(NOTE: This is part one of a two-day report on a pending lawsuit over South Carolina’s handling of a tuberculosis outbreak at Ninety Six Primary School this spring. Part two will run on Friday)
New emails and phone records released this week show confusion at South Carolina’s public health agency earlier this year as officials tried to figure out the number of tuberculosis (TB) cases at a Greenwood County school— even as they kept their investigation secret from the public.
In the emails dating back to mid-April, Department of Health & Environmental Control (DHEC) staff sent conflicting messages over the number of people at Ninety Six Primary School who had tested positive for tuberculosis germs.
The emails were released to South Carolina Radio Network by Spartanburg attorney John Reckenbeil. He is representing three former DHEC nurses who claim in a lawsuit that they were wrongfully terminated last month.
It’s the latest chapter in the unfolding argument over who is to blame for DHEC’s slow response to an infected school employee who disregarded orders to stay home and is blamed for spreading the disease. Even though the employee’s physician notified DHEC of the situation on March 8, the agency did not quarantine the employee or begin testing students until May 31. Since then, officials say 53 students and 21 faculty members have tested positive for TB. An additional 32 people in the surrounding Ninety Six community have also tested positive.
Reckenbeil’s office also released transcripts of a May 27 conference call between Greenwood County school officials and executives at DHEC’s central offices in Columbia. The attorney says it shows that DHEC higher-ups were evasive in their dealings with the district and unwilling to alert parents to the possibility of TB contamination.
“These questions are being asked by the (Greenwood District 52) superintendent (Mark Petersen) and representatives from the school and they’re really not getting a reply from the central office,” Reckenbeil told South Carolina Radio Network.
“I’m a school teacher, I’m not a doctor”
The recorded phone conversation occurred on May 27, more than two months after DHEC was first notified that a Ninety Six Primary School employee may have had the disease, and less than a week after agency director Catherine Templeton said she first learned about the outbreak.
The conference call was between Peterson, school board member Dr. Michael Bryant, the district nurse, and DHEC staffers led by Director of Public Health Jamie Shuster.
According to the transcript, Peterson asked if he could inform parents about the infected employee. “I’ve got a responsibility if we’ve got an issue that our folks need to be aware of. I got a staff that I’m concerned about. I’m concerned about boys and girls. I’m concerned about the community… Now, I am looking for some information from DHEC to be able to share on a school messenger and put the word out and have some information. I’m a school teacher, I’m not a doctor.”
The DHEC administrators responded that they wanted to first do a second round of tests on students. This round would focus on students who may have been exposed because their classroom was next to a break room used by the infected worker. In fact, the school officials said all kindergarten through 2nd grade students used the room at some point during a typical school week.
That news drew a response from Shuster: “Fortunately, or unfortunately, you’re supplying us with some information that we previously didn’t have.”
But Peterson continued, “That information… was shared back at the beginning of this… So that’s not really new information.”
Shuster then repeats that DHEC would prefer that the school wait until investigators have gotten more information.
DHEC sent notifications to parents the day after the conference call saying, “Your child has been in a classroom environment where they may have been exposed to the germ that causes tuberculosis.” It recommended that children get a TB skin test “out of an abundance of caution.”
“Why would we send out a fact sheet?”
At one point, Bryant asks when DHEC was able to confirm that the school employee in fact had the disease. Shuster replies that the agency would supply that information later.
But the emails provided to South Carolina Radio Network show that DHEC executives, for whatever reason, were giving conflicting information to each other a month earlier. And that inconsistency may have played a part in the agency’s slow response. Even the director Templeton admitted last week, “DHEC screwed this up.”
Upstate TB program manager Malinda Martin sent an email on April 17 stating that “We have a TB case, active disease in Greenwood Co.” She added that 8 of 12 skin tests conducted among faculty were positive.
But her supervisor, director of the agency’s TB division Shea Rabley, issued a different email an hour later, saying that “there are no counted cases of TB in that county to date but there are 3 suspects in the county.” A day later, Rabley sent another email to Shuster reiterating those numbers, which directly contradict Martin’s own email.
Those emails from the supervisor apparently led Shuster to decide against informing the public of the outbreak in April. “Why would we send a fact sheet when there are no confirmed cases? Have we confirmed a case at this point? Since I have been with DHEC, the only time we have sent something to a school to send home is when there is a confirmed case.”
A massive outcry came down against DHEC once the agency finally revealed the existence of TB at Ninety Six Primary in late May. After skin tests revealed dozens of students and faculty members had the virus, parents, politicians, and others in the Greenwood County community slammed the agency’s response.
Menwhile, the agency came down hard on those employees who had investigated the case. Rabley and Martin were terminated in mid-June, along with the Greenwood County nursing site supervisor Latrina Richard, and Anne Ashley— the registered nurse for Greenwood and Laurens County.
Ashley, Martin, and Richard have since filed wrongful termination suits, claiming that they did everything they could with little guidance from higher-ups at DHEC. The three say they did not have the legal power to forcibly quarantine the infected employee, nor did they have the ability to test students without approval from superiors.
In its answer to the lawsuit, DHEC says the three nurses violated the agency’s policies for dealing with TB patients. Most notably, the response claims Richard improperly brought the infected school employee to the Greenwood County Health Department for medication instead of treating the patient at his home. It also states the local nurses never sought a Public Health Order that would have quarantined the infected patient.
“(DHEC) denies each and every allegation of the Plaintiff’s complaint,” beyond a few technical issues, the agency’s attorney responded.
Reckenbeil says the alleged violations are technicalities that ignore the reality of the situation. He says the larger issue is that only Templeton or Gov. Nikki Haley could have issued the order forcibly detaining an infected patient who refused to remain in quarantine. However, there’s no evidence yet that either woman was ever made aware of the situation until late May.
The quarantine order was finally issued on June 6, almost three entire months after DHEC was notified of the possible infection. The employee, who has still not been publicly identified, is currently being kept in isolation at a Columbia facility.
This report will be continued later Friday