they do test positive, they don’t seem to become symptomatic. Nor can they spread the virus to their grandparents via hugs.

Of course the genius non medically trained members of the public claimed the opposite and people refused to see their grandkids other than via Zoom for over a year. During the Zoom sessions some grandparents insisted on wearing their masks while sitting in their parlors. Because apparently they don’t know the difference between a real virus and a computer virus.

All of which brings me to this study published in the Journal of the American Medical Association Pediatrics.

Experimental Assessment of Carbon Dioxide Content in Inhaled Air With or Without Face Masks in Healthy Children
Discussion

The limitations of the study were its short-term nature in a laboratory-like setting and the fact that children were not occupied during measurements and might have been apprehensive. Most of the complaints reported by children3 can be understood as consequences of elevated carbon dioxide levels in inhaled air. This is because of the dead-space volume of the masks, which collects exhaled carbon dioxide quickly after a short time. This carbon dioxide mixes with fresh air and elevates the carbon dioxide content of inhaled air under the mask, and this was more pronounced in this study for younger children.

This leads in turn to impairments attributable to hypercapnia. A recent review6 concluded that there was ample evidence for adverse effects of wearing such masks. We suggest that decision-makers weigh the hard evidence produced by these experimental measurements accordingly, which suggest that children should not be forced to wear face masks.

Read the entire study at the link, including the additional tables, charts, and comments on the right side of the page.

On reflection, maybe forcing children at little risk from Covid 19 to wear masks that don’t provide protection and appear to be harmful does fit the traditional definition of child abuse. d

I wonder what would happen if parents of school children forced to wear masks filed complaints with the child protective agencies in their states?

YOU CAN’T SAY THAT!

I should start with a former co worker who was my morning relief and also a shop steward in the union that represented me. Every day when he came in to start his shift we’d chat about various things and at some point in that conversation I’d say something that would cause more of his hair to fall out.

Then he’s say “EMS Artifact, you can’t say that! You’ll get in trouble.” He was half joking, but only half. Our overseers at the agency that controlled Sorta Big City EMS were humorless scolds and more than one person, including supervisors and managers, had ended up at HR explaining what they thought were innocuous statements, but ones at which someone took “offense.”

One of the nicer things about retiring is that I can pretty much say what I want, when I want, to whom I want.

Apparently, the self anointed geniuses at Brandeis University in Massachusetts want that to stop. They have come out with a list of words and phrases we must stop using in polite company if we want to be “woke.” Which is what we used to call “Politically Correct” only apparently that is no longer, uh, politically correct.

They have come up with an “Oppressive Language List” that they encourage people to learn and and make sure that they don’t use.

Oppressive Language List

PARC recognizes that language is a powerful tool that can be used to perpetrate and perpetuate oppression. As a community, we can strive to remove language that may hurt those who have experienced violence from our everyday use.

This list of recommendations for more-neutral language was developed, created, and continues to be managed by students involved with PARC. Suggestions are brought forth by students who have been impacted by violence or who have worked with others who are healing from violence, as well as students who have sought out advanced training for intervening in potentially violent situations.

This list is meant to be a tool to share information and suggestions about potentially oppressive language. Use of the suggested alternatives is not a university expectation, requirement or reflection of policy. As shared in Brandeis University’s Principles of Free Speech and Free Expression, the language you choose to use or not use is entirely up to you.

So, you can, but shouldn’t use the words in the various lists, if you don’t want to be an oppressor. Which, I’m guessing means a white person, particularly if you are a white male.

In there attempt not to be oppressive, they care categorizing a large chunk of the US population who happen to share a common or similar skin tone as oppressors.

Apparently, they never heard of Rev. Martin Luther King Jr. or heard his speech. They are “credentialed, but not educated” so to speak. In other words, morons.

You can look up the list here and play “Offensive Language Bingo” if you want to entertain yourself. Personally, I’m going to use this as a sort of primer in things to say when I want to annoy idjits.

One thing you should know is that they don’t link to one source for any of their explanations. We were supposed to just assume* that these self appointed guardians of linguistically correct words are smarter than us. Right, pull the other one mate, it has bells on it.

In case you were wondering, the cost to send your young mutton head to Brandeis to be indoctrinated with foolishness like this is over $70,000.00 a year. Which is about half of what the plumber that most graduates will need to call when their sink gets stopped up will make.

