CID Report (Death): 0537-04-CID034-72601

. •
FOR onieot. USE ONLY• . . LaNir Enforcement $6nsitiVO ,
DEPARTMENT OF THE ARMY"
U.S. ARMY CRIMINAL INVESTIGATION COMMAND..
• Fgrt Hood, ROsident AOhcy 6th Militpry Police Gtoup,U$ACIDC, P.O. BoX V, Fort Hood, texas 76544-654
. . •
20 Dec 2004 M3EMORANDOM FOR: SEL DIS'T'RIBUTION . SUBJECT; CID REPORT OF INVESTIOA:TION - FINAL/SST - 0531-2004-aD034-72601 - 5T,I9B .
. .
DAITS/TIKES/L6CATIONS, OF OCCURRENCES *i
DEC 2003, 0100 - 04 JAN 2004i 1229; UNKNOWN LOCATION IN AL ASAI)
IRAQ
DATEiTIM:4powiTt.k. 29 JUN 2004k 1800
y;

SUBJECT:
1.UNKNOWN, ; UNDETERMINED MANNER OF DEATH (NFT)

1)0Lc)
2. DELETED
.VICTIM; • . 1.UNKNOWN, DETAINEE MI (DECEASED) ; CW; IRAQ; MALE; OTHER; CT ; uNriDEMRWMD MANNER:OF DEATH (NFT) .
2. DELETED
INVESTIGATIVE SUMMARY:
This is an "Operation Iraqi Freedom" and CategOry I Monitorship Investigation. , , . b1-c.... ., ::b3.. th*Mili Police f4..31 k4
ThiS offiCe was: notified by ILT - .-, -i - ,.
Battalion (CID), Fort Hood, TX 76544 ITDC), that CO
21st Combat Support Hospital (CSI-I), 13th COSCOM, FHTX . reported fhb des, an tzaai

— ,
FOR OFFICIAL USE ONLY Law Enformfient Sensitive
01363f1
• :
FOR OFFICIAL USE ONLY Law Enforcement Sensitive
malp detainee; which gpcp.qp4 4% pat
On 20. Mil 04, an operational decision was made to initiate a report of investigation based upon
inkotnl
. 404 developed,
exhanSted all leads and did not idem the.viettin or any :log%al subjects;
StATU'It$: .
I •
Attached:
•
61-_C -. r!P(er
1111111110.13 May 04, detP:ilitig notification; interview of CO and interview of MAJ • lolc -0RD
1. Agent's Investigation Report (MR) of SA _
'3
2: Sworn Statement of LT _ :15 May 04, wherein he stated_while commanding the
21st Combat 8upport Hospital (CS , Salad; Irza, a unknown person was treated for trauma to the head, which Caused his death.
• • c
, _ • _21_______.1
3 $Woin Statement of MAISW ori . - -- - . waiiiimit.,_ . , _ ...„ P May 04, detailing-the treatine* of Iraqi EP
who died_ from severe he traumasometime n.
i Dec
D 03
• • 4. ATS of A.1*-' 13 May 04, detailing receipt of Requeit for Assistance and interview of
yim. c lwq• • •
5. SWOM Statement of. 13 May 04, wherein he stated he treated an Iraqi: detainee for injuries cons stent with bl i it force trauma to the head,
. 444
6..AIRof 1 -Jun 04, detailing receipt of Request for 'Assistance, interview of.
MAJ and coordination with CW2 bq,60-,-
. try . 7, SWorn Statement of _ 2 :Tim 04, wherein he.itated he treated. an Iraqi Ketdacidoss sone . .
male for Diabetic . i sometime in ti. o, to fan 04, "
_ .: ...- _ _
-.....i ba-,;,, . . to 44 - 5 ..
. . ' , : , • . .. . . (cis_ ,3 , • .. 8: AIR of.SA. , 5 AM 040 det _g intervieNv.Of CPT
Otuzirdiliafenvon
--.
.
9. AIR of S 29 Tun 04, detailing receipt. of Request for Assistance, interview of CPT interview of MAJ
FOR OFFICIAL USE ONLY
Law Enforcement Sensitive • 013700
•
600. 002

DOD-015649

. . .
FOR OFFICIAL., USE ONLY
Law triforcemeht Sensitive .
10. $WOrp. Statement of CPT Jnn. 04; wherein she stated who stated he did not remember this particular inoidentlmit,ktieW all medieal records Were shipped back to Fort .
. •-• • Ilood, TX, . .
11: Sworn Staten aftV.r.Aj 29 Jun 04, wherein she stated she did not remember
all of the patients she 'tteate
, • j974-C-(: -

11 AIR of SA , 26 Jul 04, detailing receiPt of Request for Assistance, and
coordination with CPT 4-PFCIONIMP

:: to 4-,,.-: , . , . ' • ' . ' 64 4i ‘.6.-:7.",„
13; AIR of 1:9 Aug 04, d.etaihng coordination with CW3 iT
• • • ' - ..:."3 1, ,3:

pertaining to detame . .
14. Interrogation ssummary 19 Jan 04, taken by SSG . ,..,..,_ ,----' --'-' 41144 if
• 1 • '•-'' -
.
t b6 • . . . . .
15: AIR of SA _24 Aug 04, detailingreceipt of Request for Assistance and
coordination witho ::ary. Affairs:

7f? -4
. , 16: Certificate of Death (overseas) 4 Jan 04 pertaining to EP 411111¦. '. ..._ ... • . .
IOC:-. - L,
. -17. Alt of SP 24 Sep 04, detailing receipt of Request for Assistance, coordiliatiott . with CW3 : d revieW ofMr111011111111111"eCOrds.,
...s:
fr-ci
. .
•• a AIR off.SA 2 Oct 04, detailing receipt of Request for Assistance and interview of SSG ' 10/9,4•001.:
19. SWorn'Statetent. of SS Oct 04, wherein he stated he completed his
.,. ..
Interrogation summary the same day or the next day after he conducted the interrogation and
that the interrogation summary was a combination ofhis interrogation note and information
• taken from' the 4 ogittOe document • • . : .
_ . _ , I si ci'c, Iii i iq

Hi ti
20: AIX o SA oV 04 detailing interviews of c l? .S$
,..
and MA,.1. 00'ordmation with SA • •
1/474,-1 •-•.: .•• .. .4 ,... ,..., , .
17Er L ; la Combat upport, ospital (CSI-1), CO Abu Gfiraib Prison, SA
614 Mrs and SiA; and review ofdetain&U mriedical records and SIPRNET

3 .
documents. • 10.414.e°6 " ft
• .
. . . .
21: Sworn Statement of CP4 3 Jun 0 , wherein be stated an nnknoWn white male •
dropped off an unknown Iraqi male 61 the Al Asad CSI-.1 sometime in Jan 04. •
..-

