Meningitis confirmed as cause of Virginian’s death


This photo provided by the Minnesota Department of Health shows shows vials of the injectable steroid product made by New England Compounding Center implicated in a fungal meningitis outbreak. (AP)
October 12, 2012

For weeks, Sharon Wingate suspected that her husband, Douglas, was the lone Virginia man that officials said had died in the spreading meningitis outbreak.

But it wasn’t until Thursday that the Virginia medical examiner was able to confirm her fears. After a lengthy and challenging investigation, researchers have concluded that the 47-year-old Salem man’s death last month was caused by fungal meningitis that he contracted from a contaminated steroid injection produced by the now-shuttered specialty pharmacy at the center of the outbreak, said Anna Noller, forensic epidemiologist at the Office of Chief Medical Examiner.

After all the uncertainty, the news came as something of relief to Wingate, said her attorney Scott Sexton. “But it was a relief that came with a dose of anger,” he said.

Douglas Wingate, a longtime account manger at PepsiCo, had been basically healthy and active before he fell ill, said Sexton. His only complaint was that a narrow section of his spine pinched a nerve, causing shoulder pain. And Wingate decided to treat the pain with a steroid injection only because he wanted to be in top condition for an upcoming cruise he and Sharon were planning to celebrate their 25th anniversary.

“He could have lived the rest of his life without ever having gotten this shot,” said Sexton. Now, said Sexton, Sharon and the couple’s two children — 18-year old daughter Amber and 14-year-old son Austin — are reeling from the suddenness of his death. “He was Sharon’s best friend, and he was a great best friend to her.”

Sharon Wingate has spoken to the news media about the case, but Sexton said he has counseled her not to give further interviews because of the emotional toll and because she is considering legal action against potentially responsible parties such as the pharmacy, New England Compounding Center of Framingham, Mass.

Virginia has the third-highest number of steroid-related meningitis cases — 33 of the 185 reported as of Friday. Tennessee has the most with 50, followed by Michigan with 41. Maryland has 14.

According to Sexton, Wingate received his injection at the recommendation of a doctor on Sept. 6 at Insight Imaging-Roanoke, one of two clinics in Virginia that officials say obtained potentially contaminated vials.

He had gotten one other shot about two years ago, with good results. But this time, Wingate quickly developed a painful headache and intense sensitivity to light. By Sept. 12, his wife insisted on taking him to the emergency room at LewisGale Medical Center in nearby Roanoke.

About 15 years earlier, Wingate had contracted an unrelated form of meningitis, and Sexton said Wingate had told his doctors, “This headache feels exactly like the one I had [then].” From the beginning, Wingate also expressed concern that the current infection might have been caused by the steroid shot, said Sexton.

A spinal tap quickly confirmed meningitis, but what type was not immediately clear. According to Sexton, further testing ruled out the viral form of the disease. So Wingate’s doctors proceeded on the assumption that he had a bacterial strain. They prescribed antibiotics, which Sexton said “did exactly nothing for him.”

Sexton does not fault the hospital. The fungal form of meningitis is highly unusual, he said, and would not have been a natural suspect under the circumstances.

Shortly after Wingate’s hospital admission, he suffered deep brain strokes. During a brief moment of consciousness afterward he was able to whisper to Sharon, “I love you.” Two days later he died. The date was Sept. 18, less than two weeks after he had received the steroid injection.

Doctors, perplexed by the ineffectiveness of the antibiotics, initially suspected that an infection such as West Nile virus might have undermined Wingate’s immune system, officials said.

An autopsy was ordered and Wingate’s death was referred to the state medical examiner for investigation.

Noller said that since the staff there did not know what they were looking for, the search for a cause of death required extensive tissue examination and other research that took several weeks.

Meanwhile, as news emerged of the multiplying meningitis cases and the link to the contaminated steroids, Sharon Wingate became convinced her husband had been an early victim.

On Oct. 5, Virginia’s state epidemiologist, David Trump, announced that the lone fatality among the patients who had been sickened with meningitis in Virginia had been a patient who had received an injection from one of the potentially contaminated lots and was admitted to a hospital in mid-September with an “unexplained meningitis” infection that was under investigation by the medical examiner.

“Sharon and I had these conversations, saying, ‘Well, it must be Doug that they’re talking about,’ ” said Sexton. But he said the Virginia Department of Health would offer no further details.

Michelle Stoll, a spokeswoman for the department, said that at that time officials had not determined whether Wingate’s meningitis was the cause of his death, let alone whether he had contracted it from a contaminated injection. It took the medical examiner’s report Thursday to make that official.

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