Neuropsychiatric Adverse Events Following Mefloquine Exposure Presentation

To Whom It May Concern:

This is a request under the Freedom of Information Act. I hereby request the following records:

An unredacted copy of the undated presentation titled "Neuropsychiatric Adverse Events Following Mefloquine Exposure", authored by the Senior Managing Epidemiologist, Division of Epidemiology & Analysis, Armed Forces Health Surveillance Center (AFHSC), which was sent by email from the official account of Dr. Eick-Cost of AFHSC on August 1, 2014, a redacted copy of which is included on pages 530-566 of a MEDCOM FOIA release available at: https://muckrock.s3.amazonaws.com/foia_files/2015/10/07/Nevin_-_14-01056_-_Attachments.pdf.

The requested documents will be made available to the general public, and this request is not being made for commercial purposes.

In the event that fees cannot be waived, I would be grateful if you would inform me of the total charges in advance of fulfilling my request. I would prefer the request filled electronically, by e-mail attachment if available or CD-ROM if not.

Thank you in advance for your anticipated cooperation in this matter. I look forward to receiving your response to this request within 20 business days, as the statute requires.

Sincerely,

Remington Nevin

Dear DHA FOIA Staff,

I wanted to follow up on the status of my FOIA request for a copy of the undated presentation titled "Neuropsychiatric Adverse Events Following Mefloquine Exposure". I originally submitted this request on Nov. 9, 2015. You had assigned it reference number DHA 2016-064 (FOIA).

Please let me know when I can expect to receive a response, or if further clarification is needed.

Sincerely,

Dr. Remington Nevin

FREEDOM OF INFORMATION ACT APPEAL
Defense Health Agency Office of General Counsel
National Capital Region Medical Directorate
Attn: Mr. Paul T. Cygnarowicz
8901 Wisconsin Avenue (Building 27)
Bethesda, MD 20889

Dear Office of the General Counsel,

Re: Partial Denial of Defense Health Agency Control Number 2016-064 (FOIA)

This is an appeal under the Freedom of Information Act.

I hereby appeal the partial denial of records responsive to this request due to redactions claimed under exemption (b)(5).

The requested records which have been redacted are not subject to exemption under (b)(5) as they are not deliberative in nature and represent final Defence Health Agency (DHA) and Armed Forces Health Surveillance Branch (AFHSB) work products delivered to external, non-DHA and non-AFHSB customers.

1. Background

On November 9, 2015, I sent a FOIA request to the Defense Health Agency (DHA) for “an unredacted copy of the undated presentation titled ‘Neuropsychiatric Adverse Events Following Mefloquine Exposure’, authored by the Senior Managing Epidemiologist, Division of Epidemiology & Analysis, Armed Forces Health Surveillance Center (AFHSC), which was sent by email from the official account of Dr. Eick-Cost of AFHSC on August 1, 2014, a redacted copy of which is included on pages 530-566 of a MEDCOM FOIA release available at: https://muckrock.s3.amazonaws.com/foia_files/2015/10/07/Nevin_-_14-01056_-_Attachments.pdf”. This request was assigned DHA tracking number FOIA 2016-064.

On April 20, 2016, a partially redacted copy of the requested presentation was sent to me in partial fulfillment of this request (see: https://d3gn0r3afghep.cloudfront.net/foia_files/2016/04/20/Secure_public_release_16-064_mefloquine_OASDHA_brief_07.28.2014_Redacted.pdf). The redacted portions included substantive portions of the presentation, including slides titled with various known neuropsychiatric adverse reactions to mefloquine, including “anxiety”, “suicide”, and “insomnia”.

In a letter dated April 20, 2016 (see: https://d3gn0r3afghep.cloudfront.net/foia_files/2016/04/20/FOIA-2016-064_Nevin_Final_Response_letter_Signed.pdf), the DHA claimed that the redacted portions of the presentation “are exempt from release under exemption (b)(5)” due to their being “internal records that are deliberative in nature and part of the decision-making process, containing opinions and recommendations”.