FOR OFFICIAL USE ONLY
Law Enforcement Sensitive
1 3 7 0 1
••••.... • .
000003

•
. • -• .
.—¦—rkre
•¦
. _ . .. • , •• FOR OFFICIAL USE ONLY
L w Enforcement Sensitive 22,-. S_Worn. Statement of $:., ..4.Allg,04;3vherein he stated he Was tiLIQ .PAp Nccaq.
•
for the 21st .siii.),Thii.0-. op*: ,-. . ... . . ,
• -• , 10.4..i..i.,. 4 . • .
25. Medical Roora§. gfpeti4ine .g Ian 03-3 Ian 05, detailing treatment at the Al Asad Combat Hospital,: Al Asad,,it
• r..• , ....• —.'...•
6. '-'( bl . • --: •
. ;• .., .-... -.. k • ..,• .-.. .. • :. . - • ‘..—,-• ,. . ::
3 Jan 03- 4. Tan 04, detailing treatment at
24. Medical Records Of Petaine..
the 21st CSIT, :LSA.Anieonda, Bat •

25, Microsoft Excel printout detailing patients treated by the 21st CSI-1, 15 May 03 -21 Ian .04::: -
•" • . • . • ... • ... •
-.:.
.--,4: 6.6g- • - . .• . , • . - • • , .
26, AIR of .S,•A:..„,,,,,,,.,.,..,.,„..,.,,,,.,,,,.. -• 23 Nov 0.4 detailing receipt of Request for Assistance and interview of$S01111111111111111010
27:. Sworn Statement of SSG. . ., .,...s, . ...„ 23 Nov 04, wherein he stated he released the body of the unknOrn prisoner to his fatri•ly:
Not Attached:
Retained in the files of the S-2, 3rd. ACR, Fort. Carson, CO:
28. SIPRNET documents pertaining to
The originals of Exhibits 1 through 13, 15, 17 through 22, 26 and 27 arc fotivarded with the USACRC copy of this report. The original of Exhibit 14 is retained in the files of the 3rd ACR, Fort Carson, CO 80913. The Original of Exhibit 16 is retained in the files of Headquarters Company, Mortuary Affairs, LSA Anaconda, APO AE 09391. The originals of Exhibits . 23 and 24 are maintained in the files of Patient Administration Systems and Biostatistics Activity (PASBA), Building 126, 1216 Stanley Road, Fort Sam Houston, Texas 78234-5053 The original ofthe information contained in Exhibit 25 is retained in the files of SSG b& Headquarters and Headquarters Company (HHC) ; 1st Medical Brigade, FHTX. • • ' .
STATUS: This is a Final Report.
FOR OFFICIAL USE ONLY
Law Enforcement Sensitive . 013702
Q00004 .

1 -S.ACkC, Belvoir, VA HCICR-CR//, 6010 6th Street, Fort Belvoir, VA

22060-5585 (original)
1 THRU Cornmander; 11th MP BA (CID), ATTN: Operations, Fort Hood, TX 76544
TO COMmander,.6th•Grp (CI)), ATTN: Operations, Fort Lewis, WA
1 - PM STATION COMMANDER, FHTX (e-mail only)
1 - PMO CIUM INTEL (e-mail only)

1 - Director, Armed Forces Institute of Pathology, ARP Annex-Bldg 102, 1413

• Research Blve, Rockville, MD 20858 1 - FILE
FOR OFFICIAL USE ONLY Law Enforcement Sensitive
013703 000005
DOD-015652

r
liCq NUMBER-•-•
REPOR

,AGENT'S INVESTIGATION
0374-04,omo34
CID Req04t40.i1
r044. . . , . ... • ..,..:--•
.,...... . .
.:.,-.1$0.0; 12 May 04, this office was • notified by LTC. •
11tb. Military 1-: C -... }3 t.t . ' .1.,. * - :': (.CID).-•,Fort Hood ,'..:. 76544
04TX)-,:.-that COL,' .......... ...._ .__ _.. ',.ntt Combat

.,,,,i,v-i.,

opl,tal-, 13th cosc...-fo.m.--;., FR a ... 64't .. ,whICPC.ff6e6i1±.f.ed. inBalad o IZ (BIZ) .,
. . .. .. ....
0,e-94.1074,3 - ::' • -- - .i•J - - - • • •• . • - : . , , . .
.,. who provided a

(:)...-1300t. 13 May 04; s4_441terviiifed. cot, _ _i:i
•

sworn:statement wherein 44':$4;'.414.1o: commanding the 21_t- c04 BM a i.001.1.0I40e$00 was tretoof.fop trauma to the head, lalillipaq$ed..to.$ death. COL 1.---4.'stated he cad not know circumstances of the dearth.
--.,-.. -- --, .. -. .-. . • .. ,,...
3-.. -105.016P735: • — -- . , , •
-,•, •_, ..,..„:„ ... , : . . ........ -....----------- --- - --"---.. • ' • ...

. . • . . . • • : -. -
•O 1517- • 13 May••04- SA • •! th
is o ffice , intex'viewed MAJ-
Headquarters Detachment

..... . . . ,.. ..,,. .. ,.. .... — . . ; 1-16adtit.4ttet and• • . •• -•• • • • ••• • • • •• • • •• .•••• • ... •-. • • • .•• • •• (HHD), 2 1st...661iii.Sat.• SupportHospital (Csx)f 13th Casco", FHTk; W110 rendered
a sworn. 'statement detailing the treatment of Iraqi ETV at a US Army C8i1:'On $2! Anaconda' Aaladi Iraq,: who died from .severe head trauma allege to have occurredr at . a EPW detention facility: sometime in December 03 . I/ /LAST ITEM//I
4
11M6. D SE E. NUMB ORGANI•Z•A-T-I4DN . • . .
a Fort Hood Resident Agency, 6 MIk) Group­ J.•••••,,,4•4•.,4
SA Fort Hoact TX 76544
SIGNATURE... DATE EXHIBIT •
•FOR OFFICIAL USE ONLY . . . 15 May 04 b1370 ,;
FOR OFFICLAI. USE ONLY
.
LAW ENFORCEMENT SENSITIVE

DOD-015653

SWORN STA-MS/LENT
.! •
".•.•.•-••••. •.•...•..•
".• •
Location-f-Fort Hood, lx..765. • •..:.:
Date i A:: le ,

int
. GradeIStatus 0-6/AD
Org/Ad&ress 2jst Combat$up0Ort flospital, 13 1 COSCOM, Fort Hood, TX 76544'
•

