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Members of The Orthopedic Group: Scott L. Baron, M.D.; Thomas F. Brockmeyer, M.D., Ph.D.; William T. DeCarbo, D.P.M.; Gerson Florez, M.D.; Mark Hofbauer, D.P.M.; Alexander Kandabarow, M.D.; Richard Mitchell, M.D.; Justin J. Petrolla, M.D.;

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Autopsy confirms UPMC transplant patient had same type of mold infection as others I Tr... Page 1 of 4

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Autopsy confirms UPMC transplant patient had same type of mold infection as others

UPMC Presbyterian in Oakland PHOTO BY GUY WATHEN I TRIB TOTAL MEDIA

I BY tq'N r.CHMIT1 (MAILTO:BSCHMITT@TRIBWEB.COM?SUBJECT=RE: AUTOPSY CONFIRMS UPMC

TRANSPLANT PATIENT HAD SAME TYPE OF MOLD INFECTION AS OTHERS STORY ON TRIBLIVE.COM )

W (htlpsl/twitter.com/BenSchmitt70) I Wednesday, Aug. 17, 2016, 4:30 p.m.

Updated 3 hours ago

An autopsy report for a transplant patient who

contracted a fungal infection during a recent stay in a

UPMC hospital indicates he suffered from the same

type of mold that led to other recent deaths in the

health care giant's facilities.

UPMC has said pneumonia was the overriding cause in theiuly 9 death of Daniel Krieg, 56, of St. Marys in Elk County. He died at UPMC Presbyterian in Oakland.

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Autopsy confirms UPMC transplant patient had same type of mold infection as others I Tr... Page 2 of 4

The autopsy obtained by the Tribune-Review listed the cause of death as "multiorgan failure

due to sepsis due to pneumonia." UPMC Dr. Penny Sappington also wrote in the report that

3 Krieg suffered from bacterial and fungal pneumonia.

UPMC officials declined to comment Wednesday.

3 Krieg, a former truck company schedule coordinator, underwent a kidney transplant in July

2015 and was readmitted to Presby in March after getting sick with pneumonia, said his

Google attorney, Brendan Lupetin of the Pittsburgh firm Meyers Evans Lupetin & Unatin. Krieg was

recovering in the hospital when he contracted a fungal infection that led to the removal of a Reddit

Slogger The autopsy stated that the removed lobe of his lung contained rhizopus, a form of mold.

Krieg became the fifth known UPMC patient with a fungal infection to die since 2014 amid an

ongoing federal investigation into mold cases at UPMC.

"The Krieg family feels vindicated that UPMC's own pathologists have confirmed what the

family had said all along — a necrotizing fungal infection that Dan Krieg contracted while

admitted to UPMC was a major contributing cause of his death," Lupetin said Wednesday.

"UPMC's prior statement to the media that Dan's 'death was not directly related to the fungal

infection' was disheartening and served as a final insult to Dan's family."

One previous mold incident at UPMC led to a $1.35 million lawsuit settlement in connection

with the 2014 death of Tracy Fischer, 47, of Erie, a heart transplant patient who contracted a

fungal infection at UPMC Presbyterian.

Fischer was treated in the same room.of Presbyterian's cardiothoracic intensive care unit in

which two heart transplant patients with fungal infections received treatment before dying.

Che DuVall, 70, of Perryopolis died in February, and an unnamed patient died in June 2015.

Another unnamed patient died in September at UPMC Montefiore.

Lupetin's firm filed a lawsuit on behalf of the family of DuVall, a lung transplant patient at

UPMC Presbyterian who contracted a fungal infection. That lawsuit is pending.

"UPMC's autopsy report could not be more clear listing the primary cause of Dan's

multiorgan failure as the same fungal infection that ravaged Che DuVall and possibly others,"

Lupetin said, adding he is considering a lawsuit in connection with Krieg's death.

Ben Schmitt is a Tribune-Review staff writer. Reach him at 412-320-7991 or

bschmitt@tribweb.com (mailto:bschmitt@tribweb.com).

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lobe of his left lung. He did not leave the hospital before he died.

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Study refutes acetaminophen danger for kids with asthma I TribLIVE

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Study refutes acetaminophen danger for kids with asthma rij BY (MAILTO:BSCHMITT@TRIBWEB.COM?SUBJECT=RE: STUDY REFUTES ACETAMINOPHEN

DANGER FOR KIDS WITH ASTHMA STORY ON TRIBLIVE.COM) fI (https //twitter corn/BenSchrnitt70) I

Thursday, Aug. 18, 2016, 5:21 a.m.

Updated 4 hours ago

The popular pain and fever reliever acetaminophen,

previously believed to exacerbate asthma flare-ups among young children, might be safe after all.

A study published Thursday in The New England

Journal of Medicine shows acetaminophen or Tylenol

— when given in usual, as-needed doses — does not

worsen asthma or wheezing in children compared with

ibuprofen.

Researchers studied 300 children ages 1 to 5 who have

mild, persistent asthma, which is defined as

experiencing symptoms more than two days a week.

The participants used daily inhaled treatments to

combat the condition.

