Doctor to sue HHC after he was fired for testing for legionella in outbreak patients’ homes
The hospital at the center of the legionella outbreak in the South Bronx this summer is being sued by an infectious disease specialist who said he was fired because he tested the drinking water in legionella patients' homes. The hospital and the city health department's policy was not to test the drinking water.
Lab results revealed that Dr. Michael Skelly's tests found legionella was present in six patients' homes.
The health department and city officials at Lincoln Hospital, where Skelly worked, contend that Skelly was fired for violating patient privacy laws and for falsely representing himself as testing on behalf of the hospital.
The outbreak of Legionnaire’s disease in the South Bronx this summer sickened 133 people and killed 16. The city believes the legionella bacteria was spread by mist drifting off cooling towers on rooftops, which passers-by then breathed in. Cooling towers were the sole source of that legionella outbreak, health officials say.
"It is an outrageous gesture of contempt for this community that HHC [New York City Health and Hospitals Corporation] would persecute and fire Dr. Skelly simply because he acted to protect Bronx residents in the middle of an outbreak of Legionnaire's disease," said Gregory Filosa, Skelly's lawyer. "We cannot wait to try this case before a jury of residents of the Bronx."
Filosa plans to file the lawsuit on Friday.
Skelly, who worked in the infectious disease department at Lincoln Hospital for 13 years, was part of a small team that helped oversee the treatment of legionella patients during the outbreak. He decided to independently culture faucets and shower heads in patients' homes, because he believed the health department decision not to test their drinking water was wrong.
Skelly says his direct supervisor was aware of his testing and agreed with what he was doing.
"We knew there was a problem," Skelly said of the health department's policy of only testing cooling towers and not testing the patients' home water supply. "Especially when they were identifying the Lincoln Hospital cooling tower as a source as well. We knew that wasn't a source."
Skelly suspected the patients' drinking water.
After consulting with Dr. Victor Yu, a leading legionella expert who runs the Special Pathogens Laboratory in Pittsburgh, Skelly began going to patients' homes and requesting to take water samples to test for legionella. The tests showed that out of 37 patients' homes Skelly tested, legionella was present in six, Filosa said.
The results are significant, says Dr. Yu. "There is evidence that he was right.”
A health department official called Skelly’s supervisor a few days after he began the testing, according to a claim Skelly filed against HHC last month. “‘They know what you're doing and they expect it to stop immediately,’” Skelly remembered his supervisor saying.
By the end of the day, Skelly was placed on administrative leave. The health department says they had no involvement in the decision to fire Skelly.
"Dr. Skelly was terminated for a gross violation of patient privacy laws," a HHC spokesperson said. According to several sources, the issue is whether Skelly's use of patient information to visit their homes was a violation of HIPAA standards that protect doctor-patient confidentiality.
But a formal termination letter sent to Skelly by HHC's chief human resources officer made no mention of privacy violations. Instead, the letter stated, "We have ascertained that you visited a number of individuals who had been treated at Lincoln Hospital at their homes to obtain and test water samples in a claimed effort to ascertain the source of their prior illness. In doing so, you misrepresented the involvement of Lincoln Medical Center and your authority." Skelly’s actions, the letter contended, constituted "gross misconduct.
Skelly’s lawyer wrote that “the true reason for HHC's termination of Dr. Skelly is clear: because he refused to comply with HHC's and the Department of Health's policy of not testing the drinking water of patients diagnosed with Legionnaire's disease.”
During the outbreak this August, City & State NY reported that several experts believed legionella patients' home water supplies should have been tested.
“You’ve got to look at the water,” Dr. Yu told City & State NY. “Legionella is actually coming through the city water supply, but in very low numbers.”
At the time, Yu also offered to run legionella tests on all the legionella-linked buildings for the health department at no cost to them through the Special Pathogens Laboratory. Skelly, it seems, took him up on his offer.
The health department maintains that the source of the outbreak was a contaminated cooling tower on top of the Opera House Hotel. If the source of the Legionnaire’s outbreak was the drinking water, health officials reason, then a majority of the patients would have come from the same building or group of buildings – which they did not.
Since the outbreak last July and August, the city has reported two smaller Legionnaire’s outbreaks in the Bronx, in Morris Park and at the Melrose Houses. Officials say both are unrelated to the first outbreak.