: •
.OATH: -.. , , Around e middle of the December 2003, and before Christmas, I remember an Iraqi civilian brought to the 21st Combat Support Hospital (CSH), palad„ 14 Mg); . This Iraqi civilian had tra410. to the head, which caused his death. ' nt. ¦_. .,••¦¦•¦¦.mAiliandthe I 661 q • XO reported thishicideut to ine, Mier learning about the ificiaent I reported to the Cl]) m BI4
• It was my idea they were going to investigate this incident, but I never heard of any doctors that •
were intervie*ed. Last week I was reading a repOrt,*here CID may have been selective on •

•• which investigations were *Orked • I wondered if there was a reason this incident was not
inves gate So I did some research and talked to my doctors and then I reported this to LTC
' ' --'" '•'- —. ''''. '10-6' S 00 ''''3

I, WANT TO MAIO TAB''01.,LOWING STATEMENT UNDER
, .re4c- IAA,-i .
0-c.-"1 1 1/- ' -. . . •
Q Do you knowwhere the Iraqi civilian records are maintained?
.
A: I,know that the 3l Combat Support Hospital, out of El Paso, T • took over the mission around 26 Jan 04 We took all the medical records of U.S soldiers back to Fort Sam Houston ; • .TX and the Iraqi medical records stayed in files of the hospital: To my best knowledge the • records are still maintained with 31st CSH, BIZ with Patient Administration. The record, which pertains to the Iraqi civilian in question, has two files, one file contnips the information of his treatment and the other is a death packet There are only about 50 to 100 records of Iraqi Civilians that were treated in the month of Dec 03 at the CSH in BIZ.- We would have about ten Iraqi death folders a month. Q Do you remember the point of origin of this Iraqi civilian? A Maybe Abb.. Ofiraib, or out west • , , i_ r
•
Q; Do you remember who or how the Iraqi civilian was brought to your hospital?
•
... ,....641 /9 '9 3
A 57.151. Air Ambulance, Fort Carson, CO, commander MAJ. brought the Iraqi civilian to the CSH, pa . . Q Do you know how the Iraqi civilian received his injuries?
A: No. , „ .• •
Q: Can you describe the injuries to the Iraqi civilian?
A Blunt trauma to head with bleeding inside the brain, .

.
Q:.. How can it be determined there was bleeding in the brain? .
A. CT scan was done determine there was bleeding in the brain. Q Did you observe the injuries? , •
A: No, ' • S ' . .
may have
. 0 . 3 7
vereen-ortreatekthis­
: Do you know of aWerdobtodrOurgide-tlireSH7BIZIWarnitSrlia- ------- --,-----..--
. ...., ,..
Iraqi civilian?
‘103C-LI INITIALS 62 1 Page /of 3
FOR OFFICIAL USEI ONLY
• FOR OFFICIAL USE ONLY • EXHIBIT . Z
LAW ENFORCEMENT SENSITIVE
• 000007
DOD-015654
t.

STATEMENT
TAKEN AT FORT " HOOL

:Dt owiodgo of this incident but I 401 low jibe saw
• patient;: , , . ,
Q: Did CW state they were going to investigate this ease?
Q: Do you knowledge was this incident investigated by OD?
A /IQ-:

.
Q Do you know of any pictures taken of the injuries?
A; The treating doctors may have taken pictures.

Q . Is there anything else you wis .to add to your statement?
No.//End of Statement/

th&-"(
•
0137,r)6
FOR . OFFICIAL USE ONLY Page 2of 3
EXHIBIT
FOR OFFICIAL USE ONLY
LAW ENFORCEMENT SENSITIVE 00131308

4- 04 -C.44009

•
TAKEN AT FORT HOODS TX

• STA2j.EDIN.T. OFci.D.03“.72GOT
•
. • AFFIDAVIT. .
,..HAVE READ OR HAVE HAD READ TO ME THIS STATEMENT
vocii•pgINs.ox PAGE 1 AND ENDS oNPAQE1, I FULLY uNDERsTA1%1D.. TxR, .
.coNTENTSEQF,!•04 ENTIRE STATEMENT MADE BY ME THE STATEMENT IS IRTJE.
I HAVE INITIALEDALL CORRECTIONS AND HAVE INITIALED THE BOTTOM OF
BAcajiwg.c9KAIN-:
Iwpf,15 STATEMENT I HAVE MADE Tms.STATpAENT
FREELy WITHOUT HOPE OF .13.pwiT OR REWARD, WITHOUT THREAT OF
PUNISHMENT AND wit:lour. COERCION, UNLAWFUL INFLUENCE, OR
mom.01.0vcgwNt - •

Subscribed and *Om to before me, a person authorized by law to
adrrirnster oaths, this J day of May 2004 at the CID office, Fort Hood, TX.
•

otiMitlisternig Oath) •
„ . : •
(Typed NaMe of Person . storing
ARTICLE 136 UCMJ -
(Authority to Administer Oath)
WITNESS:
(Typed Name)
(Signature of Witness)
• 01,3797 •
INITIAL • Page3 of
.

FOR OTIC AL USE .ONLY
EXHIBIT
().,
FOR OFFICIAL USE ONLY
• LAW ENFORCEMENT SENSITIVE'
000009
4 C D
72 6 Cry
•g • OR* STATEMENT
File Number : ViL1-4ADO3i4• -
Loeatioh! -)31aild-q.ng- 2200,- Fort Hood, T 765.44 ,
Dd.te ; • 13-Ma 04 V0* t

W
statemen .
.:
SSN • , Gre.de/Sta d$.
...
„, .. - : • • a,
¦
. Org . ea titi4r_. r..,..an _ :1:10.4(1.quatto.t.s Detachment; 21st •
....:
air HOodi, TV '76544
Con Support a 'gpit, :13th coscOmi Vott
-• --.,, -' ' • ' ' --
WANT TO MAKE THE STATEMENT.
UNDER

Executive Officer Of 71.st Combat Support Hospital, and have fOr: the last• two yearg.„
• to LSA :260.1:441 on 23 Apr 03, We Were located on an airfield southeast of
¦" •
SeUnethne early in the afternoon u1 Dedenher. 03;1 1140 that their had been:some
Imqi enemy prison of waripatients that had flown into our facility There was One male
patient that was in serious eOndition.. s 4s.yoti come through the main entrance of the Emergency .Medical Treatment. tent (EMT), there was an Iraqi male, iTl his late 20's to 30's, lying on a litter
located in the far right corner oftlio tea He was not very heavy in weight, and had a medium
fiat- .
0: I don't reoall that he had a beard, and if he did have some facial hair it was Very short
He was covered with an Artily style wool blanket I believe he had on some sort of shirt and
pantk I recall that the patient was unconscious; with severe head traum the left,Sid:e of his
fiee, and with some swelling to the right
remember that briiiseiTIM still yery, shiny, The

