EXCLUSIVE | Tuberculosis Outbreak

Top DHEC staffer knew about TB problem in April

sfretwell@thestate.comJuly 19, 2013 

Catherine Templeton, director of the SC Department of Health and Environmental Control

TIM DOMINICK — tdominick@thestate.com Buy Photo

— One of state health department director Catherine Templeton’s top advisers was aware in mid-April of a tuberculosis investigation in Greenwood County, but was cool to the idea of notifying the public about the issue, according to internal agency documents obtained by The State newspaper.

Jamie Shuster, the Department of Health and Environmental Control’s public health director, said in an April 18 email that her agency doesn’t tell the public of tuberculosis investigations unless there are confirmed cases of the disease – and Shuster questioned whether there were any confirmed cases in Greenwood County, agency records show.

“Why would we send a fact sheet when there are no confirmed cases? Have we confirmed a case at this point?” Shuster’s email said in apparent response to a request by then-state TB director Shea Rabley to tell the public. “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.”

One email, written a day earlier, April 17, by the agency’s regional tuberculosis director in the Upstate, said eight people had tested positive for tuberculosis. The email from Malinda Martin, obtained this week by The State, doesn’t reveal who received the message.

But it conflicts with a second April 17 email from Rabley saying there were no confirmed cases.

The emails obtained by the newspaper raise new questions about when high-level agency staff members knew about the probe and what they did to respond to the growing crisis in the community of Ninety Six, where more than 50 school children have tested positive for tuberculosis.

The emails also suggest confusion in the agency about how to handle the unfolding crisis.

Parents in the town are incensed that they weren’t told about the disease threat until May 28 and that their children weren’t tested for the disease until May 31. DHEC staffers learned that a school janitor had tuberculosis March 8. He is believed to have spread the disease.

Templeton freely acknowledged this week that her agency responded poorly to the tuberculosis threat, telling The State newspaper that “DHEC screwed this up.”

But she insisted that she knew little about problems that were developing until stopping at the department’s Greenwood health clinic for a routine visit May 20 and 21 with Shuster. Once aware of the problem, Templeton said she moved quickly to inform parents and test children.

The emails, however, show that Shuster was aware a month before the May 20 visit that an investigation was going on. Shuster is one of Templeton’s most trusted advisers. She was one of a handful of top administrators Templeton hired after she was named director in March 2012. Neither Templeton nor Shuster was available Friday for comment.

DHEC spokesman Mark Plowden said the agency regularly receives reports of TB and conducts investigations.

He said that in April, tuberculosis staff members had not confirmed tuberculosis. He said when Templeton and Shuster learned of “persistent problems” in May, they intervened in the investigation to speed things up. He did not address the April 17 email that said eight people had tested positive for the disease. And he did not address whether Shuster was counting the janitor’s case, diagnosed March 8, when saying there were no confirmed cases.

Sen. Joel Lourie, D-Richland, said that kind of conflicting information is a major reason a Senate committee is looking into the matter. The Senate Medical Affairs Committee will hold a hearing Aug. 8 with DHEC on how the agency responded to the tuberculosis outbreak in Greenwood County.

Lourie said “it appears the top levels of management at DHEC, including both Miss Shuster and senior media relations people, knew there was a problem. We look forward to Mrs. Templeton coming in three weeks to help us understand what breakdowns occurred, and why personnel changes were made.”

Templeton told The State earlier this week that she fired four workers most responsible for the failed response. Those included Rabley, who worked in Columbia, as well as regional nurses Martin, Latrinia Richard and Anne Ashley.

The latter three have sued DHEC, saying they were stymied by bureaucrats in Columbia in attempts to speed the tuberculosis investigation. DHEC said in response to the lawsuits that the nurses broke policy, in one instance by failing for six days to launch a tuberculosis investigation after receiving confirmation of the sick school janitor on March 8.

Lourie, a past critic of Templeton’s, said the DHEC director “certainly should have known” about the DHEC probe early in the spring.

Meanwhile, Sen. Vincent Sheheen, a Democratic candidate for governor from Camden, raised the Greenwood TB probe during a speech Friday in Conway.

If DHEC had handled a tuberculosis probe at his children’s school like it did in Greenwood, “I wouldn’t just be furious, I might be in trouble right now,” Sheheen said. “That’s how angry I am and how angry I hope the people of South Carolina are because we deserve so much better than that.”

Tuberculosis is a disease spread through the air, typically by coughing or breathing. People in close proximity can breathe in the germs and become infected. The disease can be fatal, although rarely is if treated with the proper medication. It can take six to nine months to complete medication for the disease.

The children from Ninety Six Primary School are being treated, and DHEC plans follow up tests later this summer.

DHEC has not shared TB-related documents with The State. The agency has yet to fulfill a June 10 Freedom of Information Act request for written exchanges with the school district.

Staff writer Adam Beam contributed to this story.

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