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Tuesday, November 8, 2022

The Dr. Robert Ferrante Poison Murder Case

     In 2013, Dr. Robert Ferrante and his wife, Dr. Autumn Klein, lived with their 6-year-old daughter in the Oakland section of Pittsburgh, Pennsylvania. Dr. Ferrante held the positions of co-director of the Center of ALS Research and visiting professor of neurology at the University of Pittsburgh Medical School. Dr. Klein, with offices in Magee-Woman's Hospital in the Kaufman Medical Building, was chief of women's neurology at the University of Pittsburgh Medical Center (UPMC) and an assistant professor of neurology, obstetrics, gynecology and reproductive services at the University of Pittsburgh.

     Dr. Ferrante, twenty-three years older than his wife, met her in 2000 when they lived in Boston where she was a medical student and he worked at a hospital for veterans. They were married a year later. In 2010 Dr. Ferrante left his job at Harvard Medical School and Massachusetts General Hospital to join the University of Pittsburgh's neurological surgery team. Dr. Klein moved to Pittsburgh with him.

     Dr. Klein, who was forty-one, was having difficulty getting pregnant with her second child. Her 64-year-old husband had been encouraging her to take a nutritional supplement to help her conceive. On April 17, 2013, Dr. Ferrante sent Autumn a text message in which he inquired if she had taken the supplement. She wrote back: "Will it stimulate egg production, too?" Nine hours after Dr. Klein sent that message she collapsed in the kitchen of the couple's Schenley Farms home.

     Emergency personnel rushed Dr. Klein to the University of Pittsburgh Medial Center (UPMC) in Oakland. On the kitchen floor next to her body paramedics noticed a bag of white powder later identified as Creatine, a nutritional supplement. Shortly after the patient was admitted into the hospital, a UPMC doctor ordered tests of her blood. When a preliminary serological analysis revealed a high level of acid, the doctor ordered toxicological tests for cyanide poisoning.

     Dr. Klein died on April 20, 2013. Three days later, at Dr. Ferrante's insistence, her body was cremated. As a result there was no autopsy.

     Dr. Karl Williams, the Allegheny County Medical Examiner, based on the toxicology reports, determined that Dr. Klein had died of cyanide poisoning. The forensic pathologist ruled her death a homicide.

     Cyanide kills by starving the cells of oxygen. A lethal dose for a human can be as small as 200 milligrams--1/25th the size of a nickel. The poison acts fast and metabolizes quickly. The toxic substance can be undetectable from one minute to three hours after ingestion. Had samples of Dr. Klein's blood not been taken upon her admission to UPMC, there would have been no physical evidence of poisoning beyond the contents of the bag of white powder found lying on the victim's kitchen floor.

     Two weeks after Dr. Klein's death, detectives with the Pittsburgh Police Department launched a homicide investigation with Dr. Ferrante as the prime suspect. Officials at UPMC placed the neurologist on leave and denied him access to his laboratory. A police search of the lab resulted in the discovery that 8.3 grams from a bottle of cyanide was missing. Detectives learned that Dr. Ferrante had purchased a half-pound of the poison on April 15, 2013, two days before his wife collapsed in their home. Dr. Ferrante had used a UPMC credit card to buy the cyanide and had asked the vendor to ship it to his lab overnight. Detectives believed the suspect, in his laboratory, mixed the cyanide--a substance not related to his work--into the dietary supplement.

     According to friends of the victim, Dr. Ferrante had been a controlling husband who was jealous of his wife's fast-rising career. Moreover, he suspected that she was having an affair with a man from Boston. Dr. Klein had told friends she was planning to leave the doctor. Another possible motive involved the fact Dr. Ferrante did not want his wife to have another child.

     On April 13, four days before she fell ill, Dr. Klein sent one of her friends a text message regarding a trip she planned to take to Boston by herself. In that message she wrote: "Change of plans. Husband is coming to Boston. Told me 'to keep me out of trouble.'"

