July 14, 2006

Honorable, R. James Nicholson

Secretary of Veterans Affairs

Department of Veterans Affairs

810 Vermont Avenue, NW

Washington, DC 20420

Dear Secretary Nicholson:

              I am the Chief of the Infectious Disease Section and Head of the Special Pathogens Laboratory in the Pittsburgh VA Medical Center.

              The reason I am writing you is to protest the abrupt termination of the Special Pathogens Laboratory of Pittsburgh, which specializes in unusual and emerging pathogens. The forté and the reputation of the laboratory have been built from our activities and discoveries in Legionnaires’ disease, one of the most virulent pathogens of pneumonia today. 

              In the late 1970’s we were one of the three VA’s that experienced outbreaks of hospital-acquired Legionnaires’ disease.  The other two were Wadsworth VA Medical Center in Los Angeles, CA and Togus VA Medical Center in Maine.  In 1977, the CDC discovered the bacterium that caused the outbreak; however, the source was never found during the American Legion Convention investigation.  We received a mandate from VA Central Office (VACO) to establish a special laboratory so personnel would be trained to isolate the organism by microbiological methods and to perform an epidemiologic investigation to determine the reason for this outbreak and the source of the organism.  

              We experienced our first case in the late-1979 and at that time, the source of the organisms was unknown.  Moreover, the diagnostic tests that are used today were not available at that time.  We received funding for 2 FTE’s and laboratory space.  Over the next several years, by good fortune and dedicated scientific personnel, we found the source of the organism to be in the drinking water system of the hospital. This was one of the major discoveries of

modern infectious diseases.  We subsequently designed the culture media that is currently used today for isolation of Legionella, elucidated the epidemiology of the hospital-acquired infections, described the most common clinical manifestations of patients with Legionnaires’ disease, refined the microbiological tests, and evaluated the antibiotic therapy used today for Legionella.  These discoveries have been well-documented in over 100 publications in the scientific literature including the New England Journal of Medicine, JAMA, Lancet, and Annals of Internal Medicine – the 4 premier journals in clinical medicine

              In 1994, VA Central Office issued a mandate for establishing clinical special reference laboratories.  The Pittsburgh VA administration and Chief, Pathology Laboratory, and Medicine Service collaborated with our Microbiology Laboratory in formally establishing a Legionella reference laboratory in 1995. 

            We know that many VA laboratories have tried to establish these reference laboratories; at least 4 laboratories in infectious diseases remain active today.  Ours may be the largest and most prominent one. 

            Attached is the termination memo which announced the sudden closing of the Special Pathogens Laboratory over a 2-day period and my response. 

            We had requested an appeal to the Director, but he terminated the laboratory before the any appeal could be made. I am now writing you to ask for your assistance for due process.  Since VA Central Office mandated the laboratory (Susan Mather M.D. and Max Cleland, M.D.), we believe VA Central Office should have the ultimate power to assess the fate of this extraordinary laboratory, especially since it has been self-sufficient.   The speed at which the termination was done with firing of the employees has created tremendous confusion with respect to fulfilling our mission of protecting the patients in our own hospital as well as other hospitals and institutions that have come to reply upon our services.  

            We request that you or a designated committee to review the accomplishments of this laboratory and the reasons why the director, Mr. Michael Moreland, terminated it.  It should be noted that no explicit reasons were given in writing.  I discuss this issue in my memo of July 12, 2006 (attached). 

            However, this is an emergency.  The only reason the laboratory is functioning now is that the employees are working without pay to process the specimens of patients who currently have pneumonia.  The abrupt reason for termination is in our minds highly irregular and we believe that political issues rather than scientific and healthcare priorities are dictating this sudden and shocking action.

            I have research funds being held in the Veterans Research Foundation of Pittsburgh.  In the letter given the employees of the laboratory for their termination, they were informed that they would receive generous severance pay (which proved not to be the case).  However, severance pay was to be taken from my research funds, which is illegal.  The regulations of the VRFP dictate that the use of my research funds cannot be for unstipulated purposes. 

            Our situation is urgent. The administration has refused to order needed supplies to keep the lab functional, and the employees are working without pay.  Could you please look into it immediately?  We need your assistance. 

Yours sincerely,

Victor L. Yu, M.D.

cc: Charleen Szabo, Director, VISN 4

Nichols SPL

Yu/lett