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The crisis spreading from Flint, MI’s unsafe drinking water has been broad and far-reaching. In addition to the widely publicized lead contamination, the water that the city used from the Flint River for 18 months has also been connected to an outbreak of Legionnaire’s disease between 2014 and 2015. A state report said that at least 80 percent of the outbreak, which affected over 90 people and killed 12, could be attributed to the water.

Michigan’s state health director, Nick Lyon, was charged with manslaughter last June for failing to inform the public of the outbreak. After a lengthy preliminary process, a judge on Monday finally ordered Lyon to stand trial on the charges.

Legionnaire’s disease occurs when Legionella bacteria grows in misting or cooling systems. When it’s inhaled by people, they can develop a severe form of pneumonia that is particularly hard on those who already have compromised immune systems. According to a 2017 NCBI study, areas with “high percentages of poverty, Hispanic population, and non-white population” have a higher risk of Legionnaire’s outbreaks.

Flint’s water was highly corrosive, which caused it to leach lead from pipes. It may have leached other metals as well, like iron, which could lead to the overgrowth of bacteria. One study linked the outbreak to low levels of chlorine in the water. Many of the cases of Legionnaire’s in Michigan were connected with McLaren Hospital, which used the Flint water system we now know was tainted.

Though Governor Rick Snyder and Lyon announced the outbreak in November 2016, Lyon has since acknowledged that he was aware of reported cases a year earlier. “He had the chance to save lives,” special prosecutor Todd Flood told a Michigan court in July, the Los Angeles Times reports. Judge David Goggins called Lyon’s decision to not publicize the outbreak “corrupt.”

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“It is not enough for the prosecutor to wave his hands in the air and cry bad things happened to the people of Flint so someone must be held responsible,” Lyon’s charming lawyers said in one filing.

Lyon is the highest ranking official in Michigan to be charged with crimes related to the water crisis. So far, 14 other officials have faced criminal charges, and four have agreed to plea deals.