     "Oh, dear," replied the friend. "Did you know you were in trouble?"

     "I feel like I have been in trouble for a long time now," Dr. Klein answered.

     On July 24, 2013, an Allegheny County prosecutor charged Dr. Robert Ferrante with first-degree murder. The next day, as Dr. Ferrante drove back to Pittsburgh from St. Augustine, Florida, a West Virginia state patrol officer arrested him on I-77 near Beckley. According to the doctor's attorney, William Difenderfer, his client was on his way to surrender to the Pittsburgh police.

     Dr. Ferrante's arrest for the murder of his wife caused him serious financial problems. Except for $280,000 the suspect was allowed to use for legal expenses and a possible fine, a judge seized his assets. In August 2013, his 6-year-old daughter's maternal grandmother who was caring for the girl in Maryland, petitioned a family court judge for child support.

     The Ferrante murder trial got underway on October 20, 2014 in Pittsburgh, Pennsylvania. Following jury selection, the attorneys for each side presented their opening statements. Assistant Allegheny County District Attorney Lisa Pelligrini asserted that the defendant had murdered his wife because she wanted to have a second child. The prosecutor also said that Dr. Ferrante thought his wife was having an affair.

     Defense attorney William Difenderfer pointed out the circumstantial nature of the prosecution's case, inconsistent crime toxicology reports regarding cyanide in Dr. Klein's blood, and an absence of an autopsy.

     Dr. Christopher Holstege, a University of Virginia professor and the author of the text, Criminal Poisoning, Clinical and Forensic Perspectives, took the stand as the prosecutor's key expert witness. Dr. Holstege testified that the victim's symptoms ruled out everything but cyanide poisoning.

     Defense attorney William Difenderfer put three forensic experts on the stand. Dr. Robert Middleberg, vice president of a private crime lab in Willow Grove, Pennsylvania, said tests at his facility of Dr. Klein's blood were inconclusive.

     Dr. Middleberg's testimony was backed up by Dr. Shaun Carstairs of the Naval Medical Center in San Diego and former Allegheny County Coroner Dr. Cyril Wecht. Dr. Wecht, a forensic pathologist, had testified in dozens of celebrated murder cases around the world.

     As his last witness, Diffenderfer, in a surprise and risky move, put the defendant on the stand to testify on his own behalf. As could have been anticipated, the prosecutor's blistering cross examination revealed numerous inconsistencies in Dr. Ferrante's statements to the authorities.

     On Friday November 7, 2014, the jury found Dr. Ferrante guilty of first-degree murder, an offense in Pennsylvania that came with a mandatory sentence of life without parole.

     Through his appellate attorney Chris Eyster, Robert Ferrante appealed his conviction on the ground that the prosecution had not had sufficient probable cause for the search warrant that produced evidence that incriminated his client. The lawyer also raised questions regarding the laboratory that concluded that the victim had been killed by poison.

     In September 2016, Common Pleas Judge Jeffrey Manning upheld the Ferrante conviction.

     In October 2017, appellate attorney Chris Eyster petitioned a three-judge Superior Court panel to grant Robert Ferrante a new trial. According to Eyster, Dr. Autumn Klein's post-mortem kidney donation could not have taken place had the organ been irreparably damaged by poison. The lawyer also attacked the reliability of the toxicological tests performed by Quest Diagnostics. In his motion, Eyster argued that the Ferrante prosecution failed to reveal before the murder trial that a Quest subsidiary, the Nichols Institute, paid a $40 million fine for a 2009 federal misbranding conviction, and $241 million more to settle the related litigation. Quest/Nichols, according to federal prosecutors in that case, sold misbranded tests to various laboratories that were unreliable.

     When the Superior Court judges denied Ferrante's appeal, his attorneys filed a series of new appeals based upon inadequate counsel. In August 2019, Common Pleas Judge Jeffrey manning dismissed most of these appeals but ruled that Ferrante's argument that his trial attorneys had erred when they withdrew his request for a jury drawn from outside Allegheny County had enough merit to justify a hearing.
     In May 2021, the appellate judge denied Ferrente's petition for a new trial. The 73-year-old is serving his life sentence at the State Correctional Institution at Houtzdale, Pennsylvania.

