The director of Utah’s public health lab says state officials stripped her of her position Monday because of her unwillingness to send coronavirus test samples to TestUtah’s hospital lab — which has been deemed “not in compliance” with federal certification guidelines.
“It just feels dirty,” Dr. Robyn Atkinson-Dunn said Monday, her voice breaking in a phone interview. “I dedicated eight-and-a-half years to that job. ... That lab has built a reputation across the nation and across the state. And I get removed because I refused to do something that is unethical. That’s how the state works right now. They do unethical things.”
The Utah Department of Health said that Atkinson-Dunn was offered a new position as “multi-drug resistant organism specialist" in the epidemiology bureau.
“Department leadership today made a change to staffing,” said UDOH spokesman Tom Hudachko.
The former public lab director said her supervisors took her computer and blocked her access to her email account after she was “summoned” to a Monday meeting where health officials told her about her transfer.
Atkinson-Dunn said she is not sure if she’ll accept the new position, which she considers a “demotion that is veiled as a reassignment.” She said she is not trained as an epidemiologist and is actively looking for other career opportunities.
The public health lab has been inundated with testing work, Atkinson-Dunn said, as leaders of the state’s coronavirus response gave directives to check nursing home staffers across Utah for COVID-19. The lab was also trying to process tests from National Guard soldiers deployed during the coronavirus pandemic and people participating in sporting events, she said.
Atkinson-Dunn said she repeatedly asked for backup from outside labs to deal with the glut of testing requests, warning that her lab’s turnaround times would increase if it didn’t receive help.
But she was not comfortable diverting the samples to Timpanogos Regional Hospital lab, given a recent federal inspection that found it out of compliance. The Orem lab has been in charge of processing samples gathered through the TestUtah initiative, operated by tech companies that have landed multimillion-dollar contracts with the state.
In May, regulators from the Centers for Medicare and Medicaid Services inspected the lab at Timpanogos Regional after they received a complaint, according to a letter to the hospital.
Regulators did not provide the report that identifies the violations they found at the hospital. Instead, the letter notes general areas where the number or severity of “deficiencies” were enough to imperil the lab’s certification, such as the general systems in place to monitor and evaluate the lab, how it receives, processes and reports tests, and qualifications or performance of the hospital lab’s leadership.
Inspectors didn’t immediately apply sanctions to the lab, which has 10 days to respond to the citations. Meanwhile, the lab has operated as usual, according to MountainStar Healthcare, which owns Timpanogos Regional.
However, until the deficiencies are resolved, Atkinson-Dunn said the state should refrain from sending tests results to the lab.
“I view it as unethical that we would willingly send patient samples to a laboratory that has clear documentation from CLIA that they are not up to par,” she said, referring to to the Clinical Laboratory Improvement Amendments, which govern medical labs nationwide. “Until the state gets proof that they have corrected all of their issues, I find it unethical to send samples to the lab — that could mean life or death for someone, especially in a nursing home situation."
Hudachko confirmed that the public health lab over the weekend received more samples than it could handle because of testing at a meat processing plant in Cache County and at long-term care facilities.
“It has been common practice throughout the course of the response for labs to send samples to other labs when they reach capacity,” he wrote. “In this instance, we have sent our excess capacity to the lab at Timpanogos Regional Hospital for processing.”
A spokesman for the hospital said it was “actively implementing” the changes suggested by federal regulators.
"While we can't speak to any personnel changes from other organizations, there was nothing presented in the CLIA report questioning the accuracy or validity of testing at the lab associated with Test Utah," spokesman Mike Graul wrote in an email. "The purpose of any hospital-based review process is to identify opportunities for improvement. Such reviews are standard practice and corresponding feedback for improvement are part of the ordinary review process."
He noted that the Timpanogos Regional Hospital lab has remained functioning throughout the pandemic and said “the recommendations in this report will make the lab better than ever as we continue to serve our patients and our community.”
The acting director of the health department, retired Utah National Guard Gen. Jeff Burton has described the citations as routine.
“Noncompliance findings are not out of the ordinary for CLIA audits. CLIA has provided the laboratory with the opportunity to come into compliance, and we fully expect it to do so," Burton has said.
In a statement, Nomi Health, the company leading the TestUtah initiative, said it was “unfortunate” that Atkinson-Dunn “is choosing to try to blame TestUtah as to why she was reassigned from her office.” The statement said federal regulators would have shut the Timpanogos Regional lab down if they didn’t believe it should be processing tests.
The state’s chief medical examiner, Dr. Eric Christensen, will lead the Utah Public Health Laboratory until UDOH finds a permanent replacement for Atkinson-Dunn, Hudachko said.
“As this is a personnel matter, that is all we can say,” he wrote in an email.
Atkinson-Dunn said she believes the lab workers “will be fine" and persevere despite the leadership shakeup.
“I do hope that they get the help that they need,” she said.
The state’s public health lab recently played a role in the abandoned effort to determine the accuracy of TestUtah, the coronavirus testing system operated by tech companies that have landed more than $60 million in contracts in three states.
Questions about the precision of TestUtah’s tests have been circulating since data collected in April showed that the positive rate for the symptomatic patients they tested was less than half that of other test providers.
TestUtah refused to join Utah’s other labs in a collaborative “proficiency challenge” to check the sensitivity of one another’s coronavirus tests. Instead, in a compromise with health officials, TestUtah agreed to a more rudimentary experiment that involved exchanging 90 samples with the state lab and comparing results.
The state lab and Timpanogos Regional tested the samples in early May. State health officials and corporate executives over the hospital reviewed the results — and after health officials reported that a final draft had gone to Burton for approval, Burton said he would not release them. There were problems with one batch of the samples the public health lab provided, he said.
Correspondence from MountainStar shows the public health lab sent over a new batch of samples; it’s not clear why that was inadequate to release the results. It’s also unknown whether the experiment is related to Atkinson-Dunn’s removal.