VA systems flushed again for bacteria
By Luis Fábregas and Adam Smeltz
Published: Thursday, Feb. 14, 2013, 3:15 p.m.
Plumbing systems at the Pittsburgh VA facilities in Oakland and O'Hara were filled with chlorine and later flushed as recently as Sunday, a step that an expert said shows the problem with potentially deadly Legionella bacteria is not under control.
David J. Hickton, U.S. attorney for Western Pennsylvania, said on Thursday that his office is watching the situation and has offered its resources to a VA inspector general investigation under way. Once the inspector general's report is complete sometime in March, he said his office would conduct an independent review.
“This matter is of great public interest, and we understand and appreciate the public's concern,” Hickton told the Tribune-Review. “We regard this as a very serious matter.”
VA Pittsburgh Healthcare officials confirmed that about 12-hour hyperchlorination treatments were conducted on Sunday at the University Drive hospital in Oakland and on Feb. 1 at the H. J. Heinz campus in O'Hara.
VA Pittsburgh spokesman Dave Cowgill said the flushings were not done in response to new concerns, but rather as a “preplanned mitigation strategy” that will be conducted every three months “until longer-term solutions are implemented.”
“This tells me that they haven't been able to take control of the problem just yet,” said Steve Schira, chairman and CEO of LiquiTech Inc., a firm near Chicago that previously provided the VA a different water-treatment method called copper-silver ionization. “They're probably having a problem with killing the bacteria.”
Following CDC orders
During the treatments, patients were prevented from showering, and all use of water from sinks and drinking foundations was prohibited. Bottled water and packaged wipes were provided.
The Centers for Disease Control and Prevention said Legionella at the Pittsburgh VA appeared to have sickened 21 patients in the Oakland and O'Hara facilities since January 2011. Five of them died from Legionnaires' disease, and the CDC is checking for outbreak-related cases as far back as 2007.
Legionella was found at the VA Butler campus, but no Legionnaires' cases were reported.
The restrictions follow recommendations issued by the CDC after an investigation found Legionella bacteria were widespread throughout the hospital. Among other things, the CDC recommended fixing the problem short term with hyperchlorination and superheating, which raises the water temperature to about 170 degrees, to kill Legionella.
In startling congressional testimony last week, federal officials confirmed the VA learned in late October that bacteria in the hospital was causing pneumonia. Two weeks passed before the VA told the public.
Call for transparency
On Thursday, Sen. Bob Casey Jr. urged the VA to explain how it will alert the public to health hazards such as the recent outbreaks. Casey wants the VA to make public the complete CDC report, according to a letter he sent to VA Secretary Eric K. Shinseki.
“Effective communication, both internal and external, is critical,” wrote Casey, D-Scranton. “There is more that the VA can do to provide pertinent information to the public about the outbreak and response.”
Casey requested assurance on several points, including that the Pittsburgh VA is following the CDC's water-sampling recommendations and has improved its communications practices.
“The people of Southwestern Pennsylvania have a right to know what happened,” Casey wrote.
“Please know that I will continue to give this issue my personal attention until I am confident that all questions have been answered and that a tragedy like this will never happen again.”
Cowgill said VA officials are reviewing Casey's letter.
“The Department of Veterans Affairs is committed to providing the high-quality care our Veterans have earned and deserve,” he said in an email.
Dr. Victor Yu, a University of Pittsburgh professor and Legionella expert who ran a special pathogens lab at the VA until he was dismissed in 2006, said the continued hyperchlorination treatments and water restrictions would not be needed had VA officials stuck with the copper-silver ionization system that's no longer used. He called the weekend's hyperchlorination treatment “unusual.”
“But it's well within their plan, and they have to follow it,” he said.
A copy of the CDC's 56-page report obtained by the Trib lists more than 20 recommendations to help the VA respond to the problem and prevent repeat episodes. A spokeswoman said CDC officials believe the VA has implemented all recommendations in the Jan. 25 document, sent from Dr. Alicia Demirjian at the CDC to VA and state health officials.
VA officials might have broken their department's own standards for disclosing hazardous conditions to patients or their survivors, according to lawyers monitoring the case. Cowgill said last week that officials “made disclosures to all affected patients or their representatives.”
Luis Fábregas is a staff writer for T rib Total M edia. H e can be reached at 412-320-7998 or lfabregas@tribweb .com. Adam Smeltz is a staff writer for Trib Total Media. He can be reached at 412-380-5676 or firstname.lastname@example.org.
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