Speaking of trades, if you have a youngster who is going to go to an overpriced four year adult day care such as Brandeis and most “liberal arts” colleges are they should also look for a nearby trade school where they can take classes in welding and/or becoming a machinist. Because when they come out with that $280,00.00 useless degree, they are going to need some sort of job to help pay back the student loans.

*You know what happens when you assume, don’t you?

 

A Blog of Links

Because I have nothing else to write about today, I’m posting a new link. It’s a blog with humorous images and links to other blogs that also have humorous images.

It also has some serious links and I haven’t explored them so some people might find some “offensive” web sites as the end of those links.

The normal response to finding an “offensive” website or blog is to move along to one more to your suiting and not visit a second time. These days however some people have decided to the arbiters what is right, what is wrong, what is offensive, what is racist, what is whatever it is that they don’t like.

Again, if you visit a link and don’t like it, move on to something else.

Don’t bother commenting here about it, don’t think that you can shame me by putting some stupid post on Facebook or Twitter.

If you’re offended, that’s your problem, not mine.

Which is my comment on just about everything these days.

Here’s the link to the Funny Links Blog. I don’t know why he wants to link to this blog as this isn’t generally a humor blog. Well, other than when I poke fun at progressives and liberals.

Sometimes we just need to laugh at the world.

A Finger, A Lancet, and A Glucometer

Someday, someone might be able to explain to me the preoccupation many EMS providers have with obtaining a Blood Glucose Leve (BGL) on every single patient they encounter.

I know that Type 2 diabetes is a problem in this county, however it’s not a problem that EMS is really trained, equipped, or educated to treat. Other than the occasional patient with an incredibly high BGL and Altered Mental Status (AMS), there is really no path to treatment for EMS.

Yet, providers of all levels have a bizarre obsession with sticking a needle in a patient’s finger to see if they are hyper or hypoglycemic. Patients can be substantially hyperglycemic with no outward signs of it. Again, AMS is the exception.

Treating hyperglycemia involves admitting the patient to the hospital and oh so carefully administering Insulin and IV fluids to get the glucose levels under control. While EMS can give fluid, and often does even if not required or beneficial to the patient, I don’t know of a US EMS system that carries Insulin in any form.

Hypoglycemia almost always manifests itself in the form of AMS as while the body can function fairly well with a low BGL, the brain needs glucose to work properly. Which is why EMS protocols everywhere indicate a BGL check for AMS, even if the patient is not a diabetic.

Non diabetics use naturally produced insulin to help the brain metabolize glucose. It also performs other functions in the brain that are not well understood by science. Type 1 diabetics don’t produce insulin or don’t produce enough insulin for this process to work. Which is why they take Insulin.

The problem is when they take insulin, but don’t eat. The insulin burns off whatever glucose is in the patients body to the level where the brain can’t function normally.

So, I get that in any patient with an Altered Mental Status checking the BGL is prudent. What I don’t get is why a 25 year old female who twisted her ankle, needs a splint, ice pack, and a ride to the hospital needs to have her BGL checked.

What is the diagnostic purpose of performing a test on a non diabetic who is complaining about the pain and swelling in her ankle and really wants pain relief?

It seems that some people in EMS are doing things out of habit or misunderstanding of the protocol. Or a total lack of understanding of anatomy, physiology, and good medicine.

As a cynical veteran paramedic (is there any other kind) once commented, “Learn to do without knowing why.”

That’s today’s mini rant. As always, comments are appreciated.

Juneteenth Mania

Juneteenth is a holiday commemorating the end of slavery in Texas after the end of the War Between the States. For a long time it was a Texas only holiday, but for some reason over the past year or so it’s become a national cause celeb.

I’ll leave it to the readers to discuss the reasons for that, since I don’t care to speculate.

Just a bit of perspective then.

On September 22, 1862 President Lincoln (a Republican) signed the Emancipation Proclamation. It took effect on January 1, 1863 and freed all of the slaves in territory of the Confederate States of America. Why President Lincoln waited until two or so years after the start of the War Between the States, only he knew and he never said.

Here is the text,

That on the first day of January in the year of our Lord, one thousand eight hundred and sixty-three, all persons held as slaves within any State, or designated part of a State, the people whereof shall then be in rebellion against the United States shall be then, thenceforward, and forever free; and the executive government of the United States, including the military and naval authority thereof, will recognize and maintain the freedom of such persons, and will do no act or acts to repress such persons, or any of them, in any efforts they may make for their actual freedom.

