State slow to address deadly flu in Pa. veterans home, suit claims

By ADAM SMELTZ | The Pittsburgh Tribune-Review | Published: July 18, 2013

PITTSBURGH — A preventable influenza outbreak killed as many as 38 patients over two months in the Hollidaysburg Veterans Home in Blair County, ravaging the state-run nursing facility despite repeated warnings from its medical director, according to a new whistle-blower lawsuit.

Two fired independent contract workers allege state officials endangered the 514-bed home by withholding medical information and failing to implement a prompt quarantine when the first flu patient was diagnosed on Jan. 10.

The former medical director, Dr. John M. Vasil of Northern Cambria, and a nurse, Laura O'Farrell of Duncansville, claim the state Department of Military and Veterans Affairs, which runs the home, illegally dismissed them on Jan. 14 for raising alarms with department leaders about the flu outbreak and other problems.

“They couldn't have blown the whistle harder than they did, and they got nowhere with anyone,” said Neil Gregorio, a Downtown-based attorney representing Vasil and O'Farrell. “It's below the comfort zone for any medical professional to see what's going on in that home and not do something about it.”

An agency representative disputed the allegations, filed against the department on Friday in Commonwealth Court in Harrisburg and obtained on Wednesday by the Tribune-Review.

Vasil, O'Farrell and O'Farrell's nursing agency, Adara Healthcare Staffing, faced “no retaliation for whistle-blowing or anything else” but were dismissed for a reasonable cause, spokeswoman Joan Nissley said.

A contract termination letter to Adara lists several problems, including issues with scheduling and avoidance of regular procedures at the home.

Further, Nissley said, only one resident in the Hollidaysburg home died as a result of the flu outbreak in January. The flu was listed as a secondary cause of death in that case, one of six illnesses confirmed by laboratory tests, she said.

Gregorio said the tally of 38 deaths is based on observations made by Vasil, who continues to see some patients in the home as a physician.

The state Department of Health, which tracks flu outbreaks, said that it does not typically share information about specific facilities.

“When there is an outbreak of something like this, we take immediate actions to prevent the spread of the flu,” Nissley said. She said the home established a quarantine in mid-January, limited staff movement and reiterated to workers the importance of flu prevention.

She said the quarantine went into effect on Jan. 12, two days after tests confirmed the first flu case, and workers followed department procedures. The quarantine ended on Jan. 29.

But Vasil, through his attorneys, indicated workers in the home delayed alerting him about the initial illness, a violation of standard procedures. He learned about the first case on Jan. 11, sought a fast quarantine of the patient's building and asked that the home treat other patients and workers there with Tamiflu, an antiviral drug that can slow the spread of the flu virus, according to the complaint.

It indicates that the home initially declined to begin a building quarantine or provide Tamiflu treatments for other patients and workers. A partial quarantine of the building began on Jan. 12, and a full-building quarantine followed on Jan. 13 as more patients fell ill, the complaint says. It notes that a second building was quarantined the next day.

Nissley said the Tamiflu treatments began on Jan. 12 for about 20 residents situated closest to the confirmed case. The home made the treatments available on Jan. 14 to the rest of the residents and workers, most of whom accepted the offer, she said.

“Initially, there was not enough Tamiflu on hand to do the entire facility,” Nissley said, explaining that “stockpiling that much is very expensive.”

Gregorio said Vasil and O'Farrell were unavailable to comment. They believe wholesale problems in the home, including the flu outbreak and a variety of other missteps, occurred because of a push to save money, Gregorio said.

“It goes back to the quality of care for our veterans and how the Commonwealth of Pennsylvania cannot turn its back on veterans purely in the name of saving money,” he said. “If we were going to stop caring about these veterans, we should have told them that before they signed up.”

The Hollidaysburg home is separate from the federal Department of Veterans Affairs, which has come under fire in Pittsburgh for its handling of a deadly Legionnaires' disease outbreak in 2011 and 2012. Five veterans died among 21 sickened during that outbreak, which the Centers for Disease Control and Prevention tied to contaminated tap water at VA hospital campuses in Oakland and O'Hara.

A congressional oversight subcommittee, the U.S. Attorney's Office for Western Pennsylvania and the VA Office of Inspector General in Washington are looking into the Legionnaires' matter.



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