50 comments:

  1. Excelente artículo. Soy pediatra y me apasionó esta historia desde sus inicios. Si no hubiera sido por a sagacidad del medico de guardia, probablemente, este asesinato hubiera quedado imputa.

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  2. The cyanide was a false positive. Ketoacidosis from kidney failure generate amines that cross-react with the reagents used to detect cyanide. Mayo just issued an announcement called that cyanide method obsolete.

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    1. No the test was validated and there wasn't enough timw for that to happen anyway.

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    2. Garbage - The test was never "validated." The diagnostic lab does not even run the positive control properly. They dissolve it in water, when it should be dissolved in blood. The test is flawed and according to Mayo "obsolete."

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  3. I have now identified three cyanide false positives. When people must realize is that these tests do not measure cyanide. They measure color change from a chemical reaction. If the chemical reaction is specific, then the color reflects the analyte. However, all these colorimetric cyanide tests cross-react with other things like amines, nitrites and even glutathione. If you examine the details, then this case is clearly one of a false positive and a wrongful conviction.

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    1. Don't like facts eh?

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    2. She had NO cyanosis on her face or extremities, no stomach bleeding, no lung frothing, no swift death. No cyanide symptoms at all! If she took cyanide she must have taken a very, very small quantity. Meanwhile, Quest measured 2.2mg/L a full 16hrs after the supposed ingestion. Recall that cyanide has a half-life measured in minutes, so this sample was about 100 half-lives later. The measurement is therefore impossible. A clear false positive. The medical examiner should have known better. This is almost willful negligence on the part of Pittsburgh prosecutors. They should be ashamed of themselves.

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    3. Wrong it doesn't matter what half life it had. All drugs have half lives. That means there could neverbe a valid test for drugs.

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    4. The half-life matters VERY much, since it is used to calculate the dose consumed. The sample measuring 2.2 mg/L was taken a full 15 hrs after she supposedly ingested it, which is 50-100 half-lives later. This alone proves the reading to the false. No cyanide would be detected after just two hours. Instead, the main metabolite thiocyanate should be detected within minutes. However, all the thiocyanate tests came back negative. Thus, the pharmacology proves that the reading was a false positive.

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    5. haha im studying this case and watching yall argue 4 years back is kinda funny

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  4. Cyanide murder mystery in Midlothian,Texas...https://www.facebook.com/RockEmMemorialPage/
    http://www.chriserick.com/evidence

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  5. Somehow I can't imagine Cyril Wecht missing that.

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    1. Cyril Wecht does not know anything about pharmacology or metabolism.

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    2. Cyril Wecht testified that the cyanide data made no sense, but the lawyer did not encourage him to explain why or to describe the anomaly. The jury did not realize that all experts must agree and so just picked the expert they liked the best. And that is how science was subverted by archaic court procedures, and how an innocent man was convicted.

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  6. Posts (and the info they contain) made by "Anonymous" authors have as much credibility as a doctor who would murder his wife.

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    1. You should do what scientists do: Ignore the person and follow the science. Please try to learn what "half-life" and "metabolite" mean. Then you can rely on logic instead of opinion.

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    2. After you learn those basic concepts and the math, then read this paper: https://academic.oup.com/jat/article/38/4/218/834049/Cyanide-Toxicokinetics-The-Behavior-of-Cyanide

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  7. The one thing that convinced me of Dr. Ferrante's guilt was in his own testimony ....when he stated that the minute that Autumn collapsed to the floor and started to gasp and groan, he went over to hug or comfort her ....and she vehemently pushed him away.... Dr. Ferrante made a comment on the stand about "oh my stoic wife waved me away"

    I was shocked by that statement and I believe that it admitted more than Dr. Ferrante ever imagined.

