A Detroit area cardiologist said Wednesday that the 2015 deaths of two Flint-area men were connected to Legionnaires’ disease as a criminal preliminary hearing resumed for state Health and Human Services Director Nick Lyon.

John Snyder, 83, of Flint, died of a “Legionella” pathogen and pneumonia and rather rapidly” in June 2015, said Dr. Joel Kahn, a clinical professor of medicine at Wayne State University in Detroit.

Kahn also testified in 67th District Court that Legionella also helped accelerate Robert Skidmore’s demise in December 2015 and “triggered” his death.

The nationally known cardiologist testified in a December preliminary hearing for state Medical Executive Eden Wells that John Snyder died as a result of Legionnaires’ disease based on records he reviewed.

In a hearing and testimony that largely used a litany of medical terms and became quite technical and esoteric. But Kahn stuck by his analysis that Legionella - which can create pneumonia - was a cause of deaths for the two chronically sick, elderly men.

When asked on a brief cross examination, Kahn said he “didn’t consult with other experts or people in the case other than my own independent evaluation of all the material” to come to his conclusion. He also testified that he didn’t formally form a hypothesis that both men died related to Legionella before he studied their records.

Healthcare-associated pneumonia, which is on Snyder’s death certificate, can be Legionnaires’ disease “and can be used simultaneously in place of one another,” Kahn said.

As for Skidmore’s end-stage congestive heart failure, he said it does not “contradict” his testimony that he died of Legionnaires’.

“But the acceleration and the deterioration and the loss of independence is consistent” with lung damage suffered from Legionella, which was a cause of his death in mid-December, the cardiologist said.

Skidmore, he said, had a “stable, chronically ill status” that was weakened by Legionella.

Kahn said he didn’t think any autopsy on either man would change his opinion.

Lyon attorney Chip Chamberlain spent nearly three hours walking through the medical records of both men, asking Kahn for an assessment of their ailments and the condition of their organs.

Lyon is charged with involuntary manslaughter and misconduct in office connected to the 2014-15 Legionnaires’ outbreak that killed at least 12 people and sickened another 79 people in the Flint area. Republican Gov. Rick Snyder did not declare a public warning about the Legionnaires’ cases until mid-January 2016.

Kahn was asked by Special Prosecutor Todd 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 arthritis and heart issues.

Snyder’s daughter, Mary Ann Tribble, testified in November in an involuntary manslaughter preliminary exam hearing for Michigan Chief Medical Executive Eden Wells that her father was in good health before getting Legionnaires’, staying active by running and skiing. Tribble said Snyder had a “chronic form” of arthritis and leukemia, but doctors said it wasn’t going to be fatal.

On cross-examination, Tribble admitted her father also had heart issues that resulted in the insertion of a pacemaker and had bypass surgery. He also broke his neck three years before he died.

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