An unsanctioned COVID vaccination clinic in western Connecticut was shut down in February after investigators discovered an untrained state representative was handling and preparing vials of vaccine.
The state Department of Public Health also suspended Kent-based High Watch Recovery Center, a drug and alcohol rehabilitation center that oversaw the clinic, from holding any new vaccination clinics until it complied with state regulations.
DPH investigators showed up at Heritage Village in Southbury, the largest retirement community in the state, early on the morning of Feb. 4 to find personnel from High Watch running a mobile clinic for 200 residents.
High Watch had failed to inform the state it was going to be running a mobile clinic in Southbury and didn’t have approval to do so, said DPH spokesman Maura Fitzgerald. The rehabilitation center had no prior experience hosting a mobile clinic, she said.
The state eventually decided to stop sending first doses to High Watch for about a month, resuming shipments of the vaccine in early April, records show.
The Connecticut Mirror has obtained the investigation report, internal DPH e-mails about the incident and correspondence between the state and High Watch officials and their attorney. The records for the High Watch investigation were requested on Feb. 22 under the state Freedom of Information Act; they were released by state officials on May 5.
While the vast majority of the state’s vaccination clinics have been conducted without incident, the issues with High Watch at Heritage Village and a separate investigation into how a CVS in Waterford was vaccinating New York residents show there have been isolated problems that state officials do not publicly discuss during their bi-weekly press conferences about the pandemic and vaccine distribution.
A spokeswoman for DPH did not immediately comment on the High Watch investigation Thursday morning.
In a six-page letter to High Watch officials and their attorney, the head of the DPH Facilities and Licensing Unit, Barbara Cass, outlined a broad range of problems her investigators uncovered at the Southbury clinic, beginning with the fact that the company’s vice president of communications, Jason Perillo, was opening vials of Moderna vaccine and preparing shots even though he was not trained or licensed to do so by DPH.
Perillo is a Republican state Representative from Shelton and a former EMT whose license expired in 2018, DPH officials noted.
“Every single individual handling vaccines was trained to do so by our chief medical officer at High Watch,” Perillo said in an interview Thursday night. “I’d go so far as to say we were given one-on-one training.”
In addition to finding Perillo preparing the vaccine, investigators found 10 vials of Moderna vaccine — the equivalent of about 100 doses – unattended on a counter, another 18 vials in a portable cooler with no monitoring temperature gauge, which is required by the CDC, and a box of syringes left unattended.
Perillo said that the vials of vaccine had been out of the refrigerator for at least an hour and a half when investigators discovered them. He also acknowledged that he was not a licensed health care professional but said he was trained by a physician from High Watch to prepare and administer the vaccine. He said he had been routinely opening vials and preparing shots at clinics High Watch was running at its Kent facility.
In another room, investigators discovered five unlabeled and unattended syringes containing a cloudy white liquid that Perillo told them was the first batch of Moderna vaccine. Investigators also noted the presence of at least two people in a hallway who had been vaccinated but were not being monitored for adverse reactions, as required by the CDC, and poor social distancing among the elderly residents who were waiting to get vaccinated that morning.
DPH officials halted the Heritage Village clinic until they could get personnel from Waterbury Hospital to take over the clinic on Feb 4. The clinic was delayed until Waterbury Hospital personnel arrived and completed vaccinating nearly 300 people. The state also asked Waterbury Hospital to come back several weeks later and administer the second doses.
In an email to DPH staff following the spot visit, vaccine coordinator Benjamin Bechtolsheim ordered them to ensure that High Watch officials received the second doses they needed for their regular clinic in Kent but then to cut them off.
“We basically just want to give him enough doses to wind down commitments and then quietly exit the program,” Bechtolsheim wrote in a Feb. 15 e-mail to both Cass and DPH Chief of Staff Adelita Orefice.
By mid-February, High Watch had administered more than 4,000 doses out of an office in downtown Kent. Although the drug and alcohol rehabilitation clinic could be viewed as an unlikely vaccinating partner for the state, it was a good match because DPH had very little vaccine coverage in the rural Northwest corner of Connecticut.