    A person who is in dire distress would not wave away the only other person in the room ... That person WANTS the help.

    I believe that Autumn knew what was happening to her, and I think she was trying to make sure that the man who had poisoned her didn't try to finish off the job with a final asphyxiating hug...

    Dr. Ferrante just assumed he was smarter than anyone else in any room into which he walks....And that type of smugness always fails. He just thought he was too smart to get caught.

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    1. The scenario you describe is anecdotal. The thing that convinced me of his innocence is that his wife did not die of cyanide poisoning. Not a single symptom fits.

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  8. The Supreme Court appeal is an attempt at "after-discovered evidence." Ferrante points out that cyanide causes system-wide hypoxia, ruining tissue integrity and making organ donation impossible, except when antidotes were administered and stomach contents cleared by pumping. None of those situations applied to Autumn Klein, yet her organs were donated. Furthermore, system-wide hypoxia makes resuscitation impossible, yet Autumn Klein was resuscitated successfully. I suspect Ferrante has a lot more evidence of the false positive ready to present, but has to wait for a hearing to be allowed to raise it.

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  9. btw - there is an error in your report, above. You state "Had samples of Dr. Klein's blood not been taken upon her admission to UPMC, there would have been no physical evidence of poisoning beyond the contents of the bag of white powder found lying on the victim's kitchen floor." - This is misleading. The actual blood sample that tested positive for cyanide was NOT drawn a few minutes after she arrived at the ER. It was drawn 15hrs later, including 8hrs on hemodialysis. Your comment about cyanide disappearing quickly from the bloodstream is correct. Thus, the cyanide reading cannot have been correct.

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  10. Im pretty sure his 11 year old daughter doesn't need to go through anymore heartache. If he does get a new trial and is somehow cleared.(doughtful, because he did it...well maybe not him just his ego) I hope he gives up his parental rights to the child. She deserves better. She's been through enough.

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    1. She deserves to have her dad back in her life, and she deserves to have the law declare him exonerated. And he deserves a recovery of all the wealth stripped from him. His daughter's guardians will get a rude surprise if they spend all Ferrante's daughter's trust money before he is released.

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  11. My Christmas wish is for this poor man to be exonerated and reunited with his children.

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  12. I found another cyanide false positive case. That makes seven. This one is from NYC, 2017: http://www.nydailynews.com/new-york/brooklyn/son-reels-learns-mom-died-cyanide-poisoning-article-1.3075881

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  13. Here are chemistry details of the false positive.
    Compare the red-colored products of this cyanide reaction used by Quest Diagnostics: https://openi.nlm.nih.gov/detailedresult.php?img=PMC3475106_1476-511X-11-74-4&req=4
    .....to this one, for a TBARS assay (see 'Product Details' tab for the chemistry) https://www.cellbiolabs.com/tbars-assay

    Note how the product species are almost exactly the same! This means malondialdehyde will cause a false positive for cyanide in this assay.

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    1. ....where malondialdehyde is a product of lipid peroxidation, a response to metabolic disorders under low oxygen, as might occur when an anorexic has a heart attack and is repurfused.

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  14. Science won't matter when the case is reviewed by humanity-degreed lawyers! Or, by laymen "peers" who sit on juries. Neither understand science to the degree necessary to judge this case's science. What matters is the hubris of the defendant now convict who chose to waive his right to go on the stand. He bought the poison merely days before her murder, what research experiments did he perform with that missing 8.3 grams of cyanide? As an RN, former chemist and lab researcher, who's siblings are in law, I don't believe him. My senior thesis was analytical chemistry on indicators used in test kits that change colors caused by metal atoms reacting ( to put it simply). I can understand false positives and so on. But a law of nature is that matter doesn't just disappear, and any layman can understand that. Apparently, he couldn't provide a reasonable explanation of where that cyanide went, except in Autumn Klein's system. IMO

