The armed services participate in a national registry of doctors linked to medical malpractice but under rules that drastically restrict the number of physicians who get reported.

Sandra Bean looks over the résumé of the doctor who operated on her at the Fort Meade Hospital. She was pregnant and lost the baby as a result of the surgery, which other Army physicians characterized later as unnecessary. (Rick McKay / Washington Bureau)

The U.S. Army from 1994 through 1995 was accused of medical malpractice in more than 900 incidents, and paid out $66 million to settle malpractice claims.

But the service in those years reported only one practitioner to the National Practitioner Data Bank, a national registry of health care workers linked to medical malpractice.

Most Americans have never heard of the National Practitioner Data Bank, but thousands benefit from it every day. Hospitals, state medical boards, HMOs and other authorized users search the computer database more than 8,000 times a day for backgrounds on doctors and other health care workers applying for jobs. One of nine searches matches a name with a report in the database.

Federal law requires civilian hospitals, insurance companies and HMOs to report all payments made on behalf of doctors in malpractice cases. The law doesn't hold the military to the same standard, and many military doctors aren't reported simply because they committed the malpractice while in the armed services.

The military employs about 18 of every 1,000 doctors in America, yet it accounts for just twoof every 1,000 malpractice reports in the database. Those who leave the service for private practice are also likely to leave behind any links to malpractice lawsuits.

Not a single doctor was reported for a malpractice case at more than 75 military hospitals and clinics, a Dayton Daily News examination found. Since the database went online in September 1990, those 75 facilities were targeted for claims alleging more than 1,000 incidents of medical malpractice, hundreds of cases resulting in payments.

Not all of those 1,000 cases should have resulted in reports. But roughly 43 percent of all military claims are paid, and civilians must report all payments made on behalf of a doctor.

"We understand the military's health care systems' sensitivity to reporting practitioners who are career personnel," says a July 1996 report from the U.S. Department of Health and Human Services, which runs the database. "(The) Department of Defense has informed us that if practitioners do not feel supported by the system, they will consider leaving the service."

Department of Defense officials said they are "reviewing further" policies on reporting to the database.

John F. Mazzuchi, deputy assistant secretary of defense for clinical services, said he has asked the Department of Defense inspector general to audit reports by each service.

Lt. Gen. (Dr.) Ronald R. Blanck, the Army's Surgeon General, said the service reports all legitimate claims. "I would argue that for those that we do report you know that there was a problem," he said.

An Army spokeswoman said 800 Army malpractice cases are awaiting action before the service can decide if any need to be reported.

Fairchild Air Force Base hospital near Spokane, Wash., is one of the more than 75 military facilities that never had a doctor reported for malpractice to the database. Since 1990, claims filed at the base alleged at least 25 separate incidents of malpractice.

The Air Force refused to provide information on how the claims were resolved.

In one of the Fairchild cases, the government paid a settlement to a woman who blamed Dr. William M. Lindel in the death of her child.

Lindel acknowledged that the case was never reported to the National Practitioner Data Bank. He also said that had he been a civilian, he would have been reported "whether I was responsible or not." Federal law requires civilian hospitals and insurance companies to report payments made on behalf of doctors, regardless of the amount.

When Lindel left the military in 1994 for civilian practice, records connecting him to that case remained with the military.

Kim Tank, the wife of an airman, accused Lindel of negligence when he delivered her baby in 1991.

Tank alleged in her lawsuit that she was having trouble delivering her baby. Instead of doing a cesarean section--removing the baby through an incision in Tank's abdomen - the doctor used forceps to pull the child from her womb. The baby died four days later at a civilian hospital in Spokane.

"Childbirth is supposed to be something beautiful and natural," Tank said. "It was the most horrible thing I've ever been through."

Lindel said the forceps did not injure the child.