Widow Details Tennessee Victim's Final Battle

By Walter F. Roche Jr.

BOSTON, Mass. -The widow of one of the first victims of the 2012 fungal meningitis outbreak told a jury today about her husband's fight to stay alive and his last minute recognition of what was killing him.
Colette Rybinski of Smyrna, Tenn. testified that her husband' Thomas' doctors were struggling for days to figure out how he had contracted meningitis. They needed the answer in order to know how to treat him.
Recalling his deteriorating condition, Rybinski said that at times he was unable to communicate but then he would become lucid.
"He looked at me and said, 'It was the shot,'"she said describing one of those lucid moments.
The shot, a spinal injection with methylprednisolone acetate, was administered on July 30, 2012 at a Nashville, Tenn. clinic. Laden with fungus the vial had been shipped, along with more than 17,000 others, from the New England Compounding Center in Framingham, Mass.
Rybinski's testimony came on the eighth day in the trial of Barry Cadden, the former president of that now defunct drug compounding firm. Cadden has been charged by a federal grand jury with racketeering and 25 counts of second degree murder. One of those murder charges is the death of Thomas Rybinski.
The outbreak sickened 778 patients killing 76 of them.
Rybinski said her husband had a prior spinal injection for persistent lower back pain at the same clinic, the Saint Thomas Outpatient Neurosurgical Center, but this time he was not getting the relief he expected.
Instead, she said he woke up with a screaming headache. He was eventually admitted to the Vanderbilt University Medical Center, also in Nashville, where doctors tried to figure out what was happening.
At first they thought it was a contagious form of meningitis, she said, so they put him into isolation. But treatment with antibiotics proved ineffective.
"It was very up and down," she said.
Rybinski recalled one day during the illness when a television program about Alaska came on and she asked him if he wanted to watch it. They had honeymooned in Alaska
"Do you want to watch it. He said no," she testified.
"Do you remember our honeymoon, I asked. He said no."
She said she got the same answer when she asked him if he remembered getting married, but he said he did know who she was.
Meanwhile doctors were doing test after test trying to determine how the meningitis got into his body.
Rybinski said she eventually learned he had suffered multiple strokes, and even a last minute surgical procedure was of no help. Though the fungus, aspergillus, was finally identified, it was too late.
He was transferred to a hospice where he died on Sept. 29. He was 55.
In other testimony Kenneth Boneau, a salesman for an affiliate of NECC, Medical Sales Management, described the company sales efforts including brochures which touted the testing and sterility of the company's drug drug products.
He said the company claim's that it complied with the strictest standards was a big selling point. He was also questioned repeatedly about the company efforts to get the names of real patients for each dose of drugs sold to healthcare providers.
Earlier in the day Dr. John Culclasure, the medical director at the Nashville clinic, acknowledged that one patient list submitted to NECC included the name Mickey Mouse. But he said the use of the names Mickey and Minnie Mouse were "spaceholders" so that he and other doctors would not get booked to do two procedures at once.
Culclasure, who said he has performed some 50,000 spinal injections in his career, said the use of the cartoon characters' names was not intended to fool anyone.
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