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    1. So you agree the test that measured cyanide was flawed, and you agree that the patient never exhibited signs of cyanide poisoning, yet you believe Ferrante guilty of cyanide poisoning because some cyanide is missing. I recall the US armed forces have lost a few nuclear bombs, so your logic would make them guilty of nuclear war, even though no evidence of rogue nuclear blasts exist. Right? Same logic! You want an explanation for missing cyanide? Here are two perfectly reasonable explanations: Since experiments were planned, one of the lab members took some to make a stock solution. Or, considering cyanide is highly hygroscopic, and the batch was 97% pure, that makes 250g*3% = ~8g of water. When the prosecutors weighed the bottle, they heated it (of course, since this is standard practice), and that drove off the water, leaving the bottle 8g short. Face it, you helped railroad an innocent man.

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  15. What person who walks in the door at midnight after working a 15 hr day would drink an energy drink, rather than a glass of wine or shot of hard liquor, or a warm glass of milk that would lull them to sleep? Especially if she had a headache. She had to be susceptible to his manipulation at that point in time and drank the mixture he presented to her, having put the idea in her head via text earlier in the day and emphasizing it when she came in, bec afterall, why would he still be awake (and at his age) after presumably caring for an energetic youngster? He took advantage of her having mentioned a mild headache in her text later as well when he told the dispatcher that he thought she was stroking out.
    Next, anyone who's worked in a chem/research lab knows you never taste chemicals used in the lab; it's unethical as well as dangerous. Yet, on the 15th, he's making a show of measuring out creatinine in the lab so others see him, and drinks it, "proving" nothing was wrong with it-he didn't suffer adverse effects. He repeats the show in the lab the next day. On the third day, he lures other researchers into it by having them open a brand new sealed container of creatinine and measure it out for him. "Proof" that the creatinine he provided for his wife was "safe", as he had a witness. Manipulation. (Furthermore, He proved that he was unethical by doing all this with the lab's creatinine).
    He messed up not having the body buried rather than cremated, though he thought at the time it was better to destroy evidence. If buried, he might've stood a chance to prove that her tissues weren't full of cyanide metabolites and such through exhumation and testing. Alas, he burned himself.

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    1. Autumn Klein never exhibited symptoms of cyanide poisoning, the pharmacology is completely inconsistent with cyanide and the test is flawed. Conclusion: no crime occurred.

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    2. She died of anorexia and the long-term metabolic effects of Accutane (retinoic acid). Look it up. The symptoms are a perfect fit to Autumn Klein's death.

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  16. I realized something else. Cyanide causes system-wide hypoxia, which makes resuscitation impossible. Yet Autumn Klein was successfully revived after collapse. This would be the first ever case of successful resuscitation from cyanide poisoning without antidote. Or, another piece of evidence that cyanide poisoning never occurred.

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    2. I attended the trial. Of interest was the testimony of a young physician who was the receiving resident in the trauma bay that night. He related that he thought he had entered an artery instead of an intended central vein because the blood was bright red. He had not erred. Ever see a CO suicide victim? Or a cyanide victim? Ferrante, as demonstrated by his internet searches, was concerned about dialysis and its ability to flush out cyanide. He redosed her later in the ICU with the final lethal amount of cyanide, much more than the original small dose.
      She had coded several times in the trauma bay and was placed on vasopressors, renal dialysis and ECMO, hardly a “successful” resuscitation.

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    3. If she had cyanide in her system, the blood would not be bright red. It would be cyan.

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  17. He does a google search on Cyanide Potassium, orders it ostensively for a research project. Shortly thereafter, his wife who is a physician, so completely cognizant of the the horrendous death suffered by cyanide poisoning and is a mother with a much loved young child, choses to commit suicide by using this very poison because she is distraught about not being able to get pregnant again. Then add ancillary evidence, like that the marriage was troubled and that she had told her cousin that she wanted to leave the marriage. Also the fact that Ferrante had his wife's body immediately cremated after her death, refusing and autopsy even though the circumstances of her death were puzzling and unexplainable...not exactly the type of behaviour expected from a grieving husband, especially one who is a facts driven scientist. Given the facts and circumstances here, it's completely unsurprising that Ferrante was found guilty of his wife's murder.