_ Very..ca r, left, , was *0004 to the point 'it could open I. _ bb-
noticed seeing what` appeared to be dried blOed on both sides of his face. Dr (cpitylvatt
_k?vasas treating this patient. and . informed me that he had arrived approximately 30
utes aaiN That he had been flown itt by MEDEVAC from somewhere in western Iraq.. Sheindicated that it appeat.ed he had been beaten. She did not know by whom, and that his ink : 'es Weresevere and he probably would not survive, From my understanding D '' 1 r 4•?-1
• waiting to have cr scans prefOrnied-on the patient stayed there for a few more minutes and
then left to go to our Tactical Operations Center; I can't recall the'exact tune, but I was tater .
: otiAm that this patient had died

I am assume based on the fact that this patient had heen flown
in from the west that it Wai:either the 57l Air Arohulanoe out of Vort arson; co, or the 159th
Air Ambulance out of Germany: . The standard prOCeditre after an Iraq patient died was to notify
Mortuary affairs,, who in turns collects the body of the deceased, and then releases the body to

the faintly, It was not uncommon for Iraqi patients to arrive and we not know their identity. We
. would assign them numbers as a method of tracking them at our facility. •
AlliallialOrt.C-7.
A; MAI 7::..7t'loic-If 66-v"
111111.011•10 •
Q Do you know the identity of the Iraqi patient?
.

. Q; Do You know if this Patient was a prison of wall
• A: It is my understanding that he was an enemy prisoner of war. . 0 1 3 7 a , : _ o ou know which prison he came from? -
A: No. . • • --,,-.....,===.---, =,....1
Q Do you know where medical or death record of this patient could be located?
bil.4-1 1 66. •

• INITIALS Page 1 of 3
FOR OFFICIAL USE ONLY
EXHIBIT 3 .
FOR OFFICIAL USE QNIY.
•{A* ENFORCEMENT SENSITIVE • 0 0 010
. , •STATEMENT OF TAKEN AT FORT HOOD, TX DATED 1,44y -0 4 CONTINUED;
A There shOuld b a &oath pac1et retained in the files of 31 4 CSI-1, our replacements, • .
.Q Do you recall the date that this mcident occurred? A No I believe it was in December .6, because I departed Iraq for-Kuwait on 7 Jan 04, and the Incident took place at least three weeks prio.F;.
How common was it for Iraqi patient to wive at your hospital with similar assault type injuries? A Not real often. Most of the time their gun shot victims.
Q: What was your hospital area of responsibility?
.
4; We handled everything north of Baghdad up to Tikirt and out to the east along the framan border,
Q Was it normal for a patient to be brought in from the west of Iraq?
A No, not unless the hospital in Baghdad was full:,
. 1491-6

Q Is toyEitlifialtik4siigRe4 to 21° COH?
A She'WaSfoi the deployment, but she is stationed at Fort LeOrtarclw.00d, MO.
DO YOU HAVE ANYTHING ELSE T " ADD TO THIS STATEMENT?

Q
A: NO.///END OF STATE/viENT/// c-gi
013709
AFFIDAVIT. . INITIALS • FOR OFFICIAL USE ONLY . . FOR OFFICIAL USE. oNcy LAW ENFORCEMENT SENSITINT 6- Page 2 of 3 EXHIBIT 000011.

Cr-p-CID57,9
• STATEMENT .
TAKEN AT FORT OPtizi.':TX DATED 13-May-04 CONTINUED

b:
HAVE READ OR HAVE HAD REAP, TQLE THIS STAT.$00.WW.I0C14010$7oN. PAGE 1 AND ENDS ON PAGE 3 -FULLY UNDERSTANDTHE CONTENTS OF THE ENTIRE STATEMENT MOO. BY ME.. THE
•OAttfitit#1.1.0t. t10k0 INITIALED ALL CORRECTIONS AiitL IIAVE
OtttattlitOOtTOWO 044..P$ CONTAININGi T

444R4)* THIS STATEMENT FREELYiHOPE roOBENEFIT ciA
At0015 tTli00t: THREAT OF PUNISHMENT, AND WI7.1.161TEcciikcloN,
UNLAWFUL INFLtJNCE, OR UNLAWFUL INDUCEMENT

66-.(r •
-.0 , :

go.4, viktitiltatWnopt)
i
: •-•i

•

• ••: • .i

. subscribed and .sworn tar before rat-.4 Person authorized by law to o, 13th day (;)4 May 2004 at the CID office,
. atiftiitatOt PkOisi:i

, •,

r.i•

Oath)

•
Special' Adent
(Typed Name of cittp.nirtotfj...hq Oath)
ARTICLE 136 UCM.T
(Authority to Administer Oath)

WITNESS:
(Typed Nam

)
•

. '(Signature o . Witness).i

013710
• ,INITIALS Page 3 of 3
FOR OFFICIAL USE ONLY

EXHIBIT 4$
FOR OFFICIAL USE ONLY
. LAW ENFORCEMENT SENSITIVE • 000012
DOD-015659

V5 CL L1 47 4.0 v I
ROI NUIVIK13:-'.:. • . •*4 .0037-04-Q1D
DETAILS. ., .. ,
...
RASIS•FQ13 INVESTIGATION:.About popki ,04 . this: ante received -a .eqiiest fot Assistance (RFA) from the 11th M..; ' :ip. it J7100.i. FS‘HT50 to. ooato; fully. id.400"; ar1.0..--tedaryio.Opctor 0/1N.,, op-040y (13. co); Brooke Army
•,, ,,..„.;.• .t..,. ...... • ..•• ... ••• .
Medical Center(0AW.:, O §1-6. 1 -...6.4tok •-‘7..8.234: ' e4 ordieig the homicide Of an Iraqi
.....,„,..,„.... ....:,..„......- ... ....
setainee he treated while asSigned to 11Stt ciefbito . §tiotio ''0040) csH),. soici.;leoi.. -• . • -• , ..',
.....4 • .• . • _• • .•• z, •:. . ••• ::••. , •••• ......• ••., • •••• ..••• ..z...... :•
• . • • • •• •...;• _.:••• :..: .•.. • .• .z • • •••._.• • ._„,:.,,,..• ,..--. .:: -, • ..... „,...
:"
,....
bout 1820, 13May 04,.S :„.„...,:_.,.. tetviewed000tor (r0.1.6w) .. . ..,.. , .... A4.. ...,.,.,..._ ..„....„..„.tovided sworn statement wherein ,..p 0. 04 his. unit received op. leoot 00:00,0.:W.o. 40000 .frif(ieio4 to the
. head; which was consistent. with blunt fOrCe traurtitO the head: (See sworn statement for details),
STATUS: This investigation IS closed in the files of this office. All .requestedinvestigative activity has been completed.M0/00/. 00/000/Last Erthy111111111111111111111111111111111111111111011111111111111111111111111111
013711
MY ED SIGNATUR J. _ B_QUENCE. NUMpER:: ORQAWATION Fort Sam Houston, Texas 78234 -, DATE • 1. 3 May 04. • EXHIBIT . 7sPIA
ORM 94 1 FEB 77. '• FOR OFFICIAL.USE ONLY FOR OFFICIAL USE ONLYLAW ENFORCEMENT SENSITIVE• 000013

