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Navy doctor casts doubt on Klein's cause of death

| Monday, Nov. 3, 2014, 11:50 a.m.

The homicide trial of University of Pittsburgh researcher Robert Ferrante on Monday became a battle of medical experts who disagreed about whether blood tests showed his wife died of cyanide poisoning.

At least some of Dr. Autumn Marie Klein's symptoms were not consistent with cyanide poisoning, said Dr. Shaun Carstairs, a medical toxicologist at the Naval Medical Center in San Diego.

Klein's condition shared symptoms of carbon dioxide poisoning and an irregular heartbeat, he said.

“In my opinion, it cannot be definitively stated that Dr. Klein's death was due to exposure to a toxic amount of cyanide,” Carstairs said.

Ferrante, 66, is accused of poisoning Klein, 41, a noted UPMC neurologist, who collapsed in the couple's Oakland home on April 17, 2013, and died three days later.

The prosecution's last witness, Dr. Christopher Holstege, said Klein's symptoms were consistent with cyanide poisoning, even if a test did not show cyanide in her blood.

The fact that one test revealed lethal levels in Klein's blood only reinforced his opinion that she died from the poison, said Holstege, professor of emergency medicine at the University of Virginia and director of the Blue Ridge Poison Center in Charlottesville, Va.

“I am left with a case that fits the pattern of cyanide poisoning,” Holstege said. “I have at this point in time no other diagnosis for this patient.”

The defense opened its case by calling Robert A. Middleberg, lab director and forensic toxicologist for NMS Labs in suburban Philadelphia, who told the jury that it's unclear whether Klein died from cyanide poisoning.

Middleberg pointed to lab results conducted by his company nearly three weeks after Klein's death that found only trace amounts of cyanide in Klein's blood. Middleberg said it's common to find low levels of cyanide in a person's blood absorbed from the environment.

“It's a value we commonly see ... not consistent with significant exposure,” he said. “It doesn't appear to be anything abnormal.”

NMS ran two cyanide tests on Klein's blood. The first in the days after Klein's death yielded no results because of a testing problem. A second on another sample weeks later found non-lethal levels of cyanide.

Prosecutors have argued that because the NMS test came so long after Klein's death, the cyanide could have dissipated, a theory Middleberg rejected.

“If there was a substantial amount of cyanide in our sample, it's unlikely it would disappear,” Middleberg said.

On cross-examination, Assistant District Attorney Lisa Pellegrini pounced on Middleberg for his laboratory's failures, specifically for not alerting the Allegheny County Medical Examiner's Office of its inability to provide quantitative results because its machine was broken.

Two jurors who will decide Ferrante's fate giggled.

“Does anybody tell the medical examiner's office, ‘Sorry, the machine's broken?' ”

“I don't know,” Middleberg responded.

The trial will resume Tuesday morning before Common Pleas President Judge Jeffrey A. Manning.

Bobby Kerlik and Adam Brandolph are staff writers for Trib Total Media.

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