The parents of a U.S. Army veteran will receive $2.5 million in a wrongful death settlement after their 26-year-old son died from a treatable condition at the Department of Veterans Affairs medical center in Nashville, according to court papers.

Staff Sgt. Aaron M. Merritt died in October 2014, just nine months after he was honorably discharged at Fort Campbell and less than 10 months after he was diagnosed with ulcerative colitis at the Nashville VA.

Merritt’s parents, Carol and Steven Merritt, sued the hospital in 2016, claiming negligence after VA doctors failed to monitor his reaction to prescribed medication.

The settlement, set out in court papers filed this month in U.S. District Court in Nashville four years after Merritt’s death, is a compromise of disputed claims, done to avoid the expenses and risks of further litigation.

“No amount of money will ever replace Aaron,” Carol Merritt said in an interview with USA TODAY NETWORK – Tennessee. “We struggled through a lot of bureaucracy. A part of our lives and the grieving process were put on hold. But we didn’t want Aaron to be forgotten and we knew what happened to him wasn’t right.” 

Nashville VA doctors prescribed Merritt azathioprine, an anti-inflammatory drug that often decreases white blood cell and platelet counts, according to the lawsuit. 

Merritt had a pre-existing condition that suppressed his immune system, leaving him more susceptible to the medicine’s effects. And despite doctors’ recommending frequent monitoring of his blood cell counts, the lawsuit alleges that never happened.

Doctors had only ordered one blood count in a nearly six-month span, causing Merritt’s condition to flare up. He ended up in the emergency room critically ill with low blood counts. He died Oct. 28, 2014.

The Nashville VA is a part of the Tennessee Valley Healthcare System. Spokeswoman Sandra Glover said she could not comment on the case and deferred to the Department of Justice, per the VA’s attorneys

Sgt. Aaron M. Merritt’s death ‘a tragic case’

The lawsuit filed by the Merritts targeted the already troubled veterans healthcare system at a time when its campuses in Nashville and Murfreesboro had a one-star rating – among the worst VA hospitals in the country when considering quality of care, according to the VA’s own rankings.

In the most recent rankings this year, both hospitals improved with two-star ratings

According to Mark Molos, a gastroenterologist in Missouri hired by the Merritts to review their son’s case, standard of care required 11 blood count tests from the time Merritt was initially prescribed the medication in May 2014. But VA doctors conducted just one, records show. 

His dose also was increased 50 percent in August 2014, without a blood test, Molos reported. 

“This is a tragic case involving numerous, continuing, and seemingly systemic failures of care by the clinical gastroenterologists at the Nashville VA. There were multiple deviations from the standard of care each time Aaron was seen…,” Molos wrote in his report.

Frank “Trey” Thacher, a Memphis lawyer representing the Merritts, said what stood out to him was Merritt’s own concern about his condition and the medication. 

According to court documents, Merritt’s ulcerative colitis had been flaring up for several days in October 2014. He had high temperatures, ulcers in his mouth that made eating and drinking painful and hard to keep food and water down. 

“I was wondering if this was something I should be seen for or if I could get new medication to treat this or improve my quality of life,” Merritt wrote to his primary care physician and the VA, records show. 

“He had some questions so he called in to the VA hospital but they essentially told him not to worry about it. So he really felt like they were going to watch out for him,” Thacher said. 

‘Who protected him?’

Unlike his three older brothers who work for their family’s woodworking business, Merritt “got an itch” to serve after the Sept. 11, 2001, terrorist attacks. He was also impressed with his grandfather’s service in World War II, according to the Merritts. 

One day he came home and told them he was going to enlist. He graduated from Lake Havasu City High School in Arizona in May 2006 and left the next month to serve. 

“He was our son, our brother, our uncle,” Carol Merritt said. “It was sudden but we were very proud of him.”

In his eight years of service, Merritt did three tours in the Middle East. First as a mechanic in Iraq and then as an an explosive ordnance disposal specialist in Afghanistan. He received two commendation medals, one for protecting an injured Afghan soldier. 

Once, he was part of a unit that was tasked to protect then-President Barack Obama on a visit, his parents said. 

Merritt’s diagnosis of the inflammatory bowel disease came at Fort Campbell in January 2014. He was discharged the same month. 

“Aaron protected our country and our freedom,” Carol Merritt said. “But who protected Aaron?”

The Merritts said the VA was slow to provide information in their son’s death, including access to medical records. It wasn’t until they wrote a letter to Sen. John McCain that they finally got any answers. 

That’s when they learned that their son wasn’t given vital blood tests.

‘Learning experience’ for VA

Merritt’s death certificate states his immediate cause of death was refractory acidosis (an increase of acid production in the body), septic shock, a deficiency in all blood components and immunosuppression for ulcerative colitis. 

Thacher cites the “bad lines of communication” between VA doctors that resulted in negligent care and, ultimately, Merritt’s death. 

But there is some good that has come out of his client’s case, he said.

“The doctors are all very contrite. They told me that Aaron’s story is being used to teach medical students at Vanderbilt,” Thacher said. “This is a learning experience for the VA.” 

Carol Merritt said she hopes her son’s “sacrifice though this medical tragedy” will mean better VA care for veterans and that “nothing like this will ever happen again.” 

“We all felt the pain when he died,” Steven Merritt said, describing his family as “tight knit.” His sons were especially close and they had all purchased land together “in the middle of nowhere” in the Arizona desert where they each planned to build homes. 

Their boys, he said, will “remember Aaron” through their ongoing project. The Merritts will continue to rely on the support of their community and their son’s fellow service members. And again, on Oct. 28, the anniversary of his death, a photo of Merritt will appear in the local paper as it has the past three years. 

“Now this is settled. We will go on with our lives. But we’ll never be the same,” Carol Merritt said. “The pain is just as strong as it was the day Aaron died.”  

Yihyun Jeong covers veterans and military affairs for the USA TODAY NETWORK – Tennessee. Reach her at yjeong@tennessean.com. Follow her on Twitter @yihyun_jeong.

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