Victims of Legionnaires' livid they were not told of outbreak
He lay in a hospital bed, fading in and out of a feverish haze as his body temperature hovered between 103 and 104 degrees Fahrenheit.
He remembers snippets of conversation, but even now, more than three years later, it's difficult to tell what was real. He remembers doctors, nurses and visitors concealed in protective clothing. He remembers confusion.
“They said if I didn't get there when I did, I probably would've died,” said Dewayne Rettig, 55, of Millvale.
Doctors at the Department of Veterans Affairs hospital in Oakland diagnosed Rettig with Legionnaires' disease in September 2010. That's four months before the Centers for Disease Control and Prevention says a Legionnaires' disease outbreak likely began at the hospital in February 2011.
A week before Rettig, VA Pittsburgh identified another veteran, Richard O'Malley, with the same pneumonia-like disease — something he says VA officials never revealed to him, even though internal documents obtained by the Tribune-Review show they believed he might have been sickened by the University Drive facility's water.
“They said it was waterborne. That's all they said,” said O'Malley, 69, of Castle Shannon.
Altogether, VA records reviewed show the hospital treated at least eight veterans for Legionnaires' disease before the CDC says the outbreak began. VA Pittsburgh officials suspected at least half of them might have caught the illness at the hospital, records show.
The internal records indicate the outbreak might have gone on longer and infected more people than the six deaths and 16 survivors the CDC linked to the outbreak it said ended in November 2012. The VA relied on the CDC's timeline for determining which cases were part of the outbreak, VA spokesman Mark Ray said.
The VA declined to comment on specific cases, citing patient privacy laws.
Veterans diagnosed with Legionnaires' said VA Pittsburgh officials told them they might have gotten the disease in their homes, on vacation, at their gym, or even at their grocery store — almost anywhere but VA Pittsburgh hospitals. VA Pittsburgh workers repeatedly found the bacteria infesting hospitals in Oakland and O'Hara during the same time period they were diagnosing patients with the disease, records show.
Edward Stockley, 64, of Baldwin Borough checked into the VA's University Drive hospital in Oakland on Nov. 29, 2011. CDC records say he was diagnosed on the next day. Stockley said he was not told about the illness until the last day of his 10-day stay. The news came not from a VA doctor, but from a man who identified himself as a CDC official.
At first, VA records listed Stockley's illness as community-acquired. A CDC investigation in 2012 determined he probably caught the disease in the hospital.
National VA guidelines require administrators to tell veterans when they think an infection might have come from their hospital — a disclosure several veterans told the Trib that they never received.
Others, like Rettig, say their Legionnaires' diagnoses were wrongly listed as community-acquired, a designation that means they could not have gotten the disease from the hospital because they were not there during the two to 14 days it takes for the bacteria to incubate inside a person.
Rettig said he got sick 10 days after a doctor's appointment at the VA Oakland on Sept. 7, 2010. He remembers the date because he and his wife left for a five-day vacation in Cancun, Mexico, on the next morning.
Once doctors diagnosed him, they zeroed in on his trip rather than the hospital visit, he said.
“They made me feel like a jackass because I went to Mexico,” Rettig said. “My wife never contracted anything. She used the same shower, the same bed. The same air conditioner was blowing on us.”
An Army veteran of the Vietnam War and retired cook, Stockley applied to volunteer at the VA Oakland hospital in November 2011. He said he used the hospital's water fountains to take his diabetes medication while he filled out forms and underwent physical exams. His diagnosis came during a three-month spike in Legionnaires' cases.
From late August through late November 2011, the VA diagnosed 11 people with Legionnaires' disease. Tests of the Oakland VA's water during that time found Legionella bacteria on three separate dates, according to VA records. But when hospital executives disclosed the disease to him months later, Stockley said, the VA chief of staff, Ali Sonel, told him that he might have gotten it from the produce mister at the grocery store.
“They never did tell me there were other people” diagnosed with the disease, Stockley said. He said he did not find out about the others until the VA publicly disclosed the outbreak on Nov. 16, 2012.
