Is the R.A.T.S. Tourniquet Misleading Consumers with TCCC Approval? - ITS Tactical
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Is the R.A.T.S. Tourniquet Misleading Consumers with TCCC Approval?

By Bryan Black

**Update** On September 7, 2016 at a meeting for the Committee on Tactical Combat Casualty Care, the following text was included in their public minutes. “The term “Tactical Combat Casualty Care (TCCC)” was developed as a US Military work product, and as such, should be in the public domain. A provisional trademark for this term that was inappropriately granted to a private sector individual several years ago and caused recurring issues in TCCC training and recommendations. This trademark has now been surrendered by the private sector individual after legal action contesting his ownership.”

I have an issue with the R.A.T.S. Tourniquet and what I feel is misleading information in regards to the company’s “TCCC Approval” marking. You might too once you read what I have to say.

First off, I’d like to explain what the Committee on Tactical Combat Casualty Care’s guidelines are, because it’s important to understand the development of this committee and all they’ve done for tactical medicine. I’ll also note that the guidelines are commonly referred to as TCCC guidelines and were designed to provide U.S. Combat Medics and trained military personnel with a framework to manage combat trauma on the battlefield.

TCCC Guidelines

The TCCC guidelines have three primary goals. Treat the casualty, prevent additional casualties and complete the mission. The most critical phase of care in combat is from the time of injury until the patient reaches higher echelon care, or a surgically capable medical treatment facility. The guidelines break this critical time into three definitive phases; care under fire, tactical field care and tactical evacuation care.

If you’ve been reading ITS for the past six years, you’ve probably read our articles that have kept up with the CoTCCC’s updates to their guidelines, which have been in a constant state of evolution since the original TCCC guidelines were published in 1996. The CoTCCC is composed of trauma surgeons, emergency medicine physicians, combatant unit physicians, combat medics, corpsmen and PJs. It has representation from every branch of the Military, all having deployment experience. For an idea of just what the committee does when it meets, check out the minutes of their latest meeting. Also, if you’ve never read over the TCCC Guidelines, you can find the most recent updates here on ITS.


Now that you’re up to speed on what the CoTCCC is and what the guidelines they release are, let’s get into what’s causing confusion. There’s a commercial company named Tactical Combat Casualty Care that has trademarked the words “Tactical Combat Casualty Care (TCCC).” As a fellow business owner, I understand the need to trademark what you’ve worked hard to create, but I question the decision of this particular company to trademark these words.


I primarily call this into question because the trademark was filed on March 20th, 2012. When filing a trademark, a company has to describe a class of goods and services they want a trademark to protect and in this case, the company chose to go into Class 041, which falls under educational services. Additionally on a trademark application, a company is required to list the date they first used the desired trademark and the date they first used the desired trademark in commerce. In the case of the company Tactical Combat Casualty Care, the first use date was February 1st, 2006 and the first use in commerce date was March 1st, 2006.

Looking at the timeline of 2006 when the company, Tactical Combat Casualty Care, is claiming they first used the name and added it to a product for sale commercially, you’ll see this is ten years after the CoTCCC first established it in their TCCC guidelines. As I mentioned in an example a few weeks back with my Wounded Warrior Project Article, I also believe this to be a non-enforceable trademark against the CoTCCC, because of the date they first started using the term. I’m not a trademark lawyer, so this is purely my own opinion on the matter, based on my knowledge of trademark law that I’ve had to educate myself on with owning my own business.

Our Law Enforcement Correspondent, Eric S., regularly attends the Special Forces Medical Association Scientific Assembly and wrote a great article at the end of last year about just what the TECC is and their updates from SOMA. During TECC meetings he heard first hand from CTECC and CoTECC members about trademark infringement claims by the company Tactical Combat Casualty Care and their opposition to the TECC and CoTCCC using the term “TCCC.”

Approval vs. Recommendation

Trademark disputes and the long backstory aside, the real crux of my issue comes from what the company Tactical Combat Casualty Care is doing with their approval on a product called the R.A.T.S. Tourniquet. The R.A.T.S. Tourniquet is now printing “TCCC Approved” on the tourniquet, which I believe is misleading considering it’s not approved by the CoTCCC. It is approved by the company Tactical Combat Casualty Care.

The CoTCCC (Committee on Tactical Combat Casualty Care) doesn’t approve medical devices. In the case of tourniquets, they’ve only ever “recommended” specific tourniquets and the only two that are currently recommend in their guidelines are the CAT (Combat Application Tourniquet) and the SOFTT (SOF Tactical Tourniquet).

I believe from my own opinion as a consumer that the TCCC Approved label on the R.A.T.S. Tourniquet is misleading, as it implies approval by the CoTCCC. As mentioned earlier in this article, the CoTCCC came out with their original guidelines in 1996 and since that time has been regularly releasing updates to their TCCC guidelines. This predates the company Tactical Combat Casualty Care’s first use in commerce of 2006. Labeling this device with this approval mislead me into believing they’d somehow received an endorsement from the CoTCCC.

Being in the military prior to 2006, TCCC was already a recognized term to me, which I associated with the CoTCCC. I’d argue many others with and without a military background believe TCCC to refer to the CoTCCC as well.

RATS Tourniquet TCCC Approved 02

“TCCC Approved”

Just to be clear, I’m not calling into question the efficacy of the R.A.T.S. Tourniquet, simply the manufacturer’s choice to label it TCCC Approved. The R.A.T.S. Tourniquet has many resellers, including the very Tactical Combat Casualty Care company which approved it. This makes it a more serious issue in my opinion. Having the TCCC Approved label without disclosing what that approval actually means is misleading in my book.

The company Tactical Combat Casualty Care has recently published an open letter addressing their affiliation, or lack thereof, with the CoTCCC. I found the position by their owner, Raffaele DiGiorgio, to be unnecessarily defensive. In the letter, which you can read here, Mr. DiGiorgio states that people’s frustration around his trademarking of TCCC is out of “jealousy that they didn’t think of it first” and that his company isn’t given the same consideration as larger entities when it comes to the enforcement of its trademarks.

He goes on to further call into question the endorsement (read recommendation) of products by the CoTCCC by citing examples of CAT Tourniquet failures in the field and the CoTCCC’s “dubious support” of Combat Gauze when a Z-Medica director sits on the committee. I’m not quite sure what all this has to do with the flack he’s catching for his trademarks though. I believe that it has nothing to do with jealousy or not feeling that Mr DiGiorgio’s rights to enforce trademarks are legitimate, it’s more so his reasoning for trademarking TCCC in the first place.

That and providing a TCCC approved endorsement for products like the R.A.T.S. Tourniquet. Perception is reality and in this case I feel the public is being led to perceive the R.A.T.S tourniquet carries an endorsement that it doesn’t.

What do you think? Is the R.A.T.S. tourniquet misleading consumers with their TCCC Approval?


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