None of this took effect in Texas until after the end of the war. General Gordon Granger landed in Galveston on June 19, 1865 to assert federal control over the former CSA state. One of his charges was to enforce the Emancipation Proclamation in Texas.

The general issued the following proclamation officially informing Texans that there would be no further slavery in the state.

The people of Texas are informed that, in accordance with a proclamation from the Executive of the United States, all slaves are free. This involves an absolute equality of personal rights and rights of property between former masters and slaves, and the connection heretofore existing between them becomes that between employer and hired labor. The freedmen are advised to remain quietly at their present homes and work for wages. They are informed that they will not be allowed to collect at military posts and that they will not be supported in idleness either there or elsewhere.

The holiday was celebrated “Jubilee Day” and celebrated as that for many years.

In 1938 Governor of Texas James V. Allred issued the following proclamation,

Whereas, the Negroes in the State of Texas observe June 19 as the official day for the celebration of Emancipation from slavery; and

Whereas, June 19, 1865, was the date when General Robert [sic] S. Granger, who had command of the Military District of Texas, issued a proclamation notifying the Negroes of Texas that they were free; and

Whereas, since that time, Texas Negroes have observed this day with suitable holiday ceremony, except during such years when the day comes on a Sunday; when the Governor of the State is asked to proclaim the following day as the holiday for State observance by Negroes; and

Whereas, June 19, 1938, this year falls on Sunday; NOW, THEREFORE, I, JAMES V. ALLRED, Governor of the State of Texas, do set aside and proclaim the day of June 20, 1938, as the date for observance of EMANCIPATION DAY in Texas, and do urge all members of the Negro race in Texas to observe the day in a manner appropriate to its importance to them.

Note that this was a Texas only holiday and a strict reading implies that it was a one year only holiday.

In 1970 Texas made it an official state holiday. Again, commemorating the end of slavery in TEXAS.

So, here’s the problem with it being a national holiday. Texas was over two years behind the rest of the nation in officially freeing it’s slaves. Actually, the slaves in Texas had been free since January 1, 1863, but Texas refused to comply until Union troops forced the issue.

It’s moot point of course because the mania has resulted in all 50 states and the federal government declaring June 19 as “Juneteenth.” Except that it appears to be one of those Monday holidays, not one celebrated on the actual date like US Independence Day on July 4.

A cynic, which I am not, might think that it’s just an excuse for politicians to signal their virtue and for some employees to get another paid day off. In some states the employees have the option of taking Friday or Monday off. Which surprised me on June 18th, when my trash lay outside all day uncollected.

If we as a nation were serious, we’d make September 22 “Emancipation Day” as that was the day the proclamation was signed by President Lincoln.

I suppose we could consider November 1, 1864 since that is the day that Maryland (a Union State) officially ended slavery in the state. Yes, Maryland despite being a union state, was also a slave holder state.

We could start another debate about the real causes of the War Between the States, but that’s a debate that will go on for another 100 years.

Texas should keep “Juneteenth” and the rest of us should celebrate “Emancipation Day.”

Oddly enough, I couldn’t find the etymology of the word “Juneteenth.” Who came up with that and why?

A final note on Wikipedia. It’s convenient, but not particularly accurate. Some of the articles are horribly slanted, so use a lot of caution when reading articles and using it as a source. You’ll note that I took a couple of quotes and dates, but not much of the rest from the articles there.

 

Only Police And The Military Can Be Trusted With Firearms

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Or so we are told by the anti gun Main Stream Media.

Which makes this story by the always anti gun Associated Press a surprise.

Some stolen US military guns used in violent crimes

In the first public accounting of its kind in decades, an Associated Press investigation has found that at least 1,900 U.S. military firearms were lost or stolen during the 2010s, with some resurfacing in violent crimes. Because some armed services have suppressed the release of basic information, AP’s total is a certain undercount.

Government records covering the Army, Marine Corps, Navy and Air Force show pistols, machine guns, shotguns and automatic assault rifles have vanished from armories, supply warehouses, Navy warships, firing ranges and other places where they were used, stored or transported. These weapons of war disappeared because of unlocked doors, sleeping troops, a surveillance system that didn’t record, break-ins and other security lapses that, until now, have not been publicly reported.

