Defense Witnesses Attack Cyanide Death Diagnosis
PITTSBURGH (KDKA/AP) - The trial of Pitt researcher Robert Ferrante, accused of poisoning his wife, is making national headlines again as People Magazine posted coverage this afternoon.
The defense on Tuesday delved into Dr. Autumn Klein's medical issues. They are issues that the defense says Klein tried to keep hidden, and issues they believe could explain her death.
It's just part of what Ferrante's lawyers say points to the fact that he's innocent.
Dr. Laurie Knepper, a UPMC neurologist, testified she consulted with Klein on a "curbside" basis, meaning the treatment was not formally on the books or entered into the computer system because Klein did not want anyone at the hospital to know about her medical treatment, including her fertility treatments.
But Knepper confirmed that Klein had migraine headaches most of her life, and once had a dizzy spell at church, but that she found no heart problem that contributed to it.
Knepper testified that had she found such a heart problem, she would have entered it into the UPMC system.
Earlier, Edward McCabe, whose funeral home handled the arrangements and cremation for Klein, testified that Ferrante was in no rush to have her body cremated.
The prosecution in opening statements implied Ferrante was anxious to have it done quickly.
"Was there a rush put on it?" asked defense attorney Wendy Williams.
"No," replied McCabe. "There was nothing out of the ordinary. He had not indicated he was in a great hurry for the cremation to occur."
McCabe also testified that the cremation could not have occurred without authorization from the medical examiner's office.
The day began with the testimony of Dr. Shaun Carstairs, from the Naval Medical Center in San Diego. He reaffirmed his opinion that Klein's death was more consistent with a heart dysrhythmia than cyanide poisoning.
On cross examination, the prosecutor pointed out that Carstairs read some relevant reports only after his initial report was submitted, and that he is being paid $500 an hour for his testimony.
The defense pointed out that is standard payment for expert testimony like that, and Carstairs said, "I am a Navy man and no amount of money would affect my integrity."
Then, referring to the prosecutor he said, "Your experts don't come here for free either."
On Monday, The director of a lab that tested Klein's blood and a California expert on the care of poison victims both testified that they can't say with certainty that Klein was poisoned.
Allegheny County Assistant District Attorney Lisa Pellegrini contends Ferrante, 66, killed Klein, 41, by lacing her creatine energy drink with cyanide in April 2013. Klein collapsed almost immediately and died three days later.
Pellegrini rested her case after testimony by Dr. Christopher Holstege of the University of Virginia, author of the book, "Criminal Poisoning: Clinical and Forensic Perspectives."
Holstege testified that Klein's symptoms ruled out anything but cyanide poisoning. He based his opinion on documents ranging from police reports, records of medical treatments that Klein received after the 911 call until she died three days later, and, finally, on a lab test that found lethal levels of cyanide in blood drawn from her by physicians trying to save her life. Those results weren't until several days after she died.
The test that found the lethal level was conducted by Quest Diagnostics, of Chantilly, Virginia.
The first defense expert, Dr. Robert Middleberg, is the lab director and vice president of quality assurance at another private lab, NMS Labs of Willow Grove, Pennsylvania.
NMS is being paid $5,000 to testify for the defense. But Middleberg - and defense attorney William Difenderfer -noted NMS' involvement began when the county medical examiner's office also sent Klein's blood and plasma samples to also determine the level of cyanide in her blood after a county crime lab test also confirmed cyanide in her blood.
But the NMS test couldn't be completed because a piece of equipment needed to examine the precise level of the poison in Klein's blood wasn't working and because another kind of test on a known amount of cyanide - known as a "control" - came back negative, indicating that the test being used wasn't reliable. Eventually, NMS did find a cyanide metabolite - a substance created when the poison is broken down in the bloodstream - but only at a level that could normally occur in a person's blood, Middleberg said.
As such, Middleberg said the results are "equivocal" - meaning they neither prove nor disprove that Klein was poisoned.
That was essentially the testimony of the second defense witness, Carstairs. Testifying as an expert in cases involving acutely poisoned patients, he said, "It cannot really be definitively stated that Dr. Klein died of cyanide poisoning."
Carstairs testified the difference in lab results between Quest and NMS, as well as the fact that some of Klein's symptoms could have been caused by other problems - including cardiac arrhythmia - makes her cause of death unclear.
Holstege and Pellegrini contend there's no other reasonable explanation for Klein to fall suddenly ill in her kitchen after drinking the creating that Ferrante told a colleague he had prepared for his wife. Ferrante did that two days after ordering cyanide be overnighted to his lab, using a university charge card. Ferrante's attorneys contend he needed the poison to simulate neurological cell death in his research on Lou Gehrig's disease.
But Holstege contends the medical evidence suggests Ferrante used it to kill Klein.
"It's an assumption the DA wants you to make, right?" Difenderfer said.
"No," Holstege said, "it's an assumption I came to from reviewing the case as a physician who's been practicing for 20 years."
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