By Walter F. Roche Jr. / The Tennessean

Records in a newly filed federal lawsuit indicate the officialdeath toll among Tennessee patients from the nationwide fungalmeningitis outbreak may be understated.

According to the complaintfiled in U.S. District Court in Boston last week, Gokulbhai Patel ofGoodlettsville died Jan. 13 from fungal meningitis caused by two spinalsteroid injections he received at the Saint Thomas OutpatientNeurosurgical Center in Nashville.

However, the official deathcount maintained by state and federal officials shows no deaths amongTennessee patients in that month from the outbreak blamed on the NewEngland Compounding Center, the source of the tainted steroids.

Theofficial Tennessee death toll, which climbed to 14 in mid-December, didnot increase to 15 until a Kentucky woman, who had undergone injectionsin Nashville and contracted fungal meningitis, died on April 16. Theofficial count remains at 15, according to the latest data from the U.S.Centers for Disease Control and Prevention.

State healthofficials confirmed Thursday that no fungal meningitis deaths amongTennessee patients were reported in the month Patel died.

"We havenot been made aware of any deaths that occurred in January linked tothe meningitis outbreak associated with products from NECC," TennesseeHealth Department spokeswoman Shelley Walker wrote in an email responseto questions.

CDC officials said they rely upon state health officials to gather the data from health-care providers on deaths from outbreaks.

Whilethe Patel case gives the first indication of a possible undercount in apublic record, it comes as no surprise to attorneys representingvictims of the outbreak.

"Clearly we don't have the exact count,"said J. Gerard Stranch, who represents several area victims or theirfamilies. He said he was personally aware of about a half dozen casesnot included in the official count.

Stranch said there could be avariety of reasons, including the fact that some other illness waslisted as the final cause of death when, in fact, a cascade of illnesswas initially triggered by fungal meningitis.

The latest CDC datashows that in addition to the 15 deaths, 153 Tennessee patients havebeen sickened from the outbreak. Nationwide, 63 deaths have beenrecorded with 749 patients sickened.

"There are potentially asignificant number of additional patients who have been injured orkilled by the contaminated medications sold in Tennessee and in otherstates," said Mark Chalos, a Nashville attorney who represents severalarea victims.

He said that he and other plaintiff lawyers havebeen pushing for the federal court to require health-care providers tonotify all possible victims, but some have been resisting those efforts.

OliviaColonero at the law firm of Janet, Jenner and Suggs, which representsthe Patel family, said she was not aware the death wasn't included inthe official count.

"Maybe there was some miscommunication," she said, adding that the firm would look into the matter.

Patel,80, died some five months after he received the second of twoinjections with methylprednisolone acetate at the outpatient center.

SanmukhPatel said in a telephone interview that his father was hospitalizedtwice after contracting fungal meningitis. He said his father, who cameto the United States from his native India in 1997, got the injectionsseeking relief from chronic back pain.

He said his father, who wasretired, had been sick "for a long time" and never recovered. "He spenta lot of time in the hospital."

According to the federal lawsuit,Patel was referred to the neurosurgical center by the Howell AllenClinic, which is part owner of the outpatient center.

Thecomplaint states that the elder Patel was given injections on Aug. 27and Sept. 10, 2012. He was admitted to Saint Thomas Hospital on Oct. 17suffering from chills, fever, dizziness and weakness and lower extremitypain.

"He was diagnosed with fungal meningitis after steroidinjections," the complaint states. "From the time of Mr. Patel's illnessto his death he experienced extreme conscious physical pain and mentalsuffering."

The 34-page complaint states that the elder Patel wasfirst hospitalized for two days shortly after his second shot and thenreadmitted in October.

Named as defendants in the case are theowners of NECC, which has shut down and filed for bankruptcy. Otherdefendants include Ameridose, a sister company of NECC; Medical SalesManagement, the sales arm for the two companies; and a testing companyhired by NECC to check the sterility of its products.

The plaintiff is Pinal Patel, a grandson of the victim and the personal representative of his estate.

Thesuit is one of several being filed as a deadline approaches under thestate health-care liability statute, which carries a one-year time limitfor filing a claim.

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