'This is significant," said Dr. Deborah Gentile, Allegheny

Health Network's director of allergy and asthma clinical

research. "Tylenol is a very commonly used form of

medication for children in this age group. This should give families a sense of relief and

assurance that this type of medication will not worsen their child's disease."

Gentile co-authored results from the Acetaminophen Versus Ibuprofen in Children with

Asthma (AVICA) 18-site trial, in which the children received acetaminophen or ibuprofen to

treat pain or fever. The trial lasted 48 weeks.

In an accompanying journal editorial, Dr. Augusto Litonjua, a pulmonary and critical care

specialist at Brigham and Women's Hospital in Boston and professor at Harvard Medical

School, said parents and caregivers of young children should be "reassured by this result

that the use of acetaminophen in usual, as-needed doses will not worsen asthma symptoms

in their children and that acetaminophen and ibuprofen can be used similarly in situations

for which they are indicated."

The research noted that previous studies did not rule out the possibility that the asthma

exacerbations were caused by children's respiratory infections, leading to assumptions that acetaminophen was the cause.

http://triblive.com/news/healthnow/10985179-74/asthma-acetaminophen-ibuprofen 8/18/2016

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Study refutes acetaminophen danger for kids with asthma I TribLIVE Page 2 of 3

"A controlled study like this is helpful because it refutes a myth among treating pediatricians

that acetaminophen was related to higher results of data," said Dr. Albert Rizzo, a senior

medical adviser for the American Lung Association. "There was previously no hard data, and

this is groundwork to clear up the misperception." 0

The Allergy and Asthma Foundation ranks Pittsburgh as the 27th-most challenging U.S. city

0 in which to live with asthma, based on factors that include high levels of exposure to known

asthma triggers such as poor outdoor air quality, indoor allergens and tobacco smoke Google

exposure.

Reddit

Some Pittsburgh-area school districts report asthma rates that rank among the state's

Blogger highest.

According to the recently released American Lung Association annual "State of the Air"

report, the Pittsburgh metro area ranked as the 14th-most-polluted area in the country for

daily fine-particle emissions and eighth-worst for annual particle pollution that can cause

asthma.

Gentile said the study will help pediatricians advise parents on how to treat fevers for young

children with mild forms of asthma.

"These types of questions confront pediatricians every day," she said. "Hopefully, this puts

some parents at ease."

Ben Schmitt is a Tribune-Review staff writer.

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Monongahela Talley Hospital HEALTH CARE

National/General Health Care 8-18-16

Body donations at U.S. medical schools are on the rise ASSOCIATED PRESS

Many U.S. medical schools are seeing a surge in the num-ber of people leaving their bodies to science, a trend at-tributed to rising funeral costs and growing acceptance of a practice long seen by some as ghoulish.

The increase has been a boon to medical students and researchers, who dissect ca-davers in anatomy class or use them to practice surgical techniques or test new devices and procedures.

"Not too long ago, it was ta-boo. Now we have thousands of registered donors," said Mark Zavoyna, operations manager for Georgetown University's body donation program.

The University of Min-nesota said it received more than 550 cadavers last year, up from 170 in 2002. The Uni-versity at Buffalo got almost 600 last year, a doubling over the past decade. Others that reported increases include Duke University, the Univer-sity of Arizona and state agen-cies in Maryland and Virginia. ScienceCare, a national tissue bank, now receives 5,000 ca-davers a year, twice as many as in 2010.

One reason is religious ob-jections to dissection and cre-mation hold less sway today than in the past, said Ronn Wade, director of Maryland's State Anatomy Board.

Also, bodies donated to medical schools are cremated once they are no longer need-ed, and the remains are often returned to their families at no expense. As of 2014, a tra-ditional burial cost around $7,200, an increase of 29 per-cent from a decade earlier, according to the National Fu-neral Directors Association.

"Funerals are expensive. That certainly has something to do with it," Zavoyna said.

j_,_.se it almost has this

snowball effect, where you get five people to donate, and then their families tell another 25 people."

Milton Larson, a longtime science teacher who was stricken with Parkinson's dis-ease and died in 2014 at age 82, left his body to the Univer-sity of Minnesota in what his wife, Jean, of Falcon Heights, Minn., called "his last act of teaching and generosity."

But she initially struggled with his decision and said she tries not to think about the de-tails of dissection.

"To put it quite bluntly, you have to realize that they are going to cut the body of your loved one apart. That's hard," she said. Still, she plans to do-nate her body, too: "This is the most generous donation we can make."

Cadavers are being used for an expanding range of research and training pur-poses, including the testing of prosthetics and new robotic surgery techniques. Medical researchers are also increas-ingly relying on human bodies instead of animals.

"The uses that we can bring to these very precious gifts have really escalated," said John Tomaszewski, chief of Buffalo's pathology and ana-tomical sciences department.

Some parts of the country still struggle with cadaver shortages. A state agency in Il-linois has been receiving only 500 donations a year for eight medical schools, down from 750 in the 1980s. Although many programs shun adver-tising, the Anatomical Gift Association of Illinois is buy-ing more newspaper ads to try to boost numbers.

When donations fall short, Duke and other schools turn to private suppliers that ob-tain cadavers through dona-tion, often in other countries. In some states, schools can ob-tain bodies that go unclaim by their families.