When Autumn Klein died with what investigators have called "toxic levels" of cyanide in her body, she left behind few clear clues for her mother to trace.
Lois Klein, of Towson, Md., said she knew of no trouble in her daughter's life, although she wasn't necessarily sure she would have seen the signs if it did exist.
"She was the type of person -- 'It's my problem, I deal with it,'" Ms. Klein said of her only daughter, the chief of the division of women's neurology at UPMC.
The police investigation "is delving into both homicide and suicide at this point" while detectives work to make sense of the circumstances surrounding a rare poisoning, said Mike Manko, spokesman for the Allegheny County district attorney's office.
Homicide detectives obtained search warrants Thursday for the Oakland home where Dr. Klein lived with her husband and young daughter and for the University of Pittsburgh, where her spouse, Robert J. Ferrante, works as a professor of neurological surgery. Investigators also obtained a subpoena for the school seeking information pertaining to cyanide.
Also, a private attorney has asked forensic pathologist Cyril Wecht to make an inquiry into the matter. Dr. Wecht would not provide details about the client.
"I'm totally baffled," Ms. Klein said. "I really don't know what to make of it. I'm shocked. I'm surprised. I'm hurt. I'm sad. I just, I don't know what to make of it."
Ms. Klein and her husband, William, intended to travel to Pittsburgh on April 18 to take care of their 6-year-old granddaughter Cianna while her parents attended a medical conference.
Instead, Ms. Klein said she received a call from Mr. Ferrante close to midnight April 17 saying that her daughter, who had returned home from her lab between 11 and 11:30 p.m. that night, had collapsed and was en route to the hospital. The three of them were the only ones inside the house, she said he told her.
"He called in a panic and said something had happened to Autumn," Ms. Klein said. "The hospital did not tell us anything. I don't know that anybody has told us what happened to her. There were some assumptions, I guess you would call them."
Ms. Klein said she and her husband watched as her daughter remained "flatlined brainwise" until the people who coordinate organ donation came and she was pronounced dead on April 20.
Throughout that time, Ms. Klein said she watched almost with admiration the way Mr. Ferrante explained the troubling situation to his young daughter.
"He said something about 'Mommy's sick and I don't mean a headache and I don't mean Mommy has a tummyache' and 'Mommy's heart stopped beating and the doctors are trying to help her and get her heart to start beating again.'"
She said he reminded Cianna how they had talked about the way blood flows through the body and said, "They're trying to get Mommy better."
They took Cianna to see her mother at least twice before she died. Each time, she stood there seemingly content just to observe, Ms. Klein said.
The adults, meanwhile, struggled to find answers. Some initially thought Dr. Klein suffered a stroke, but a stroke and aneurysm were later ruled out, Ms. Klein said. She said they considered the possibility of a heart problem but found no signs of heart damage.
Ms. Klein said Mr. Ferrante told her that at one point he began presenting her daughter's case to medical colleagues without telling them whose it was and asking for their opinions. One person suggested the possibility that Dr. Klein's brain could have had a "massive electrical surge," Ms. Klein said.
Mr. Ferrante could not be reached for comment and his attorney did not respond to multiple requests for comment.
Allegheny County Medical Examiner Karl Williams said toxic levels of cyanide were found in Dr. Klein's body, but his office is awaiting the results of additional tests and the police investigation before releasing more details.
Ms. Klein said that sometime between when her body was taken for organ donation and the gathering of friends on April 24, the family had her cremated.
Ms. Klein said her first contact with Pittsburgh police came Thursday morning, when she called them for information.
"They were mostly asking me for information. They did not share any of their case with me," she said. They asked about "what Autumn was like, when was the last time we saw her, when did we talk to her last, what kind of a person was she."
And, now, Ms. Klein said, she has no idea what to make of her daughter's death and of the cyanide, which she said officials have not discussed with her.
Could someone have given it to her without her knowledge? Could she have taken it on purpose? Could she have run across it in her own research?
"I have no knowledge," Ms. Klein said, "but I have great doubts that anything like that would be used in her research."mobilehome - homepage - neigh_city
Liz Navratil: firstname.lastname@example.org, 412-263-1438 or on Twitter @LizNavratil. First Published May 3, 2013 4:00 AM