Two Steps Forward

In the wake of controversy over the city's lagging health initiatives, the family of a lead-poisoned child wins a settlement and the city's health director steps down

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The family of Albert "Little Al" Evans, a boy who was severely lead-poisoned while living in a South St. Louis apartment, has agreed to settle for $385,000 a lawsuit filed against their former landlord.

The settlement was reached just two days after a story on lead poisoning -- featuring Little Al's photograph on the cover -- appeared in The Riverfront Times. The story described Little Al's struggles with speech impairment and other disabilities in the years since his blood was found to contain more than five times the level of lead deemed acceptable by the U.S. Centers for Disease Control and Prevention (CDC). Lawyer Todd S. Hageman of the law firm Hopkins Goldenberg, who represented Little Al, says the net settlement proceeds, after attorney fees, will be used to purchase an annuity. The structured settlement will provide a lifetime of monthly payments and periodic sums to Little Al after he turns 18, Hageman says.

The terms of the settlement were not confidential, though Hageman says he is prohibited from disclosing the identities of the defendants or the defendants' insurance company. However, court records identify the landlords as Elmo and Anna Quinn. Their lawyer declined to comment.

Little Al was 3 when he and his family moved into an apartment at 3518 Juniata St. in South St. Louis. Months after he moved in, his blood was tested for the presence of lead during a routine clinic visit. His blood-lead level was 18 micrograms per deciliter -- above a limit of 10 micrograms per deciliter set by the CDC. Inspectors from the city's Health Department visited the apartment and identified seven exposed lead hazards in the apartment -- consisting of peeling or cracking lead-based paint -- and sent a violation notice to the property owners in May 1997, ordering them to make repairs. Hageman says lead inspectors visited the apartment twice, in June and July, and, after finding that no repairs had been made, pursued the case in the city's Housing Court. When Little Al's blood-lead level was tested in July, it had increased to 52 micrograms per deciliter -- a level so high it required Little Al's immediate hospitalization for a five-day treatment. Lead levels above 50 can have a variety of harmful effects on a growing child, including brain damage.

"In that two-month period, when the landlords didn't address those violations, his blood-lead level skyrocketed," Hageman says.

Little Al and his mother moved out of the apartment after he was hospitalized. The lawsuit also named as a defendant the family's next landlord -- Jim and Mary Pitts -- because that apartment, too, had lead hazards. Hageman says the case against them ended in a "nominal" settlement.

Little Al, now 6 years old, suffers from developmental problems, his mother says. He has a very limited vocabulary, cannot form simple sentences and struggles to recite the alphabet. He is enrolled in a special Head Start class for children with developmental delays.

Little Al's difficulties were described in an April 12 RFT story ("The Lead Menace") that examined the city of St. Louis' history of failing to take adequate steps to prevent thousands of children from being lead-poisoned each year. In St. Louis, nearly 25 percent of the children tested each year have increased blood-lead levels, a rate nearly six times the national average. Although a major lead-poisoning prevention effort was announced by St. Louis Mayor Clarence Harmon last year, that initiative exists largely on paper and has had little impact so far. The initiative included stepped-up inspections to look for lead in homes in the city's housing-conservation districts but resulted in only 20 of 5,000 inspected buildings' being referred for actual lead inspections. Loan funds have been established to assist homeowners, but no loans had been extended as of April, and the criteria are so restrictive that only families of already poisoned children may apply.

The city's health commissioner, Dr. Larry Fields, who has played a key role in that initiative, announced his resignation less than a week after the story appeared. But he discounts any relationship between the timing of the article and his decision to resign. He says he is stepping down as head of the city's Health Department to concentrate on his other role, president and CEO of the financially troubled St. Louis ConnectCare, a program that provides health care to the uninsured.

"The decision is one that I had been working on for a couple of months in terms of what to do," Fields says. "This allows me to devote additional energies to the uninsured issue."

The mayor appointed Fields head of the ailing Health Department in 1997 and president and CEO of ConnectCare in October 1998. In a prepared statement, Harmon credited Fields with helping "stabilize" the Health Department. Fields came to the city post from Washington University, where he was associate director of the cardiac-stress-testing lab and an assistant professor of medicine and pathology.

Asked whether it was too difficult to juggle two potentially full-time jobs -- as head of ConnectCare and as the city's top public-health official -- Fields says this: "I think that the accomplishments speak for themselves and should be compared to what accomplishments preceded it. We formed a really excellent team of individuals. We've brought a lot to the table and converted it to outcomes as well." A two-page list of 1999 accomplishments, provided by the Health Department, touches on a range of issues -- such as reducing the number of documented tuberculosis cases by 25 percent, from 55 to 41 cases; administering 28,277 doses of vaccine; managing community outbreaks of hepatitis A and shigella; and taking a "leading role in accelerating the effort to prevent lead poisoning by increasing blood-lead screenings and building inspections."

A recent item by St. Louis Post-Dispatch columnist Jerry Berger suggested that Fields' resignation came one day after a tense meeting with the mayor, who had been "stung by recent criticism of the snail's pace of several widely publicized mayoral health care initiatives." Fields denies that the mayor expressed any disappointment with the progress of the lead initiative -- to him. As for the item in the Post, he says: "What can I say about Berger's column?

"It was my choice, my decision completely," Fields says. "I made a decision, prepared a letter of resignation and presented it to the mayor."

Chuck Miller, spokesman for the mayor's office, says a meeting between Harmon and Fields did take place the day before Fields publicly announced his resignation, but he says it wasn't tense: "The resignation wasn't triggered by any disappointment the mayor had with anything going on in (the Health Department). I think it's fair to say the mayor was concerned there wasn't enough focus on ConnectCare. Dr. Fields has a lot of responsibilities, and the mayor was very interested in ConnectCare's longevity."

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