More than a half-dozen people died at a state-run residential facility in Virginia from infections that typically are easy to treat with antibiotics.
The state has acknowledged the deaths, which first were identified by a nonprofit watchdog organization that advocates for people with disabilities. Several of the residents who died, state officials also noted, had other medical issues.
Six deaths connected to urinary tract infections occurred within a 14-month period, part of a pattern documented by the Richmond-based DisAbility Law Center of Virginia, which monitors state institutions.
A seventh infection-related death occurred after the law center alerted the facility and state officials in September 2016 to the “alarming conditions” at the institution, “leading to prolonged and painful death.”
“We are saddened by this unnecessary loss of life,” said Colleen Miller, the law center’s executive director. “People should not be dying from urinary tract infections.”
The deaths are particularly disturbing, she said, because such infections are usually easy to prevent and treat.
The findings are the latest in a series of problems identified at the Central Virginia Training Center near Lynchburg, which is slated to close in 2020 as the state moves away from institutionalizing people with intellectual and developmental disabilities. The living conditions at the campus were initially investigated by the Justice Department nearly a decade ago.
In response to the report last week, state officials said the center had already been “taking steps to mitigate the effects of infections, specifically urinary tract infections,” by training staff on the importance of hydration and spotting symptoms.
In a statement, Jack Barber, interim commissioner of the Virginia Department of Behavioral Health and Developmental Services, thanked the law center for “tracking this vital issue and highlighting DBHDS’s efforts to address this challenge.”
Virginia was one of the last states to begin shuttering its large institutions. In 2012, the state announced that it would close all but one of the facilities, known as training centers, and move people into smaller group homes or family houses.
The shift came as part of a $2.1 billion settlement with the federal government that is still under review in federal court. The Justice Department declined to comment on the new report.
Two state institutions, including a facility in Northern Virginia, have closed. The population at the center close to Lynchburg, where the infection-related deaths occurred, is currently about 150. At one time in the 1970s, there were more than 3,500 there.
Of the six deaths that involved urinary tract infections (UTIs), state officials said four individuals had “other complicated medical issues.”
Department spokeswoman Maria Reppas confirmed a seventh infection-related death in November 2016 but said there have been no reported infection-related deaths since then.
Although most people can easily prevent such infections, individuals with developmental disabilities, particularly in institutionalized settings, may be more susceptible because of issues with urination or communication, she said.
“Despite the cleanest of techniques, these individuals may be at risk for infection,” Reppas said.
Jamie Liban, executive director of the Arc of Virginia, called on the state to take action to avoid such preventable deaths. Because people with developmental disabilities often communicate in different ways, and sometimes non-verbally, Liban said, it is important that the medical community “pay attention to those forms of communication and respond appropriately.”
“The painful, slow death these people went through is unimaginably horrifying,” said Liban, whose organization advocates for people with disabilities.
Del. Mark D. Sickles (D-Fairfax) said that even if the infections were not the sole cause of death, “there is no excuse.”
“The department is doing its best to make sure basic care takes place without exception,” said Sickles, who has worked on issues affecting the community. “They must do this because UTIs could be a contributing factor in the death of a patient who is already in a fragile condition.”
The nonprofit law center, which regularly monitors state-run institutions, first became concerned when it identified a “disturbing number” of deaths at the training center between March 2015 and May 2016.
In 2015, the state developmental services department had issued its own alert about the potential dangers of such infections and recommended preventive measures.
In the September 2016 letter to the facility and the state, the law center asked the institution to “take immediate steps” to improve prevention and treatment, according to the letter. By late 2016, the report says, the facility acknowledged the law center’s concerns and began to increase training and awareness, outlining its plan in an April 2017 employee newsletter, the report shows.
“Thankfully and at long last,” Miller said in a statement, the center “appears to be responding appropriately to prevent further suffering and death.”