For a civilian gun owner losing a firearm is a big deal. A really bid deal in some states. In my state, which has very strict firearms regulations losing a handgun will at the least result in loss of one’s concealed carry license. At worst, it can lead to felony charges and permanent loss of the right to own firearms. That includes thefts if the state can demonstrate that firearms were not properly stored when not in use.

Top officials within the Army, Marines and Secretary of Defense’s office said that weapon accountability is a high priority, and when the military knows a weapon is missing it does trigger a concerted response to recover it. The officials also said missing weapons are not a widespread problem and noted that the number is a tiny fraction of the military’s stockpile.

“We have a very large inventory of several million of these weapons,” Pentagon spokesman John Kirby said in an interview. “We take this very seriously and we think we do a very good job. That doesn’t mean that there aren’t losses. It doesn’t mean that there aren’t mistakes made.”

I should keep this quote in mind if I ever suffer a loss of one of my firearms. I’ll just tell the police that it’s only a tiny fraction of the number of firearms I own and I took it very seriously once I figured out that this expensive piece of hardware had vanished from my safe.

Yeah, that will work.

It’s often an insider who does the theft, especially someone who is in a position to handle firearms or parts on a regular basis. Human nature is to become a bit complacent about this and trust people you know to behave responsibly.

In 2014, NCIS began investigating the theft of weapons parts from Special Boat Team Twelve, a Navy unit based in Coronado, California. Four M4 trigger assemblies that could make a civilian AR-15 fully automatic were missing. Investigators found an armory inventory manager was manipulating electronic records by moving items or claiming they had been transferred. The parts were never recovered and the case was closed after federal prosecutors declined to file charges.

Yet the AP and other media outlets are constantly worrying about people making “ghost” guns in their basements. Why do that when you can buy high quality parts from a government employed thief?

BTW, this sort of thing also happens in EMS, only with controlled drugs like Fentanyl and Versed instead of firearms.

Note also that federal prosecutors declined to press charges. There are valid reasons for this, but there are also invalid reasons such as not wanting to embarrass anyone.

The entire article is worth reading, although there is some slant in it like all media articles. There also appears to be some prevarication on the part of the military so admit that there is a problem or how they plan to address it.

There are two things to keep in mind in addition to what was reported.

First, there are a measurable number of criminal gang members who enlist in the military. They do this for legitimate reasons such as wanting to escape the gang life and it’s risks. Some also do it for non legitimate reasons. One is to get military training so as to be more efficient at dealing with rival gang members and resisting the police. Another is the potential to bring criminal activity, such as theft and drug dealing into military housing. Firearms theft would also be a motivator. Something to think about, isn’t it?

The other is that this article covers theft or loss from out military, not civilian law enforcement agencies. I couldn’t find any good stories on the overall issue, just scattered articles on individual thefts.

Thefts include those of law enforcement weapons and thefts of guns taken in evidence or held for other reasons. It also includes more than a few stories where law enforcement officers left guns in places like public rest rooms or other places. Again, if a civilian does this, he is going to have a lot of explaining to do.

Somewhat embarrassingly, the federal agency in charge of enforcing firearms laws in the US also has a lost gun problem,

ATF’s problem of ‘lost, stolen, or missing’ guns has gotten better, but it’s still a problem

TF firearms have vanished under embarrassing circumstances, according to the report:

  • Ten firearms, including one rifle, were stolen from government vehicles in separate incidents. The agents received four- or five-day suspensions.
  • A neighbor found an ATF gun on top of a vehicle. The responsible agent was suspended for four days.
  • Agents twice lost pistols at restaurants. One officer received a letter of reprimand; the other was suspended for eight days.
  • An agent who left a weapon in a briefcase on the Metro was suspended for 10 days.
  • A missing revolver was found in an employee’s personal car, resulting in a 25-day suspension, the severest disciplinary action listed.

Horowitz said his office identified “several significant deficiencies related to tracking and inventory of ammunition. For example, ammunition tracking records were understated by almost 31 thousand rounds at the 13 sites we audited. Given that ATF has over 275 offices, the number of unaccounted ammunition rounds is likely much higher.”

Need I drone on again about what would happen to me if I lost any of my firearms? And at the prices ammunition is selling at these days, I know where every single round I own is sitting!

So, when you hear someone talking about how gun owners should be penalized for losing guns or ammunition, point them this way.