VA under scrutiny after Legionnaires' cases in Pittsburgh

Fiveofthecases"areknowntohaveacquiredthediseasefromthehospital,"theVAsaid.Anothereightwereinfectedelsewhere,andthesourceoftheinfectionin16casescannotbeendetermined.
Thespateofillnesseshasledrelativesoftwoveteranswhodiedaftercontractingthedisease,atypeofpneumonia,toblamethehospital.
CNNhaslearnedthathospitalofficialsknewtheyhadaproblemwiththewatersystemasfarbackaslastDecember,butchosenottorevealthatuntilamonthago.
That'swhenthehospitalbeganturningoffthewaterinpartsofthehospital,staffandpatientstoldCNN.
"Theyshouldhavethebestandutmostcarethananybodyelse,evenbetterthananormalcivilian,"saidDaveNicklas,whosefather,Bill,diedlastmonthatage87.Accordingtohisdeathcertificate,hediedofheartfailureandLegionnaires'disease.
Nicklasenteredthehospitallastmonthfortreatmentofdehydration;theWorldWarIINavyveteraninitiallyappearedtobeimproving,buthisconditionreversed,hissonsaid.
Theman'sdoctorstoldthefamilyshortlybeforehediedthathehadcontractedLegionnaires'.
"Imean,theyfoughtfortheircountry,youknow,"DaveNicklassaid.
"Theygotobattle,theylovetheircountryandwheredotheygo?Theygotoahospitalandtheybasicallydieinthere."
AnotherNavyveteran--JohnCiarolla,83,--diedJuly18,2011,afterbeingdiagnosedwithLegionnaires'atthehospital,hisdaughterMaureenCiarollasaid.
ThoughtheKoreanWarveteranhadbeenlivinginthehospitalforseveralmonthsafterhebecameunabletoliveonhisown,thehospitalsaidhecouldnothavecontractedthebacteriainthehospital.
Whenshequestionedhowthatconclusionhadbeenreached,shesaidshewastold,"Ifhehadgottenitheretherewouldhavebeenothercases."
"Ifeltguilty,veryguilty,thinkinghegotitwhenItookhimouttheSundaybeforeFather'sDay2011,"MaureenCiarollasaid.
TheVA'sproblemextendsbeyondPittsburgh.Thisweek,itturnedoffthewaterinabuildingatitscampusinButler,Pennsylvania,30milesfromthefacilityinPittsburgh,saidAmandaKurtz,aspokeswomanforthefacility.
TheactionwastakenafterLegionellabacteriawereidentifiedinapreliminarysampleonTuesday,shesaidinastatement.NocasesofLegionnaires'havebeenidentifiedintheButlerfacility"asaresultofthispreliminaryfinding,"sheadded.
TheVeteransAdministrationwouldnotsayifanyofthepatientsknowntohavebeensickwithLegionnaires'diseaseatthehospitalinPittsburghhaddied,butittoldtheAlleghenyCountyHealthDepartmentthatoneofthemdid,ahealthdepartmentspokesmansaid.
Legionnaires'disease,whichisspreadthroughwater,ispreventableandtreatable.
"Beingaveteranmyself,I'mshockedandappalledthattheVAwouldputtheirveteransinthattypeofsituation,"saidDaveNicklas.
AccordingtodatacollectedbythehospitalandobtainedbyCNN,hospitalwateroverthepastyeardidnotcontainenoughdisinfectanttopreventLegionnellabacteriafromreachingdangerouslevels.
Recordsfromthecompanythatinstalledthehospital'swatersystemshowthat,inDecember2011,aninspectionnoted,"Theyhavelegionella"and"Systemsarenotbeingproperlymaintained."
Fivemonthslater,thesamecompany--LiquiTech--concludedthattheproblemswerecontinuing:"Obviousevidencethatthesystemshadnotbeenproperlyregularlymaintained,"therecordssay.
