Twins hospitalized for lead poisoning sent back to unsafe home

Nurse did not follow up after kids’ treatment

Twins with lead poisoning so severe they were hospitalized were released and sent home to a property with chipping and peeling lead paint because of a Milwaukee Health Department nurse, city records show.

Those actions put the children at serious risk of additional lead poisoning, according to a September 2017 written warning for Margot Manassa, the city’s public health nursing coordinator.

“The employee informed the hospital that the property was clear even though the inspector informed the nurse that there were lead hazards; windows and entrance door had chipping and peeling lead paint,” the warning reads. “The employee failed to document any conversation with

hospital staff or lead risk assessor.”

Manassa spent two days at a health fair in August 2017 rather than providing follow-up care for the twins and their family, the warning says.

“The employee informed Children’s Hospital of Wisconsin that she would be out and there was limited staff for follow-up case management and investigation,” it reads. “The employee decided to attend a setup of a health fair and a second day at the event in place of providing nursing case management to a high-risk child.”

The twins’ lead levels were so high they were in the hospital to receive chelation therapy, a medical procedure used to remove metals like lead and mercury.

Despite the seriousness of their poisoning, the city failed to keep complete records and there was “no education to the parent” offered, the warning says.

“The charts for the pair of lead poisoned chelated twins are; incomplete, illegible and show that no case management was conducted,” it reads. Manassa was later suspended for five days in April. The suspension notice listed a number of problems with Manassa’s job performance, including failing to follow up with lead-poisoned children, failing to send follow-up letters to families of children with elevated blood lead levels and failing to assign cases.

The records were obtained by the Journal Sentinel under the state’s open records law.

Interim Health Commissioner Patricia McManus cannot comment on personnel issues, the department said in a statement.

The statement also said Manassa was not available for an interview.

Previous problems

This was not the first time Manassa has received warnings over her job performance.

In December 2007, she was reprimanded for arriving to work late.

In June 2008, she received a verbal warning for calling in sick more than an hour after she was supposed to show up at work at the Keenan Health Center.

Later that year, in December 2008, Manassa received a written warning for using a Health Department computer “for personal use during regular work hours logging into fark.com, CraigsLists, African Gray Parrots, etc, which interferes with the performance of the employee’s job duties and responsibilities.”

But her latest problems were the most severe. The 2017 written warning states that Manassa was in violation of City Service Commission rules. The document said she “has been guilty of acts which amount to an act of insubordination” and “is incompetent or inefficient in the performance of or fails or refuses to perform the duties required for the position.”

Manassa isn’t the only Health Department staffer who has been disciplined because of problems with the city’s lead poisoning prevention programs.

Lisa Lien, who was then serving as the city’s home environmental health manager, was suspended for 10 days in December after city officials found she was “ineffective,” “insubordinate” and “incompetent or inefficient” in her work for the department.

“The magnitude of the injustice served to the children of the City of Milwaukee is immense,” reads Lien’s suspension notice, which was signed in December by former Health Commissioner Bevan Baker.

At the time, Lien accused the city of using her as a scapegoat.

The city’s Health Department has been reeling for months since news broke that it failed to provide follow-up services to the families of thousands of children with lead poisoning — or at least failed to document those efforts. Problems also emerged with a federally funded city program aimed at reducing lead dangers, especially lead paint risks, in city homes.

Problems with the city’s lead programs led to Baker’s sudden resignation in January.

A report released soon after his departure detailed a wide range of problems with the department, including staffing shortages, inadequate training, high turnover and poor coordination.

McManus, who was picked by the Common Council to lead the troubled department in February, has recently said problems with Milwaukee’s lead programs were just the “canary in the mine” for the entire department.

The department has also faced problems with its programs involving family planning, breast cancer screenings and testing for sexually transmitted infections.