State, McLaren clash over water samples in outbreak
Lansing – The Michigan Department of Health and Human Services is demanding more answers and information from McLaren Flint, expressing concern the hospital or a consultant may have destroyed internal water system testing samples related to an initial regional outbreak of deadly Legionnaires’ disease.
In a letter Monday, the department questioned whether McLaren withheld or destroyed bacterial cultures, called isolates, collected during testing of the hospital water system. McLaren strongly denied the suggestion in Wednesday emails to The Detroit News.
It’s the latest public skirmish over who is to blame for an outbreak of Legionnaires’ disease in the Flint area that began soon after the city switched its water source to the Flint River in April 2014 as a money-saving measure. Flint previously used Lake Huron water drawn from the Detroit water system.
“We are not aware of any isolates (environmental or clinical) that have been withheld or destroyed,” McLaren spokeswoman Rosemary Plorin said in an email.
“All isolates have already been provided to the State. In fact, all Legionella testing results (dating back to 2014) have been provided to one or more of the public agencies involved with this matter: the Genesee County Health Department, the State Department of Health & Human Services, and the Special Prosecutor’s Office.”
The state health department two weeks ago ordered McLaren to “immediately correct conditions” in its facility to reduce the risk of future exposure to Legionella after two hospital-associated cases in 2016.
Previous outbreaks, which many experts have linked to the larger Flint water contamination crisis, killed 12 Genesee County residents and sickened 91 during the summers of 2014 and 2015. The state says McLaren was associated with 40 of those cases and notes a hired consultant told the hospital in late 2014 that its internal water system was “likely” contributing to Legionella issues.
McLaren has twice responded to the state and expressed a willingness to cooperate with the order. But Health Department Director Nick Lyon, in a Monday letter to hospital president and CEO Chad Grant, said McLaren has not produced all requested information, including documentation of enhanced environmental and clinical surveillance testing practices in response to the 2016 cases.
“Additionally, MDHHS must have access to any and all isolates from any consultants who have tested the water system in McLaren Flint’s hospital from 2014 to present, or McLaren Flint must provide a written statement as to why they are not available, if destroyed, who ordered them destroyed, and when they were destroyed,” Lyon wrote.
Lyon said it remains unclear whether McLaren has fully implemented recent recommendations made by the U.S. Centers for Disease Control and Prevention, requesting prompt clarification. He also outlined eight other requests for information he said the hospital “must” produce immediately.
In demanding action by the hospital two weeks ago, the state health department noted that McLaren worked with an outside firm, Environmental Testing & Consulting, to test the hospital’s water system in late 2014 in the aftermath of the initial Legionella outbreak.
In a December 2014 letter obtained by the state in January after the Michigan Court of Appeals lifted a protective order that prevented it from investigating Legionella cases, ETC Vice President Jeremy Westcott told the hospital “it seems that the supply water coming from the City of Flint is not contributing to the Legionella issues at McLaren and that any issues are likely internal to the hospital system.”
Westcott did not respond Wednesday to a voicemail seeking comment.
Geralyn Lasher, deputy editor of external relationships and communications, said the state health department has been requesting consultant testing data “for some time, and some of the responses back have indicated maybe those aren’t in place anymore.”
If isolates were destroyed, that would be particularly concerning for the state health department, Lasher said. “I don’t believe that’s standard practice, so we certainly want to take a look at that.”
McLaren is “not aware that ETC has any water samples (much less environmental isolates) from the testing they performed for McLaren in 2014 and 2015,” Plorin said in an email. “Once the water samples were tested by a lab to identify the presence of Legionella, there would be no reason for a lab to preserve those samples. It’s not a standard practice.”
A hospital-acquired case of Legionella occurred within McLaren Flint in November 2016, Lasher said. That case and two from 2015 were genetically linked to Legionella isolated from a McLaren Hospital environmental water sample recovered by the CDC in August 2016.
Asked if the state health department has requested isolates from any other Flint-area hospitals, Lasher said “McLaren Flint is the only hospital with more than one health care associated case of legionella in 2016 so they are the only hospital being asked to provide this information.”
McLaren’s Grant responded to the state’s demands in a Feb. 22 letter, outlining the data and information his facility has provided to the state, as well as allowing “public health authorities to repeatedly inspect the hospital facility, interview our employees and contractors, and conduct environmental sampling.”
Grant added: “MDHHS reports show that many other hospitals and health care facilities reported cases of Legionnaires’ disease after the water source change, and that many cases were never linked to a common source other than the city of Flint water, and yet there is no indication that MDHHS has directed even remotely comparable scrutiny at any other facility in Genesee County or other potential sources of legionella in Genesee County.”