"Theywerenotdoingthemonitoring;theywerenotdoingthethingscriticaltotheefficacyofthesystem,"saidLiquiTechChiefOperatingOfficerTorySchira.
Hesaidhisstaffalertedhospitalofficialstwicetothedeficiencyintheirmaintenancepractices.
Buthesaidthereisnoevidencethathospitalofficialsfixedtheproblemandthatthedeaths"absolutely"couldhavebeenpreventedhadthesystembeenmaintained.
Schira'sviewwassharedbyJanetStout,anauthorityonLegionnaires'diseasewhoworkedasamicrobiologistatthehospitalfor23years.
"Thisoutbreakwasabsolutelypreventable,"shesaid.Stoutandhercolleague,Dr.VictorYu,pioneeredtheresearchontheionizationfiltrationsystemnowusedinhospitalsnationwide.
Butsixyearsago,thescientists'laboratorywasclosedbythehospital,whichdescribeditas"notproductive"and"adrainonclinicalresources."
Theresearchers,wholeftthehospitalaftertheirlabwasshut,disputethatcharacterization.Theysaidthat,duringthedecadebeforetheirdeparture,hospitalwaterhadnotbeenlinkedtoasinglecaseofLegionnaires'.
Hadthelaboratoryremainedatthehospital,thedeathsofBillNicklasandotherscouldhavebeenpreventedwiththeturnofaknob,Stoutsaid.
"Thisisnot,astheysay,rocketscience,"shesaid."Thisisstraightforward."
AsourcetoldCNNthat,aboutsixmonthsago,thehospitaldidbringinaconsultantwhomaderecommendationsabouthowtofixthewater,buttheVAapparentlydidnottellthatconsultantthatthehospitalhadhadanyLegionnaires'cases.Hadtheconsultantbeentold,thesourcesaid,theconsultant'srecommendationstothehospitalwouldhavebeendifferent.Thesourcesaiditwasnotclearwhetherthehospitalhadfollowedanyoftheconsultant'srecommendations.
Lastmonth,thefederalCentersforDiseaseControlandPreventionsentateamtothePittsburghVAtoinvestigateandmakerecommendations.TheirfindingsaretobeissuedtotheVAinthecomingweeks.
VAspokesmanDavidCowgillwouldnotagreetoaninterview.Instead,hereleasedmediaadvisories,oneofwhichconcluded:"VAiscommittedtoprovidingsafefacilitiesandqualitycareforveterans."
Itaddedthataninvestigationwasunderwayandtestshadshownthatremediationeffortshadprovensuccessful.
OutsidehissuburbanPittsburghhome,BillNicklas'flagstillfliesoverhisfrontlawn.Hewouldhaveturned88lastweekend,butinsteadofcelebratinghisbirthday,hisfamilyheldamemorialservice.Heleavesthreesons,fivegrandchildrenandawifeof59years.
ThefamilyhasretainedalawyerandbeguntheprocessoffilingaclaimagainsttheVA.
Inthemeantime,Sen.BobCasey,D-Pennsylvania,andothermembersofCongressarecallingforafullaccountingoftheoutbreak.
Thediseasehaslongexisted,butgotitsnamein1976,whenanoutbreakoccurredamongpeopleattendinganAmericanLegionconvention.
Some8,000to18,000peoplearehospitalizedwithLegionnaires'eachyearintheUnitedStates,accordingtotheCDC.
Thoughitprovesfatalin5%to30%ofcases,mostcasescanbetreatedsuccessfullywithantibiotics,thediseaseagencysays.
Peoplecontractthediseasewhentheybreatheindropletsofwatercontaminatedwiththebacteria,itsays.
Hospitalsarevulnerablebecauseoftheircomplexwatersystems,andbecausemanyoftheirpatientsalreadyhaveillnessesthatcouldputthematincreasedriskofinfection.
Olderpeople,smokers,peoplewithimpairedimmunesystemsorchroniclungdiseasealsotendtobeathigherrisk,theCDCsaid.


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