Top health care officials at the Department of Veterans Affairs apologized for a recent string of preventable patient deaths, but not for the big performance bonuses paid out afterwards, during a congressional field hearing in Pittsburgh Monday.

The apologies followed tearful testimony from the families of veterans who died at VA facilities in Pittsburgh and Atlanta, and from agency whistleblowers who described cover-ups and retaliation by hospital administrators when they tried to expose wrongdoing.

Yet, despite acknowledging the “deeply compelling and very upsetting” stories of how VA failures led to the deaths, Robert Petzel, the department's under-secretary for health, maintained that the bonuses paid to top administrators were justified and in some cases legally required.

That includes the nearly $63,000 bonus paid to Michael Moreland, director of the VA health care region that includes Pittsburgh, where at least five patient deaths resulted from an outbreak of Legionnaires' disease between July 2011 and November 2012.

Moreland collected the Presidential Distinguished Rank Award earlier this year, three days after the agency’s inspector general issued a report concluding improper maintenance and mismanagement at VA medical facilities in the Pittsburgh area led to the Legionnaires contamination.

“I have significant sympathy and empathy for the families,” Moreland told the House Committee on Veterans’ Affairs, which held the hearing in Pittsburgh to investigate the deaths there and at other VA facilities.

“I can’t express more sincerely my apology and appreciation for the suffering that the family faces,” he said.

As to the bonus, Moreland said the presidential award was to recognize his entire 30-year career at VA.

“The timing of it was very bad, and I understand the families that would look at that and make the connection and be upset about that,” Moreland said. “I received the award. I’m proud to have received it.”

As a presidential appointee, Petzel is not eligible for performance bonuses.

Rep. Jeff Miller, R-Fla., the committee's chairman, said the VA has a history of rewarding failure by paying bonuses to top executives with troubled histories.

After Petzel explained bonuses are required to be paid to executives who meet a standardized set of pre-determined goals, Miller asked whether meeting those metrics is more important than preventing patient deaths.

Both are important, Petzel said, drawing a sharp rebuke from Miller.

“The death is,” most important, Miller said. “It is absolutely unconscionable that we would award bonuses to anybody who had a preventable death occur on their watch. It’s just unbelievable what has occurred here in Pittsburgh. Bonuses were awarded. The people that got the bonus knew what was going on.”

In later questioning, Petzel was asked by Rep. Keith Rothfus, R-Penn., whether he would accept a presidential award in circumstances similar to those that led to the deaths in Pittsburgh.

“I would certainly hope that I wouldn’t even be in the running if that happened,” Petzel responded as Moreland sat silently at the same table.

Moreland had already been nominated by the VA and approved for the presidential award before the inspector general issued its report blaming failures at the Pittsburgh facilities for the Legionnaires outbreak, Petzel said.

After the report was issued, Moreland had no choice but to accept the award.

“This was already a done deal,” Petzel said. “I would think that if the opportunity were there prior to what happened, that Mike or I or anybody else would step up and say ‘let’s wait and see what happens.’”

The first confirmed death from Legionnaires at the Pittsburgh facilities occurred in July 2011. By Nov. 1, 2012, contamination of the water supplies had been confirmed by the Centers for Disease Control and Prevention.

That same day, Navy veteran William Nicklas, 87, was admitted to the VA hospital in Pittsburgh, complaining of nausea.

VA officials did not warn patients of the risk that had by then been confirmed by CDC, Nicklas’ son, Bob, told the committee. On Nov. 16, signs were posted that said people should not use the drinking fountains due to water line problems. No mention was made of Legionnaires disease.

William Nicklas’ condition deteriorated, reaching the point that he would obsessively pick at his blanket and tell family members “I have to get the poison off of me.” He died Nov. 23.

“It was heart-wrenching to watch my father’s slow, painful decline,” Bob Nicklas said. “We are very disappointed that no one has been held accountable.”