Perillo said it was Heritage Village officials who first contacted High Watch about holding a mobile clinic at the Southbury facility. In e-mails and letters to DPH officials, High Watch CEO Jerry Schwab said they were expecting help with the clinic from the Heritage Village ambulance service that didn’t materialize.
“Unfortunately, at this particular mobile Southbury site, High Watch was promised assistance from the Heritage Village Ambulance Service, which it did not receive,” Schwab wrote. “Notwithstanding, High Watch does not dispute this finding and has decided to discontinue holding any further mobile clinics.”
Shipman and Goodwin attorney Joan Feldman, who represented High Watch in the aftermath of the Southbury clinic debacle, wrote a letter to DPH Chief of Staff Adelita Orefice and Cass downplaying Perillo’s role at the clinic and emphasizing that High Watch had stepped up to help the state reach an area sparse on vaccinators.
“The one compliance issue that High Watch is aware of involves one retired High Watch EMT preparing vaccine (BUT NOT ADMINISTERING THE VACCINE) for administration by a licensed practitioner,” Feldman wrote. “This retired EMT completed the vaccine administration training provided by the High Watch Medical Director who was a trained Skills Validator pursuant to DPH guidelines.”
Feldman then reminded DPH officials that High Watch had already administered more than 4,000 doses at its Kent clinic since late January.
“It is our hope and expectation that DPH will take into consideration the current circumstances, the fact that there was no bad faith, that all other aspects of the State’s vaccine program have been strictly adhered to, there is a great need for vaccines, and that access is limited in the subject area,” Feldman wrote.
But DPH officials weren’t buying it.
“There is no retired EMT status, you are either current or expired. Mr. Perillo’s EMT certification expired in 2018,” DPH’s Office of Emergency Services Paramedic Director Raffaella Coler wrote in a Feb. 18 e-mail to Cass.
“The Commissioner’s Order states that you must complete an approved training by the Department. There is no record of Mr. Perillo completing any department approved training,” she added.
Cass’s one word response: “Amen.”
Plea for more vaccine
DPH officials also canceled a mobile clinic High Watch had scheduled in Shelton a week after the Heritage Village clinic. On March 3, DPH conducted a site visit at the center’s Kent location, and on March 5, High Watch submitted its corrective plan.
High Watch informed DPH officials that as part of their corrective plan, “they were immediately removing its Director of Communications (a retired EMT) from any further involvement in its vaccine administration program.”
“Only High Watch licensed physicians and nurses will be involved and responsible for the safe administration of vaccine,” Schwab wrote.
“High Watch is experiencing a very high demand for its vaccine services and is eager to respond to the needs of this community for vaccination. Upon submission of our plan, we welcome swift direction and communication from DPH regarding our ability to restart our process for making appointments for vaccinations,” Schwab said.
The letter also addressed the issue of vaccine being left unattended or unrefrigerated.
“Vaccines will never be left unattended by the administrating clinician,” Schwab wrote. “Specifically, effective 3/5/21, High Watch will adopt the checklist for the safe handling and storage of vaccine as set forth in CDC guidance.”
DPH officials responded within three days and approved the corrective plan of action, but Cass said first doses would not be available again to High Watch until early April.
In the meantime, she wrote, High Watch should schedule no new patients and honor all scheduled first and second dose commitments.
“The clinic should not expect to get additional doses for further clinics until after April 5th,” Cass said. “Vaccine supply is limited, so DPH will not be able to restart High Watch’s participation in the network , that is, provide vaccine allocation for new first dose appointments – until after April 5th.”
Perillo said that High Watch never stopped vaccinating people, although by now — like most vaccinators — the supply far outweighs the demand.
“We still have the clinic open right now,” Perillo said. “We’re kind of facing the same thing that everybody’s facing, that in January it was mobbed and people were banging down the doors to get vaccinated, and now, unfortunately, we’re kind of twiddling our thumbs.”