Hearing: State ‘wouldn’t help’ in Legionella outbreak

Leonard N. Fleming
The Detroit News

Flint — The state Department of Health and Human Services failed to protect the lives of residents during the Legionnaires’ disease outbreak and didn’t show much care that “people were dying,” a McLaren hospital administrator said Tuesday.

Julie Borowski, a risk management specialist at McLaren Regional Medical Center, was testifying in the involuntary manslaughter hearing for Michigan Chief Medical Executive Eden Wells. She said McLaren officials pressured the state to become involved after discovering the first Legionnaires’ cases in 2014.

It was a preliminary exam hearing with sharp exchanges between prosecutors and defense attorneys. At one point, Special Prosecutor Todd Flood implored 67th District Court Judge William Crawford II to note that Wells was stare-stalking him as he questioned Borowski and called it “a bit disturbing.”

Flood said he plans to call Borowski to the stand in Wednesday’s hearing with Health and Human Services chief Nick Lyon, who is also charged with involuntary manslaughter and misconduct in office for his role in the Legionnaires’ outbreak and related deaths.

“My personal opinion is, in 2014 and 2015, person after person was coming to us with Legionella and people were dying. They wouldn’t pick up their phones and answer our calls,” Borowski said during cross examination. “ ... They wouldn’t help us. We had to run around in circles to try and get a response.”

When news coverage picked up about the Flint water crisis in 2016, Borowski said, “the help we were begging for for two years comes out. ... Now all of a sudden they want to know what we did in 2014 and ’15. They didn’t do any of that work.”

The hearing focused on tension between state, local and county officials over the Legionella crisis that took the lives of 12 people in the region.

Testimony earlier Tuesday featured Dr. Joel Kahn, a nationally known cardiologist, who testified that John Snyder died as a result of Legionnaires’ disease.

In a question about whether the HHS is charged with safeguarding the public’s health, Borowski retorted, “if you say so.”

Wells attorney Steve Tramontin asked if she has an opinion “contrary to that mission?”

“Yes, based on my experience,” she said.

Borowski also testified about an “eminent threat order” letter in January 2017 from Lyon and Wells that requested records in an effort to see if the Legionnaires’ cases were the result of the hospital’s water system. The system had already gone through increased testing after the outbreak, she said.

She testified that she took the threat as a means to shut McLaren down over the issue. Tramontin argued with her that it was meant to protect life and figure out the source of the outbreak.

A year ago, the Michigan Court of Appeals canceled three confidential protective orders issued by a Genesee County judge that limited state agencies’ access to Flint health data.

Earlier in the day, Kahn, a plant-based cardiologist who is a clinical professor of medicine at Wayne State University, Snyder, 83, passed away June 30, 2015 of pneumonia with a specific “pathogen” being Legionella. Special Prosecutor Todd Flood has accused Wells of contributing to Snyder’s death.

Kahn was asked by Flood’s team to review records from Snyder’s two stays at the McLaren Regional Medical Center during June 2015 for myriad issues that included chronic leukemia, rheumatoid artritis and heart issues. Even an autopsy wouldn’t have changed his mind, he testified.

Snyder developed hospital-acquired pneumonia, Kahn said, citing a urine sample that turned up positive for Legionella. Legionnaires’ disease is a form of pneumonia that is blamed for killing 12 Flint area residents and sickening 79 others in 2014-15.

Lawyers for Wells are arguing Snyder died one month after she started the job as the state’s chief medical officer in May 2015, when the Legionnaires’ outbreak was well underway. In a court filing, the defense also has called the involuntary manslaughter charge a “physical impossibility” because Snyder died in June 2015, while Wells is accused of not giving public notice of the Legionnaires’ disease outbreak in December 2015 — a charge she also denies.

Snyder spent six days in McLaren from June 16-22 and was released to his daughter. He was readmitted on June 30, the day he died, when his family was told his condition was dire with low oxygen levels. His treatment, Kahn said, went from “aggressive therapy” to “comfort care” to prepare for end of life.

When asked what was his opinion based on the medicals records, Kahn said Snyder “died of pneumonia that was determined on the last day of his life to be related to Legionella.”

“One was his status, his medical records from June 16 to June 22, where although he had certain chronic medical problems, there was no evidence of medical notation that he had anything that would be considered an infection or pneumonia.”

Once Snyder was admitted to the hospital, doctors began to change their diagnosis from an infection in his shoulder -- and stopped antibiotics -- to bleeding in the shoulder related to a blood thinner he was on for his cardiac condition, said Kahn, who is based in Bloomfield Township.

On cross examination from Wells’ lawyer, Kahn said he wouldn’t really change his mind on the cause of death, even in the case of an autopsy.

“In my opinion, no,” Kahn said.

Jarold Lax, Wells’ attorney, asked again if he wouldn’t have learned anything new from autopsy data that he didn’t learn from the medical records.

“We would not have learned anything more,” Kahn responded. “There would be the possibility that tissue would be obtained and other confirmatory test for Legionalla ... but I don’t actually think there would be a difference.”


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