2. Description of Records

The requested records that were subject to redaction represent a final work product distributed to multiple stakeholders outside of AFHSB and DHA. On page 523 of the aforementioned MEDCOM FOIA release, the requested “briefing slides” are included in an email sent to an external organization (MEDCOM) together with the “research protocol (deemed exempt public health research)”, which had itself been reviewed by the U.S. Army Public Health Command.

As described in multiple news reports (e.g. http://bigstory.ap.org/article/elite-army-units-stop-taking-anti-malarial-drug), this research protocol investigating the neuropsychiatric adverse effects of mefloquine was requested by senior military health leadership, and was described as being underway as of September 2013, the final results of which were to be completed by January 2014. The requested slides, sent to external customers August 1, 2014, consist of the final results of the analysis described in this and other news stories.

3. Basis for Appeal

As a final work product shared with external non-DHA and non-AFHSB customers, these slides are not subject to exemption under (b)(5) as they do not contain “opinions and recommendations”, but instead contain objective, fact-based epidemiological analysis. The production of such objective, fact-based epidemiological analysis on behalf of external customers is a primary function of AFHSB.

4. Summary

In summary, I appeal the redaction of portions of the responsive document under claimed exemption (b)(5) on the basis that this exemption is inapplicable. I hereby request a fully unredacted copy of this presentation from AFHSB and DHA at the earliest possible opportunity.

I thank you in advance for your anticipated cooperation in this matter.

Sincerely,

Dr. Remington Nevin

Defense Health Agency Office of General Counsel
National Capital Region Medical Directorate
Attn: Mr. Paul T. Cygnarowicz
8901 Wisconsin Avenue (Building 27)
Bethesda, MD 20889

Dear Office of the General Counsel,

Re: Partial Denial of Defense Health Agency Control Number 2016-064 (FOIA)

Please acknowledge receipt of my appeal of the partial denial referenced above, which I sent to your office April 29, 2016. The partial denial I received from DHA was dated April 20, 2016.

Sincerely,

Dr. Remington Nevin

FREEDOM OF INFORMATION ACT APPEAL
Defense Health Agency Office of General Counsel
National Capital Region Medical Directorate
Attn: Mr. Paul T. Cygnarowicz
8955 Wood Road, Building 1, Floor 9
Bethesda, MD 20889-5628

Re: Partial Denial of Defense Health Agency Control Number 2016-064 (FOIA)

Dear Mr. Cygnarowicz,

Thank you for your letter dated July 28, 2016, in which you acknowledge receipt of my appeal related to the partial denial of DHA 2016-064.

In your letter, it is stated that you first received this appeal on April 24, 2016, and then again on June 1, 2016.

I am writing this letter to clarify that my appeal was in fact originally written April 29, 2016. It should have been received by your office shortly thereafter.

It is my understanding that my appeal remains under review. Please advise me at your earliest convenience as to the status of your deliberations and whether any further clarification of the basis for my appeal is needed.

Sincerely,

Dr. Remington Nevin

FREEDOM OF INFORMATION ACT APPEAL
Defense Health Agency Office of General Counsel
National Capital Region Medical Directorate
Attn: Mr. Paul T. Cygnarowicz
8955 Wood Road, Building 1, Floor 9
Bethesda, MD 20889-5628

Re: Partial Denial of Defense Health Agency Control Number 2016-064 (FOIA)

Dear Mr. Cygnarowicz,

I am in receipt of your letter dated July 28, 2016, in which you acknowledge receipt of my appeal related to the partial denial of DHA 2016-064.

In your letter, it is stated that you first received this appeal on April 24, 2016, and then again on June 1, 2016.

I am writing this letter to clarify that my appeal was in fact originally written April 29, 2016. It should have been received by your office shortly thereafter.

It is my understanding that my appeal remains under review. Please advise me at your earliest convenience as to the status of your deliberations and whether any further clarification of the basis for my appeal is needed.

Please be advised that much of the material which appears to be the subject of this request, and which has previously been redacted, has recently been published by the authors in a peer-reviewed manuscript. This should affect the basis for the initial redaction and withholding of responsive material.