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    1. He followed his wife's specified wishes for her body: for organs to be harvested ASAP and the remains cremated. Not his choice, hers. He was respecting her wishes. btw- no cyanide suicide. No cyanide at all. The symptoms are completely wrong. The reading by Quest was a false positive.

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  19. In addition to Quest Diagnostics, the other party that deserves blame for this wrongful conviction is Karl Williams, Medical Examiner. He should have known the half-life and symptoms were completely wrong for cyanide. I accuse him of negligence and hope he loses his job when Ferrante is exonerated.

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    1. Les Edinboro of Quest perjured himself when we told the court the test was specific. He should know better. I can't believe it was incompetence. It was perjury.

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  20. At trial, one of the State's 'experts' said everything except cyanide poisoning had been ruled out. That is either an incredibly lazy person, or someone who never studied math at high school. It is impossible to rule out everything, especially when you do not even go looking. For example, note how Autumn Klein's death is an exact match to the case studies described here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3292410/

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  21. Autumn Klein is sometimes described as vibrant and healthy. She may have had a bright personality, but she was far from healthy. Autumn Klein had a mitochondrial dysfunction, a thyroid problem, she was infertile, suffered from adult acne and migraines. On the day she fell ill, she complained of migraines and auras. And she was under weight her entire life. All of these are side effects of anorexia nervosa.

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  22. There is a major error propagating on the internet and in the media. It concerns the timing of the blood sample sent for cyanide testing. According to the trial transcript, the sample sent to Quest was drawn at 14:55, a full 15.5 hrs after supposed consumption. Your report in this article is wrong. Please fix it.

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  23. Autumn Klein was diagnosed with mitochondrial disease while still alive.

    The symptoms Autumn experienced in the weeks before her death, and on the day of her collapse are all known presentations of mitochondrial disease. Stroke-like symptoms begin around age 40, as the mitochondrial count per cell goes down. First symptoms of adult-onset appear to be migraine and visual auras, followed by fainting.

    The organs most profoundly affected by mitochondrial dysfunction are the ones that need the most energy: Brain, heart, muscle. Lactic acidosis is a known symptom of mitochondrial dysfunction.

    Here is the symptom list on the official site of the mitochondrial disease foundation. https://www.umdf.org/what-is-mitochondrial-disease/possible-symptoms/

    See also these case reports:
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402098/
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6511931/
    https://www.ncbi.nlm.nih.gov/pubmed/27716753
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215404/
    https://ghr.nlm.nih.gov/condition/mitochondrial-encephalomyopathy-lactic-acidosis-and-stroke-like-episodes

    A Harvard professor called Varmsi Mootha, has shown that when high oxygen was administered to mice engineered to express mitochondrial disease phenotypes, it killed them. Instead, mice with mitochondrial dysfunction need low oxygen conditions to thrive. Oxygen does not get converted to ATP, so toxic levels of oxygen build up in the brain. Autumn Klein was treated with high oxygen conditions, per normal post-heart attack management. Maybe that is what actually killed her brain.

    Here are the references that Vamsi Mootha published, on hypoxia as a treatment for mitochondrial dysfunction:
    1 - https://science.sciencemag.org/content/352/6281/54.long
    2 - https://www.cell.com/cell-reports/pdf/S2211-1247(19)30468-1.pdf
    See also a video of him presenting- https://www.youtube.com/watch?v=Xw6hbf7CKvI

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    1. Did Mooth'a mice also have cyanide in their system? Enjoy prison for life idiot.

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  24. It seems Professor Robert Ferrante will get a hearing. Hopefully, the court will learn its mistakes this time.

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  25. I'm not sure what type of world believes a husband would want to kill his wife for wanting to have his child. Perhaps this is the most denigrating accusation a man could have made against him.

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  26. this is absolute madness....

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