Thursday, September 21, 2017

Outbreak Victim's Daughter Details His Final Hours


Boston, Mass. - Holding back tears, the daughter of one of the first victims of the deadly fungal meningitis outbreak described his final fight for survival in a Nashville hospital.
Karen Talbott, the daughter of Kentucky Judge Eddie Lovelace, said doctors could not explain how or why the healthy 78-year-old suffered an unusual stroke centered in the middle of his brain.
His death came in early September of 2012, weeks before the public learned that a deadly fungal meningitis outbreak was taking lives in some 20 states.
"We thought it was just a stroke," Talbott told the jury in U.S. District Court. That panel is hearing testimony in the racketeering and second degree murder trial of Glenn Chin, a supervising pharmacist at the New England Compounding Center which produced thousands of vials of a spinal steroid laced with fungus.
Lovelace, who regularly walked five or six miles a day, was in a car accident earlier in the year and suffered a back injury. The fatal injections were supposed to relieve his pain, Talbott said.
She testified that it was only after state and federal officials publicly announced the growing outbreak, that she and her family figured out what took his life.
Lovelace, she said, had received three injections of methylprednisolone acetate at Nashville's Saint Thomas Outpatient Neurosurgical Center in the months before his death.
Talbott said that when they heard early October news reports about the outbreak they immediately suspected what had caused the judge's death.
His body was exhumed and the diagnosis was confirmed.
She said a grand daughter was the first to notice that Lovelace was having difficulty understanding and one day he fell walking out of the courthouse.
"He was complaining he had a headache," she said.
After he fell twice in one morning and complained his fingers were numb, she said they decided to take him to a local hospital, which quickly transferred him to Nashville.
She said doctors were baffled and couldn't explain why he would have an unusual stroke when he didn't have stroke risk factors
Though he rallied briefly, even asking when he could go back to work, his condition deteriorated. She said it broke her heart when she had to restrain the one arm he still could move because he kept pulling out a breathing tube.
Earlier in the Thursday court session, the doctor who unknowingly injected Lovelace with the contaminated steroid, told the court the epidural steroid injections acted as a powerful anti-inflammatory agent.
Using a model provided by federal prosecutors, Dr. John Culclasure described and demonstrated the two methods of injecting the steroid into the affected area of the spine.
As the deaths among his patients grew, Culclasure said he became worried that his method of injecting the steroid might be the cause.
Other possible sources of contamination were a dye used to target the injection, a numbing drug and the steroid itself, he testified.
Under questioning, Culclasure estimated he had performed some 50,000 spinal injections in his career. He said that the Saint Thomas clinic began using steroids from NECC after experiencing supply problems. He said the procedure takes about 5 to 7 minutes and the clinic does 150 to 160 such injections a week.
He said 116 of the clinic's patients were sickened and 13 died.
He said the NECC version of the steroid, unlike the brand used previously was made without preservatives. He said the clinic, which was shut down for weeks after the outbreak, now uses steroids containing preservatives.
Calling the events "a slow moving mass casualty," he said he went to visit some of his patients who had been stricken with fungal meningitis and was surprised by their reaction.
"I thought they would be very worried and upset. They were not. They were worried about us," Culclasure said.
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