0 3. 7 rd.4.61.•
. ",. • e . SVVORN STATEMENT••:0or -woo of this form, see AR 10945; the P4-011416.Vit.t • ' qiitai
Fort Sam Houston, TX, 7834 --i.-At-N-AmE :poor fs..1:40E mooix NAME
1.miwTc.)-MAIO Mg teittti.d*P10.4:rkrmartit t.RIMR cpk • •
in 1:i.eeenfbef,.gos :I was ototl., ...K ,,..r.or,g1::: 0 . , .: ti000tol (poMititoorti t Iraq 0ecci$Q01,00-: ...,-
Infantry Division) purino th0(tinir • -.'. • , w.O..t000k: , 06. fr. , .:**Itioo,00.6. ici.A Ort.O. 4,Wo *00160 that tAt giOn

,. _. • . -.• .. , . • . , „,. , . ... ... • . .,.
hOor"egilopogrooCfonly... at the facility .: ai ,arrival4: had -0 I revef 0 ovlsolookele.O .tlefikirw:
, ----„„, .. --„..• -,, -:4:-...:..:. .• -..- :, . .. . ...„..,.. ., . .. • -- - ",
.,
irjtuz.betionoNeOheni* ventilation lie had some ' Minot. bruising th ef001 . 04.1 no Offief visible Wit.:11,1041V1111100$, A
•
.8togorti 0..*4r toigroilot.-WW.."''''P'"1#14010.14,-ft 1.10s felt that the CT SOO of the kra.111 00vistrotolliolertzig* intaoffqrkoV00 ti:triOttiogpo. There -
' CT scan of the brain woo performed vhd:W00.1.04withe.e0i-o*koo-ig ok,kr .tIouti .-'
were no skull fractures that ,l, recall, We felt that this was mostdookterft WI blunt rootto the plvo, me patient 1St*
expired at the CSI-3 o, - • . " • chain. :• • , " -• •• ...,.•,•. ... • .._• • •., . .,. _.•
, We forhied out chain of command as well as the phyo000$ r'orwring 1410Nti001# 4re: We viiere told that CID would be notified I was Later told by 'our command that Cil) had i4iVeditiated the date ad fi5izilif 110 evidence of "WO play • • :. • ' • -.. . . - , : : , • : :. , The cletgihee.'.$ films and . medical records would I* tyy0$--t.'hoispfoi in further eveNttting PO Oti$0. I eftf Cfr4tite if tile, •
records returned to Ft. Hood cnit• the 21.4 C$H.or if they are staff in salad w/ the $.1 4-001 v,ilti , repic
Idtd us-- et ftlrli.s • WareperfOrtned on a very old CT-scanner that May or may not still have the images St6014: . . QIIIIIIPTC -1 i00 -1. .
. .
,4,11" . . . ,
------ .016.1-604-q
.. . -.
Q. Where -woo the hrtii.SeS. on the face of the detainee?
A: On both sides of his face, .. ' • C);•000 you describe the detainee'?
A: An Iraqi male, mid twenties tO.thirtieS, Well developed end Well nourishedQ Ho 10:40..vil$ the detainee in Mit 0$1-Pe °are'?
A: Less than tyviehty400r hours:
.. . . , . . .., . . .
Q PO you remember who told you the detainee collapsed? • .
A: NO;•
Q: 0.0 you have anything else to add to this Staternent7 -•
A: Noll/End of Staten-lentil/.
,....
0:1,1.161:.:$41F--.00.e-ONAK:110437,4141V111t, -m,*fii
. 41,
ADDITIONAL PAGES MUST CONTAIN THE HEADING "STATEMENT QF.
TAKENAT.DATED CON1INUED."THE BOTTOM OF EACH ADDITIONAL PAGE MOT BEAR THE INIT01#$O ThE PERSON MAKING THE STATEMENT AND INITIALED As TJAG.OF.PAGES.' WHEN ADDITIONAL 134:0$ ARE LithaEa THE BACK OF PAGE 1 WILL BELINED OUT AND THE STATEMENT IMLL BE CONCLUDED ON THE REVER$E SIDE OF ANOTHEA COPY OF THIS .p0A)m.
_ . . . .
8UPERSEDES OA FORM zals 1 JAN "
68 WM Wit BE USED •
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S'ElSITIVFOR OFFICIAL USE ONLY • EXHIBTr-t.

DOD-015661
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72 601
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STATEMENT • . • • t.. •

V
•.•-•
•••:•
. •
AFFIDAVIT HAVE ROA01*
ATT WHICH BEGINS ON PAGF1 AND ENDS ON PAGE 2. i UNDERSTAND THROONTrisad
IVIAM 144 •
THE STATEMENT tS TRUE, I HAVE INITIALED ALL coRREcTiQNS Ablb. HAVE WALED:THE Bottom
t.00.Altsgtie:TH8
STAtalvigur.. I KAN/EN:Ai* 11-US aTA:ruitegr PREFIxAffil4Qpr mom OO BENEFit OR REWAR0
lUNISIteitr;
AND VVITHOUT OOER .
CION, UNLAWFUL INFLUENGE,-ORVILAWFUL INDUCES ND • •
d!'
WITNESSES: •
Britoil to administer
ORGANIZATION OR ADDRESS •
0.Peti40.."Aefivii i ippArhf OWN'4
•• • " • • -.
;,
, .,Mat,
ORGANIZATION OR AQDRESS
Aftide IM¦ (b)f4), . Oho* To. Acfrpirlistar Opths) ,, .
INITIALS OF PERSON MAKING STATEMENT $4140 -,..,pA
FOR OFFICIAL USE OW LAW ENFORCEMENT SE NSITIVE

