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Legionnaires' victim checked in at VA 2 days after CDC's warning

| Saturday, March 16, 2013, 10:56 p.m.
Stephanie Strasburg | Tribune-Review
The family of William Nicklas, a World War II veteran who contracted Legionnaires’ disease at the Pittsburgh VA and died, gather in the Hampton home of Nicklas' widow, Greta (center), 81, on Wednesday, March 6, 2013. They are son Dave (from left), widow Greta, son Bob and daughter-in-law Judy, all of Hampton. The family brought a wrongful death complaint against the federal government on Friday, Aug. 2, 2013.

In the end, hallucinations that he'd been poisoned overtook the faith William Nicklas placed in the VA Pittsburgh Healthcare System.

Doctors told the World War II veteran on the Wednesday before Thanksgiving 2012 that he'd contracted Legionnaires' disease, a deadly form of pneumonia. Two days later, as he breathed in short gasps in his hospital bed, his wife of nearly 60 years, Greta, leaned down to kiss him and say goodnight for the last time.

He pushed her away.

“He said, ‘Get out of here. Get out of here ... before you get poisoned. Just get out of here before they get you,' ” recalled their son, Bob Nicklas, 56, of Adams, who was in the room.

The Legionnaires' outbreak at the VA Pittsburgh hospitals in Oakland and O'Hara infected as many as 21 people and is linked to five deaths, according to the federal Centers for Disease Control and Prevention. Nicklas, who died Nov. 23, appears to be the most recent death, though neither the CDC nor the VA Pittsburgh would disclose names, citing privacy laws.

Families of patients who died during the outbreak told the Tribune-Review that VA administrators failed to warn them about Legionella bacteria in the VA water pipes and haven't answered their questions about why administrators didn't do more.

“It shouldn't take forever for the truth to come out,” said William Nicklas' son, David, 46, of Hampton. “Somebody is going to answer to this family to what the heck truly happened in that hospital. Until I take my last breath, I'm going to find out what actually happened there.”

The CDC told the VA on Oct. 30 that Legionella bacteria in the Oakland hospital's water system matched bacteria infecting three patients. Yet, the VA didn't publicly disclose the outbreak in its water system for 17 days.

VA Pittsburgh spokesman Dave Cowgill said the delay occurred because the three patients had not been in the same area of the hospital from where the water sample came, so “we were unsure as to how they acquired it and that's why the CDC was asked to visit the facility and perform an investigation with us.”

William Nicklas checked himself into the hospital on Nov. 1 because he was dehydrated and had a negative reaction to new heart medication, his family said — two days after the CDC warned the VA about the patient-water match.

On Nov. 7, the CDC began an investigation that found Legionella throughout the VA Pittsburgh's water system, according to CDC epidemiologist Lauri Hicks' testimony at a congressional hearing Feb. 5.

On Nov. 15, workers began flushing water lines to combat the bacteria.

Nicklas' family said their first warning about the outbreak came when they found a pamphlet about the disease lying on a table in his hospital room, and signs throughout the building advising patients and visitors not to use water fixtures and fountains.

Dr. Robert Muder, the VA Pittsburgh's chief of infectious diseases, told Nicklas' family two weeks after he died that he wasn't in the part of the building with bacteria-contaminated water lines, Greta Nicklas said.

Muder called her the day before her husband's funeral, she said. It was the first time an infectious diseases doctor from the VA spoke to them, the family said.

“He gave me his condolences. I thanked him. He started by saying, ‘You know, Mrs. Nicklas, your husband was critically ill when he came here.' I said, ‘No, he wasn't. He walked into that hospital on his own. He was not critically ill,' ” she said.

She said Muder told her that her husband “ ‘wasn't on the floor where they had the problem.' I said, ‘You mean to tell me they had it on every other floor but the fifth?' I said, ‘I don't believe that.' I said, ‘I think it was throughout the whole hospital.' He didn't answer me.”

Muder referred Trib questions about the call to Cowgill, who said the VA would not comment on pending legal claims. The Nicklas family has filed a notice of intent to sue the VA.

Adam Smeltz, Luis Fábregas and Mike Wereschagin are Trib Total Media staff writers. Reach Smeltz at 412-380-5676 or asmeltz@tribweb.com. Reach Fábregas at 412-320-7998 or lfabregas@tribweb.com. Reach Wereschagin at 412-320-7900 or mwereschagin@tribweb.com.

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