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Witness Testimony of Dr. Victor L. Yu, Professor of Medicine, University of Pittsburgh

I was the former Chief of the Infectious Disease Section at the Pittsburgh VA Medical CenterI. I received Superior evaluations for 29 consecutive years.   I was also the Chief of the Pathogens Laboratory  (SPL) – a laboratory initiated under the aegis of VACO during the Legionella outbreaks in VA hospitals in the late 1970s.    Discoveries were made by the VA Special Pathogens Laboratory that brought honor and renown to the Pittsburgh VA Medical Center.  .

●   Discovery of the source of hospital-acquired Legionnaires’ disease was the drinking water of the hospital.  In 1982, this historic discovery was published in the New England Journal of Medicine.  It was a controversial article that was not accepted by authorities at that time, notably the CDC who favored cooling towers as the source. 

●   Formulation and application of disinfection strategies which included :  Superheat and Flush, Chlorination, Copper-Silver Ionization, Chlorine dioxide, Monochloramine (see Appendix).

●   Testing and patient evaluation of new antibiotics effective for treating Legionnaires’ disease.  Azithromycin and Levofloxacin decreased the mortality to < 5%. 

●   Development and testing of the current laboratory methodologies including the culture media for patients and water plus the evaluation of the urinary antigen test in pneumonia patients. 

●   Creation of the strategy for prevention of hospital-acquired Legionnaires’ disease that has been adopted by the VA and worldwide.  Ironically, CDC opposes this strategy which uses contamination of drinking water as the key parameter for prevention.

In 2006, our SPL was abruptly closed.   I was fired because I had disobeyed an order not to process specimens during my appeal to VACO.  One set of cultures uncovered an  outbreak of Legionnaires’ disease.  This VA later thanked me for processing the cultures knowing that I had been fired because I assisted them in their time of need  (See Appendix).  After protests from my patients, the American Legion and members of Congress , Mr. Michael Moreland, Hospital Director, informed the press and others was that I had conducted unapproved research and operated a rogue laboratory for profit.  Both of these accusations were proven false.  (See Appendix)

The primary issue before you is the deaths of the 5 veteran patients.  From 1996 to 2006, we saw no cases of hospital-acquired Legionnaires’ disease. After closure of the SPL, patients began contracting Legionnaires’ disease after entering the VA.   Physicians were not warned that Legionella had re-entered the drinking water. Attempts to disinfect the re-contaminated water supply were unsuccessful for more than one year.

In Congressional investigations, you have uncovered deficiencies and mismanagement by senior VA bureaucrats and you have been frustrated by a culture in which maximum effort is given to protecting the bureaucrats rather than the veteran patients.   Despite a 2008 congressional investigation and the adverse media publicity, all of the bureaucrats s involved in closing the SPL and destroying a valued scientific collection were promoted.  The VA is an excellent healthcare care system but it is tragic that its reputation has been so tarnished. 

APPENDIX

 

Special Pathogens Laboratory and Disinfection

VA Cases and hospital-acquired Legionnaires’ disease

First two pages of CV

Special Clinical Resource Center

Publications of Legionnaires’ disease