FOR OFFICIALIJSE ONLY 'Extinkrit-
DOD-015662

About 1425. 2 Jun b4 Special Agent (SA)
.
who re ndered wotti statement relating his Or il
dotaS):
• stiat
OW:4;f:( #;:117:• I
Atitil.iti 134$; 7 Jiin 94, SA .coordinated with CW2 Regimental, Strength Manager, eiiitental S-1 Office, 3rd AC C, who related tiiat CPT • 3 rd ACR, FCC, was on orders to Hunter Air Force Base (AFB), GA, with a report date of 15 Jul
64. She further related that the US Adjutant General's Office, FCC, would probably have a copy of his orders and leave form.///LAST ENTRY/// • ,
•
Y.B.13.0 ACTEN1 S N AN WM-it N qb443E4 3idfrAN17-4:40N
-
48th Military PoliCe Det (aD),roatir016111—
A",14 ; 13)411.1311,-
• 7 Jiro..04 CIO FARM FOR OFFICIAL USE ONLY • .0.1371.4 - •
(Airtop*ted). . Protective Marking is Excluded From Automatic TeminatiO (Pdra, 13, AR.•34-16) 00001.6 -. FOR OFFICIAL USE ONLY • LAW ENFORCEMENT SENSITIVE
cv.sct•-• 1
3 7 • SWORN STATEMENT
FILE NUMBER : 0204-04-CID056
LOCATION : Fort Carson. - -.
DATE : 2 1.11.11 1994--q t loo --ci TimB: 1,4

. .
NAME•
SSAN 101-c, -4 to 0, • bradeiStatUS: 0:-4/AD .4\c; ORG/ADDRESS : HHT, 37 Armored Cavalry Regiment, Fort Carson, CO 80913
0 \o
WANT TO MAKE TIIE FOLLOWING STATEMENT ER OATH In regards to death of a detainee that occurred in late December 2003 or early .• January 2004. I do not recall the identity of this detainee but he was of middle eastern decent and . had been evacuated to the 21 st CSH located at Balad. This individual was brought to our Medical
• Troop at Al Asad from the 3d ACR detention facility also located at Al Asad during the night .
hours. He was brought in with poor responsiveness and was treated under the care of Dr (CPT)
10'3 111111111111kid held in the ICU (that was manned by staff from the attached 945 th Forward

foro-3 . -
. Surgical Team). I saw the individual the following morning _ 10 to check into the situation by the Regimental Executive Officer (LTC Vhen I saw the individual, he was sedated, on a ventilator, and unresponsive. I discussed the case with Dr We felt .
that a possible metabolic disorder was the cause of his illness (he had an abnormal blood gas that although we couldn't run a full assortment of test could have been caused by Diabetic • Ketoacidosis or another metabolic acidosia). I examined the individual and there was no obvious evidence of any acute trauma to include any facial or head trauma. The individual was transferred that morning to the 21 st CSH as medevac was available. He subsequently died at the CSH.. I don't recall the exact time frame but less than 48 hours. I disc ase with Dr (MAJ)11.1/1044
‘9"(-14..q mapwho cared for the individual at the CSH Dr. tated that the CT Scan revealed
1496
intra-cranial blood that was at least but probably older. I informed LT01111111Pand

• the Regimental JAG Officer (CPT about the findings at the CSH. I believe that informed CID in Iraq, but I am not 100V certain. I was informed that the'
1°1'4 CPi 0 individual had been detained and in our custody for less than 24 hours to include in our Medical Troop. I speculated at the time that the detainee in question had significant head trauma 1-2 • . weeks prior to being detained and that the detention process caused asecondary event such as he became anxious, and his blood pressure increase& The brain would be very prone to further damage foi-potentially several weeks after significant trauma.
•
. A: MAT b'(tb&-t/
Q: Do you know the exact date that the individual was brought to your medical facility? No. • . •
Q: Can you describe the individual who you treated? .
•A: I don't know that I could pick the individual out, but he would be of medium build, middle eastern descent And lie had thick dark black hair.
Q: Did he have any facial hair or wear glasses
16-c--14
10,6-4
INITIALS OF PERSON MAKING STATEMENT ./o144i FOR OFFICIAL USE ONLY Page 1 of 4 Pages . 0 137 1. 5
FOR OFFICIAL USE ONLY EXHIBIT _1 •
• LAW ENFORCEMENT SENSITIVE 00(1017

acial hair but idOn't"remember if he had a full beard or mustache or what IT e
wear glasses: .. , • •
1_. What was he wearing?
I don't ieCalf —

Q: Did he have any scars?
- • A.: I don't reoall: ' •

.,..
Q Do you know how tall he. was?
• . . A He was lying in" a gurney or bed, so. standing up I don't knoW, He was probably 5'8" to 6'0", ' . but I can't be sure because he was lying down. -
, : - • • •
Q: What was the color of his skin?
A: It wasn't light It was tan to dark
•
Q: What was his eye color?

A.
I don't recall. , . ' . • • • .
• Q When was the individual brought to Al Asad? • ... .• . •

. . • - Al To my knowledge, I don't recall the date, he had been detained for a very short time and was brought to our medical troop: In the neighborhood of a few hours . •
•
Q: ..Do you mean that the individual was brought to your medical troop hours after he arrived at

•
' Al Asad?

A: Correct. . -. .
. Q: Why do you think that the individual was at Al Asad for only a few hours?

. A That's what I was informed.
Q By who? ic, 4.4 4.,. -3 - ' •

A: By Co -
Q Why Was -the individual evacuated to Balad?
A: Because we didn't have the ability to care for him. That's where the CSH was located.
Q Is that where you sent patients who didn't have the ability to care for?
A:. One of two places. We also sent people to the 28 th CSH located in Baghdad.

Q: • What determined who went where?
A Either availability or aviation conditions . . . .

. Q:- When you examined the individual, did you think that he had experienced blunt force trauma .
to the head? . , .. . . . . , . , . . • . • . • ' • . • .

A: It's always a concern when someone comes in in his condition, but when I looked the
individual over, I could see no evidence of recent trauma

. .. -. Q: - What type of actions in the detention process co'uld-cause a secondary event, as you described in the narrative of this statement? . • . ' -= . . .
A. Anything that could increase your blood pressure, such as the apprehension of anyone.,
Anything that could make someone anxiout Certainly if someone became asphyxiated.
Potentially any further trauma. You're apprehending someone and you knock them down and
they hit their head. Even though its not significant trauma, its on top of the previous trauma. I
tcould be additive. The brain can only swell so much, Anything that could increase that
sWelling, A metabolic problem could have caused things to get worse too.

