State again blames hospital in legionella cases

Karen Bouffard
The Detroit News
Flint McLaren Medical Center and the Genesee County Health Department have been ordered to take “immediate corrective action” to reduce the risk of bacteria that may have contributed to an outbreak last year of Legionnaires’ disease.

State health officials reiterated their position Tuesday that an outbreak of Legionnaires' disease in Flint in 2014 and 2015 originated from a local hospital rather than the city's troubled water system.

The Michigan Department of Health and Human Services  released the report a week and a half after a Flint special prosecutor claimed in court that Flint pneumonia deaths surged 400 percent after the city changed its water source in 2014.  Legionnaires' disease is a type of pneumonia.

State officials denied the allegation and provided their own data showing a smaller increase in pneumonia deaths.

Special Prosecutor Todd Flood introduced hundreds of death certificates on pneumonia deaths into evidence in the preliminary criminal hearing for MDHHS Director Nick Lyon, who is charged with involuntary manslaughter and misconduct in office for allegedly trying to cover up the outbreak, which sickened 91 people and caused 12 deaths.

For Tuesday's report, MDHHS broke down the cases by timeline, geography, potential sources, and baseline data and concluded that the only common source of infection was Flint McLaren Medical Center. The department said 51 of the patients who came down with Legionnaires' disease had been at McLaren, and no other common source of infection was identified.

"We find the timing of the state’s release today to be an interesting coincidence as the first phase of the criminal proceedings against MDHHS leadership winds down," McLaren Hospital officials responded Tuesday in a statement to The Detroit News. "Initial review of the report reveals no new information regarding our community’s epidemic of Legionnaires’ disease in 2014 and 2015, but reflects the state’s normal pattern of attempting to shift liability away from those criminally charged."

In reaction to McLaren's statement, MDHHS spokeswoman Angela Minicuci said in a statement to The Detroit News, "It’s unfortunate that this hospital system continues to ignore crucial details regarding the outbreak in Genesee County directly linked to their facility.

"Our report was released when it was completed," she said. "Due to difficulties caused by the Protective Order that McLaren Flint requested, subsequent data sharing issues, as well as new information that was gathered regarding the 2014 and 2015 cases, this review was not completed sooner.

"The facts are very clear in this comprehensive analysis of the cases and do account for other sources that were identified during the case investigations," Minicuci added. "The fact remains that the only common source that has been identified that explains the majority of the increase in cases is McLaren Flint Hospital.

"Rather than shifting liability or even accusing McLaren Flint, we followed the evidence and remain committed to providing thoroughly vetted and accurate information on this issue."

MDHHS has repeatedly claimed McLaren was the source of the outbreak, an allegation the hospital has strenuously denied. In January 2017, state health officials ordered McLaren and the Genesee County Health Department to take "immediate action" to reduce the risk of Legionnaires' disease at McLaren, prompting backlash from the hospital and county health officials.

McLaren Flint responded with a scathing, 137-page report accusing state officials of "baseless attacks" against the hospital, saying the state was pointing a finger at McLaren to deflect attention from the Flint city water system as a possible source of a Legionnaires' outbreak. Changes were made to the water system as a money-saving measure while the city was under the control of an emergency financial manager appointed by Gov. Rick Snyder.

Several scientific studies have determined that the Legionnaires' cases were caused by changes made to the water system, though their conclusions have been the subject of scientific debate.

 A study published in February in the Proceedings of the National Academy of Sciences concluded that the risk of acquiring Legionnaires' disease increased more than six-fold across the Flint water distribution system after the city switched from the Detroit area water system's Lake Huron source to the Flint River in April 2014.

The study was published by the Flint Area Community Health and Environmental Partnership, which was funded in large part by MDHHS. The research team includes scientists from Wayne State University, the University of Michigan, Colorado State University and other institutions. Researchers concluded the increase in Legionnaires' cases "was consistent with a system-wide proliferation of Legionella bacteria."

The report estimated that 80 percent of Legionnaires' cases during the outbreak can be attributed to the change in water supply.

MDHHS disputed the results, calling the study inaccurate and incomplete, and discontinued funding the research team. Health officials said the department hired an outside firm, KWR Watercycle Research Institute, to do an "external, independent third party" review that found numerous flaws in the analysis. 

In other preliminary exam testimony, defense attorneys have attempted to show that there is disagreement among scientists over whether changes to the water system caused the Legionnaires' outbreak.

Marc Edwards, a Virginia Tech environmental engineer who helped uncover the problem of lead in Flint's water, testified that his own research team’s hypothesis — that in tracking high levels of lead in Flint drinking water they also would find dangerous levels of Legionella bacteria in Flint homes — was never met, although higher levels of Legionella were found in two Flint hospitals where nearly 90 percent of the cases were discovered.

"(U)ltimately, dueling experts within the legal system, or third-party evaluations that attempt to reconcile the differing estimates, will be necessary to eventually bring some kind of closure on the science," Edwards said Tuesday, when asked about the conflicting scientific evidence.

"One current hypothesis is that a significant part of the outbreak was concentrated in McLaren Hospital AND that the switch to Flint River was also a key triggering event — these are not mutually exclusive."


Twitter: @kbouffardDN