U.S. Sen. Bob Casey on Monday asked the federal Centers for Disease Control and Prevention to re-check its report listing 32 cases of Legionnaires' disease it found that occurred in 2011 and 2012 during an outbreak at Pittsburgh's Veterans Affairs hospital.
His request, made in a letter sent to CDC director Tom Frieden, was in response to a Pittsburgh Post-Gazette story on Monday that revealed that a sixth death may be tied to the Legionnaires' outbreak at VA facilities. The CDC report, released in February, listed five deaths.
"I believe it is important to ensure all cases have been accurately reported, and I request the CDC conduct a thorough review of the Post-Gazette's findings," Mr. Casey wrote.
The story Monday found that the CDC's review of the death of Frank "Sonny" Calcagno, 85, may have wrongly been classified as a non-hospital acquired case that did not originate at the Pittsburgh VA.
Though Calcagno of Delmont spent nearly two months at the Pittsburgh VA, he had transferred to Forbes Regional Hospital about a month before he died on Nov. 22, 2011.
But that finding appears to have been based on a mistaken "onset" date -- the date he first began showing symptoms of the disease. In addition, a Forbes spokesman said the hospital believes Calcagno did not contract Legionnaires' during his stay there.
Because of that apparent mistake, Calcagno was one of 11 veterans on the CDC's list whose cases were considered non-hospital acquired. The other 21 cases -- one more would be added well after the report was concluded -- were considered "probably" or "definitely" hospital-acquired at the Pittsburgh VA.
Members of Congress and family of the victims of the outbreak were troubled by the finding that Calcagno's death may also have to be added to the list of victims.
"It's beginning to look as if some government bureaucrats would prefer to just forget about this tragedy," Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans' Affairs, wrote in an emailed response to the story. "Congress is committed to ensuring the families of those who died get the answers they deserve, and our investigation will continue until we have a full accounting of the facts."
One of the more troubling aspects of the story for Mr. Miller and victims' families was that a CDC spokeswoman said officials were too busy to answer questions about Calcagno's case and why it was classified as non-hospital acquired.
U.S. Rep. Tim Murphy, R-Upper St. Clair, said in an emailed statement that Calcagno's case "illustrates the need for effective reporting requirements of infectious diseases" and he hoped a bill he has introduced requiring VA hospitals to report infectious diseases helps prevents cases like this in the future.
"Someone's life was lost and they can't respond to questions about it?" asked Judy Nicklas, daughter-in-law of William Nicklas, 87, of Hampton, who was the last veteran to die during the outbreak on Nov. 23, 2012. "That's terrible."
Maureen Ciarolla, the daughter of John Ciarolla, 83, of North Versailles, who died July 18, 2011, was so upset when she read about Calcagno's case that she found a phone number for Calcagno's daughter, Deborah Balawejder, and called her Monday morning.
"I had to call her because we're all in the same boat," Ms. Ciarolla said. "I told her, 'You've got to get on your case because they've got to be held accountable.' "
The addition of one more victim to the list bothered Victor Yu, an internationally known Legionnaires' researcher, but it didn't surprise him.
Since the CDC's report was released, he has questioned the information used to classify patients.
Just looking over the data, he said he found problems, including the fact that 28 of the first 29 patients listed had admission dates that were after the date of onset, which would mean almost all of the cases were community-acquired.
"But we knew that wasn't right," said Dr. Yu, who was fired from the Pittsburgh VA after a dispute with the administration there in 2006.
Though he pointed out the problem, the CDC has never explained why that apparent error exists, either.
He agrees that the CDC's list of cases should be re-checked and said it shouldn't be done internally: "I think they should give us all the case of Legionnaires' and allow a group with no ties to the VA to review the cases."
Sean D. Hamill: firstname.lastname@example.org or 412-263-2579.