Sincerely,

Dr. Remington Nevin

FREEDOM OF INFORMATION ACT APPEAL
Defense Health Agency Office of General Counsel
National Capital Region Medical Directorate
Attn: Mr. Paul T. Cygnarowicz
8955 Wood Road, Building 1, Floor 9
Bethesda, MD 20889-5628

Re: Partial Denial of Defense Health Agency Control Number 2016-064 (FOIA)

Dear Mr. Cygnarowicz,

I am in receipt of your letter dated July 28, 2016, in which you acknowledge receipt of my appeal related to the partial denial of DHA 2016-064.

In your letter, it is stated that you first received this appeal on April 24, 2016, and then again on June 1, 2016.

I am writing this letter to clarify that my appeal was in fact originally written April 29, 2016. It should have been received by your office shortly thereafter.

It is my understanding that my appeal remains under review. Please advise me at your earliest convenience as to the status of your deliberations and whether any further clarification of the basis for my appeal is needed.

Please be advised that much of the material which appears to be the subject of this request, and which has previously been redacted, has recently been published by the authors in a peer-reviewed manuscript. This should affect the basis for the initial redaction and withholding of responsive material.

Sincerely,

Dr. Remington Nevin

FREEDOM OF INFORMATION ACT APPEAL
Defense Health Agency Office of General Counsel
National Capital Region Medical Directorate
Attn: Mr. Paul T. Cygnarowicz
8955 Wood Road, Building 1, Floor 9
Bethesda, MD 20889-5628

Re: Partial Denial of Defense Health Agency Control Number 2016-064 (FOIA)

Dear Mr. Cygnarowicz,

I am in receipt of your letter dated July 28, 2016, in which you acknowledge receipt of my appeal related to the partial denial of DHA 2016-064.

In your letter, it is stated that you first received this appeal on April 24, 2016, and then again on June 1, 2016.

I am writing this letter to clarify that my appeal was in fact originally written April 29, 2016. It should have been received by your office shortly thereafter.

It is my understanding that my appeal remains under review. Please advise me at your earliest convenience as to the status of your deliberations and whether any further clarification of the basis for my appeal is needed.

Please be advised that much of the material which appears to be the subject of this request, and which has previously been redacted, has recently been published by the authors in a peer-reviewed manuscript. This should affect the basis for the initial redaction and withholding of responsive material.

Sincerely,

Dr. Remington Nevin

FREEDOM OF INFORMATION ACT APPEAL
Defense Health Agency Office of General Counsel
National Capital Region Medical Directorate
Attn: Mr. Paul T. Cygnarowicz
8955 Wood Road, Building 1, Floor 9
Bethesda, MD 20889-5628

Re: Partial Denial of Defense Health Agency Control Number 2016-064 (FOIA)

Dear Mr. Cygnarowicz,

I am in receipt of your letter dated July 28, 2016, in which you acknowledge receipt of my appeal related to the partial denial of DHA 2016-064.

In your letter, it is stated that you first received this appeal on April 24, 2016, and then again on June 1, 2016.

I am writing this letter to clarify that my appeal was in fact originally written April 29, 2016. It should have been received by your office shortly thereafter.

It is my understanding that my appeal remains under review. Please advise me at your earliest convenience as to the status of your deliberations and whether any further clarification of the basis for my appeal is needed.

Please be advised that much of the material which appears to be the subject of this request, and which has previously been redacted, has recently been published by the authors in a peer-reviewed manuscript. This should affect the basis for the initial redaction and withholding of responsive material.

Sincerely,

Dr. Remington Nevin

Paul T. Cygnarowicz
Office of the General Counsel
Office 3M215
Defense Health Agency
7700 Arlington Blvd
Falls Church, VA 22042
Paul.t.cygnarowicz.civ@mail.mil

Dear Mr. Cygnarowicz,

Thank you for your message. My apologies for the outdated mailing address. My current mailing address for this request is:

Dr. Remington Nevin
c/o Muckrock
Department 22301
411A Highland Ave
Somerville, MA 02144-2516

Thank you for your attention to this matter.

Dr. Remington Nevin
22301