Stockley and his wife, Paula, sued the government in March for negligence and loss of consortium. The government, in a response filed on June 16, said he cannot sue because, as a volunteer at the hospital, he's an employee, even though he doesn't get paid.
‘Close ... to dying'
Gerald Caskey, 72, of Pine, a retired 22-year Army veteran and Baptist minister, checked into the VA Oakland hospital on Oct. 20, 2011, just over a month before Stockley.
“It's as close as I've ever come to dying,” said Caskey, who also is suing the VA.
Caskey's family life is inextricably linked to the military. He met his wife while the two were stationed at a helicopter training center in Alabama. One son is a Marine, another an Air Force chaplain. A third, Marine Sgt. Joseph Caskey, died while leading a convoy through Afghanistan's Helmand province when insurgents detonated an improvised explosive device beneath his vehicle on June 26, 2010.
Sixteen months later, on Oct. 11, 2011, Caskey picked up prescriptions at the VA Oakland before a weeklong vacation to his native Louisiana. He ate lunch there and drank the hospital's water, he said.
A week later, after returning from Louisiana, he said he felt sick.
“It's a life-threatening thing. My heart goes out to those who've died,” Caskey said.
VA executives met with Caskey in March 2013 — more than a year after his illness — to admit a possible link to the hospital. They also apologized.
Caskey filed a lawsuit with paperwork they provided him. Then in December, he received a letter from the VA saying they denied any wrongdoing.
“They didn't think this thing through because you've got discrepancies — blatant, blatant discrepancies,” Caskey said.
Testing the water
Allegheny County Health Department workers tested the water in Caskey's and other veterans' homes “to investigate all possible Legionella exposures,” the VA's Ray said.
They never found the bacteria there, according to a January 2013 message to employees signed by Terry Gerigk Wolf, the hospital director who was recently suspended.
But the VA did find it in its own water. Dozens of tests from 2007 through 2012 — most of them using just faucet swabs rather than larger, CDC-recommended one-liter water samples — showed significant amounts of the bacteria throughout the hospital's water lines, records obtained by the Trib showed. The CDC last year declined the Trib's offer to look at those records.
“VA Pittsburgh never intended to direct veterans' attention away from the hospital as a source of infection,” Ray said. “We believe it prudent and reasonable to ask veterans to consider allowing testing of home water supplies in cases where the source of exposure is not clear.”
“I'd usually fill my water bottle up and take a drink before my appointments,” Rettig said. “Now I won't drink out of anything over there.”
Legionella bacteria live in water but infect people when they inhale droplets thrown into the air from a shower, fountain or other source. When VA Pittsburgh workers found Legionella in their hospitals' water, they sometimes covered faucets with plastic bags and taped up signs to warn people away while they tried to disinfect the lines with hot water or, more recently, chlorine.
Several veterans, including Frederick Tait, 65, of Brighton Heights, told the Trib that they were treated in rooms where the water had been shut off. Hospital staffers did not tell them why, the veterans said.
Tait was diagnosed with Legionnaires' disease at the VA in Oakland on Aug. 18, 2011, and put in a room in which water had been shut off.
“I kept asking them, ‘Why can't I have some water?' You couldn't wash up,” Tait said.
Tests a few weeks later — on Sept. 7, 2011 — found Legionella bacteria at several places in the hospital's water system.
Veterans — even those suing the VA — say they generally like the medical care they get at the VA. None told the Trib that they plan to stop getting treated there.
“The doctors and nurses I deal with are fine,” O'Malley said.
“They took good care of me,” said James Piatt, 72, of Avella.
VA leaders told him during a meeting in the fall of 2012 that he likely contracted the disease at the VA Oakland. Officials gave him the paperwork needed to sue them.
“I said, ‘I'm not going to sue you. As long as you took care of everything, that's all that matters,' ” Piatt said.
Caskey, too, continues to get medical care from the VA.
“This is not a personal vendetta on my part,” Caskey said of his lawsuit. “It's just a question of right and wrong.”
Mike Wereschagin is a staff writer for Trib Total Media. He can be reached at 412-320-7900 or firstname.lastname@example.org.