Q: What is Diabetic K.etoacidosisj? • • , • • . --1-60.--Ilsr-whert-dialYete" &-geto •ontrolyzunningx. , high431Q0d.,sugar$,And.the.cascade_of. ••.-..... - •
,..events that occur after th — /049-Csq(06;-1/
INITIALS OF PERSON. MAKI/4G STA• Page 2 of 4 Paps
FOR oFFT.clAL USE ONLY •
EXI-II13IT01137:16
, FOR OFFICIAL USE ONLY . • LAW ENFORCEMENT SENSITIVE

000018-
iv,cfiA - •
DOD-015665

4 ,, c 1 p•Vili''7260-f•
:.:Case No 02947.047C1p.056 .
4,-0017q4.40#1-90r00#64; :I0 or what ung apehended th.e: in., :.vidnal and brought hirn to Al As447 ....4 On't know Ittliiikiaidiiii6 told me the Special Forces but I honestly don't blow
Whei:e*aksthe 44404 apprehended? ,
, ..... , .. 3 •
'aiiii.--ii. ;,‘.:ii4:..cro-:i to Agocttot i464't. W.* theega0 little town •-: ...- - '• . ' '', : _ ,. . Q W-4$7. do you believe this?:, : , : ''. ' : : .: , . •-• . At,' I think, and' don't recall, in one of my conversations I had when this whole event happened, ' that Ofie:ofthe Special Forces tearuSlr4 driven him in from somewhere locally. I hOtieStly don't'
,
. . know WhOlOk'wheroF:' Q#- Do you recall who told you this? : :; : , bO? ' d-1: : A; Most of the conversations I had were with LT
d CPT It may have
been one of thelti,

To your knowledge, was the individual transferred from another prison or detainment
Q
facilitY. .?
A,: '14.0 : ., , ' • i , • :

Q: Did you notice any swelling on the individual head . or around the eyes?
A: No . ' , .. ,•
Q Did you notice any blood?
A: NO. -.
•
;', When did yoU cli§cuS's the case with Dr ....,: : ,. ,
A The day he was transferred, and over the nett couple of days :
Q:, Pertaining to the injuries received by the individual and his subsequent treatment, did you :.

• •
suspect any wrongdoing by anyone affiliated thee VS . Government?
-A; I did•tiot 6,1•4:„..4:i 6c,..4 :
Qi. bidljr1.11P010"..! • : -

.. „. . ' .
A: -t believe iii light Of the brief custody, he did not at the tii?ie.: .
Q Did Dr. ,

11¦11111telieVe at a later time that there was any wrongdoing?
A Not to my knowledge --6-44 -c-( 1(4,-..c(

.ow believe there was any wrongd.oing? • • .
A CpT11:......,...."' our 1A0 officer; was always very aggressive of investigating cases or

Q. Did anyone that you .10*. , .
100,111.
. potential OaseS.b.WN
Q Is that why he informed CII) of this individual? . . .

•1 clivichion ,„ •
. •••••
'Como: Any suspicious cases or events; he was sure to have CII) involved: .
A
. Q:. Did you type the narrative portion of this statement?
A Yes I. did:. • • . .. ,

Q: Did you he on any portion of this statement?
. -. , . .
•: 4; No: . .
Do you have anything to add to this statement?
Q
A: I might be able to discover the date: In our medical troop we kept a patient log. When they
. saw detainees, they kept a lot-. . " . • .
Q:. Will you contact this office if you obtain the date?
A.: Yfes,. . . : • : ,

•1,
Q.: Do you have anything else to add to this statenient?
•.
Page 3 of 4 Pass
INITIALS OF PERSON MAKING STATEMENT.
013717.
OFFICIAL USE ONLY.. EXT-TIBIT
.
•
FOR OFFICIAL USE ONLY
LAW ENFORCEMENT SENSITIVE

'TARA
HAVE OR HAI) READ TO 14 THIS STATEMENT Vv.T.Eigg.0.pOpis ON
• PAGE Ais.o.igb§ oN 0: 0,, 4.: I Fr..4.,j...y.u.N.M$TgoD THE CONTENTS Of 'ME : -•• STATEMENT MADE is­
4z STATEMENT IS *TX, HAVE 1:1904.10‘ml CORRECTIONS AND:,
HAVE INITIALED THE BOTTOM OF EACH MOO CONTAINING STAT.P4N.T.:1,14v-1¦4::p oro-
st47Whisrtf'RgEt.y WITS HOPE OF BENT OR REV ARDS wagon. IHREAT OF.,•
PUNISHMENT,, CoOiCION; UNLAWFUL. INTI IJENCEi (*Oki:LAO*,

WITNESSES: .
Subscribed and 0414 kg btf*t-o; a person gy
to adiiiIiiii147'4Uffiio 2 lays of June, 20.04, PO-#4c.4.
- • '
ORGANIZATION AND ADDRESS
'7.­
orgrYiAriviAkstieixag
-
•
.
13718
INITIALS OF PERSON MAKING STA Pag0 4 of 4 Pages:
FOR OF)FICIAJ, USE ONLY •
.
EXHIBIT
FOR OFFICIAL USE ONLY
• LAWENFORCEMENT SENSITIVE 000Q20.. 3-
s 4 :4 CI4.
. .
.
x 0 4 44_72 0-01 • .
AGENT'S INVESTIGATION REPORT. . , . •ko.) 14 'ail 0034704-ciposq
•CID 'Regulation 195-1
pA

.
. was an unidentified Iraqi 000 that eras brought to Al Asad sometime 1014 r,*$0** early Jamar , CPT
About 14 04, IA 'lephOnlOallY interviewed CPT. -" . , :.:_ho stated that. lie embered there
fie..
*t00 that the did not. remember wpc) brought•hirn into the oornoSbo that never sOwtoinoikito just
iriTher-
heard .about the spot report th?L ihid.eAl died after being transferred Baghdad . op6r
stated.tht IfieOnii-. reaSOrt he notified 010,.14 due to thOro being two cases of it0.0 dy109 in vs custodytha t . ere
•
Under investigation so he wanted to cover ell the aspects to report possible detainee ahuSet .044 z.It
. • . ',6-444•Sfig
. . , 7.t "
AbOut 0936,15 Jun 04, IATIOOtclinated this inVestigatiOn with LTC ray/pN:,;_ho stated that he did not believe • that any abuse occurred to the tinidenfifieq Iraqi male ; LT..9:011111.plated it was standard to send clOWn the
regiffiental doctor to observe any dotainoss coining into the cql.;:, LTC _Ow stated that he never saw the individual but remembers he was only in the CSH fOr a very short perk:id Of tith before being sent on to Baghdad for a higher jeVel Of treetnieht.N.LAST ENTRYM -3k6 -3
; !.•• ••• z
• .? )t:i . • t
F.,• ¦ •!1:". '
. ' Jr.
:noasraiAQMZPEINIAIVIEAND, *- . • 0.12A.141.KA. TIM
SA SIGN Carson, CO, 80913 DATE . 15 :Jun 04 • EXHIBIT a*, 13719 ..
,• 1 FE§77: FOR OFFICIAL USE. ONLY OoR OFOICIAII USE ONLY 0000.21
LAW ENFORCEMENT SENSITIVE 5%.3c.L.
DOD-015668

. . .. .

13, .F9 ItsIV40.IdATIO* too 01 5;25-.Itin -0.4ktl04. .office tOceili. ' it0.51, foe;;:
Assistance RFA) 0,Esi* .tho v4itvoect RelidOot Ageo.0(0P);.Uplifect$0 , ... .., .:_ .:itiiiitt :. .01..,y.i. Fortgoo to locate, fully idea
. . itire4tiggiop.. COW** ..,..: ..... full
Ir ice
., _. T -.egardnig ail aqi.
interview 1YIN ­
or blunt three trauma to the
. cI.etgliie . . . who .Mkrii. treated''ifilie .21.0 .Ca'
and later do
.
out 0930 24. AM 04 SA intervio704 err
-.-: .
igg)p.Ac; Fort 4o4rd Wood, MO 65473..(FLWM10'w o related he . 00$1,44
04.back to Fort
remember this particular.ippi:40:kl?Ot he knows all Iii0.4id41.00004. were sh.40 .
TX, to lie-tetirod;:.•:: • ' -
Rood; TX, rio,1 thore theyet0 sent to Fort Sam • ....-.. • • • .•,,• •• - -
. ,. . .. , . . .

4641' .. ' .
About 1030, 29 .104 04, SA ........„,.,,..,,, miteryx.owed. ...

she cloes tot remernbe00 ijiCiderit; due to the large arib:tint
MEDDAC, FLWMO„ who relatea .
whom were treated for head injuries.///LAST ENTRY//!
of patients she treated, rdthiy of-
Fort 1,00440, woo4 RA (CID)
. SA
. SgOc 41 Ageg v:cart Leogard vtoodi MO 65473.
' • • -Exhibit s.

Pate:
29 Jun (i• J113720

000022
FOR OFFICIAL USE ONLY ,
LAW ENFORCEMENT SENSITIVE

SWORN $ TATE rvl• EN •
•
.
• •• .-• • • , ••¦ •••
rOf 00,0: if* 410,45; (60. 0:0001 4.04:4 bilhe • Of" tart, fOr o
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WE;
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OF PERSON MAKINCp STATE,%?:,-' ¦ :f
VAR*
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PAGES MUST CONTAIN THE HEADING "STATEMENT OF.' TAKEN AT . DATED .
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INITIALED AS "PAGE.

OUT AND THE STATEMENT WILL BE CONCLUDED ON THE REVERSE. SIDE OF ANOTHER COPY OF ri-11 FORa
LINED.
suFT9$Ecg_--s Ftw a otty 68, WHICH WILL BE ()SW,. u j 4 •.:„
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(29 °2 a
DOD-015670

PAGES
• PAGE OF
INITIALS OF PERSON MAKING STATEMENT.
0137qZ2
62 4.
FOR OFFICIAL USE ONLY.

ONLY
LAW, ENFORCEMENT M¦ISITOR OFFICIAL
p
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TAKEN Al' DK
STATEMENT OP
STATP.I.ENT (cont.thopy'.:' •
:.•
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AFFIDAVIT. : .
• - . F,Ava REAP OR HAVE HAA READ TO ME THIS STATEM'CNT
: . .
QF THE ENTIRE l'AtTE.1,1FENT f;t4;DE SYLIE,
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OFK OSE ONI.YFiCFOR usE..010 EXHIBT"i'.1'16. 96925

.LAWENFORCEMENT SEW
.

DOD-015672

SWORN S'IATErvl EN 726C!'
For use Or this (pt.05 ..N3 19g-45 OP proponent agepcy Is Mice of TheAir1:
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ADDITIONAL PAGE MJST BEAR THE INITIALS OF THE pERsOlv MA KING THas7-47-gf,1ENT
THE BOTTom.oF EACH ADDITIONAL
PAGES? WHEN ADDITION.4L PAGES ARE UTILIZED, THE BACK OF PAGE 1 WILL BE .
OF \
INITIALED AS PAGE . .
LINED OUT AND THE 'STATEMENT WILL BE CONCLUDED ON ..
THE REVERSE SIDE OF ANOTHER ....... COPY or. THts FoRm-
. ..
. •.
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su.papss.5o:pA row..4 ?i2.3. AN Ss. wi-HcH WILL BE VSEO, •
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DOD-015673

0 7 2 .0.1 TAKEN AT FLO KO ON C-6NTINCJECiz, . •
STATEMENT 1./§TE1.1ENT (Cornii00:
A
. • •
AFFIDAVIT .
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DOD-015674

I
-03-1-/A-cmovi- 1Nto
ROI NUMBER
AGENT'S INVESTIGATION REPORT
0214-04-CID919
CID Regulation 195-1
Page 1 of 1 Pages
.
DETAILS
About 1400, 15 Jul 04, this office received a Request for Assistance (RFA) from Fort Hood Resident Agency
(CM), Fort Hood, TX, 76544-0740, to coordinate with the 31 st Combat Support Hospital (CSH), Balad;
APO AE 09391, and obtain Serious Incident Reports (SIR), they have on adult Iraqi male deaths during Dec
03. Further requested to provide documentation to their office of any death of an adult Iraqi male, not already documented in a OD report of investigation, which occurred as a result of closed head trauma injuries during Dec 03, at the 20 CSH, Balad, Iraq, APO AE 09391.
o6-j_ ko 3
About 1527, 16 Jul 04, SA boordmated with CPT
1 st CSH,
LSA Anaconda, Balad, Iraq, APO AE 09391, (Fort Richardson, AK), who stated his unit did not have any records or reports from the 21 St CSH. CPT tated all SIR's done by the 21 st CSH, Fort Hood, TX, would be maintained at that unit in Fort Hood, TX. bl-G -3 tb6-3
-( -About 1600, 26 Jul 04 SA ordinated with PFC Headquarters and Headquarters Detachment (HHD), 299th Forward Support Battalion.(F , Mortuary Affairs,.LSA Anaconda, APO AE 09391; who conducted a search of Mortuary "Affairs records for any paperwork pertaining to remains released to family members of Foreign Nationals, in Dec 03, which met with negative results. •
--•
STATUS: This RFA is cloSed in the files of this office as all investigative activity is completed. /////////////////////////////////////////(//////////////////////////////LAST ENTRY/M///////////////////////////////////////////////////////////
TYPED-AGENT 'MAW-AND SEQUENCE NUMBER:— -1
75th Military Police Detachment (CI))SA LSA Anaconda, Balad, Iraq APO AE 09391
.
SIGNATURE. DATE EXHIBIT
•
26 Jul 2004
• \). 013726
. CID FO OR OFFICIAL USE ONLY •
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.
CID FORM 94: FOR. OFFICIAL USE ONLY 1 Fai ' . FOR oFFIciAl. USE ONLY •
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