But it soon became a murder mystery. I said, are you sitting down . Because once they discovered what killed her, the next question was who. If he couldnt have her, no one was going to have her. I still havent made sense of it. I still havent made sense of it. I am lester holt, and this is dateline. Heres Dennis Murphy with lethal weapon. Reporter the Emergency Room Trauma Team was losing her. Shed been wheeled in glassyeyed and gasping for breath. Her heart stopped, and they had to restart her heart. Reporter and within minutes machines were doing the breathing and blood circulation for 41year old autumn klein. Wife, mother, medical doctor, a rising star in the field of womens neurology. A star whose light was dimming even as they tried desperately to keep her going. These are doctors who are treating trauma patients every day. This one had totally puzzled them. Reporter the woman failing in the e. R. , dr. Klein, was in many ways what modern pittsburgh was all about. The gleaming downtown towers didnt need to worry anymore about grimy soot from the steel mill smokestacks along the river. The Steel Industry here had mostly died by the early 80s and moved overseas. Universities, technology, medicine and finance, that was the foundation of the new pittsburgh they called the renaissance. And Robert Ferrante and his wife, dr. Autumn klein, relocated from boston, were just the kind of renaissance minds the city was hoping to attract. Autumns colleague, dr. Karen russe. She said that she loved pittsburgh. She loved her patients, that the people of pittsburgh were wonderful and she was so happy to be there. Reporter autumn had always intended to be a caregiver. Her cousin, close as sisters, sharon king, remembers that even as a little girl she administered playtime tlc. We had a doctors office. And our patients were our stuffed animals. Reporter and dr. Autumn klein was holding clinic hours, huh . She was the doctor. Reporter it was an interest that took root early for autumn and never left. Always a top of her class student in the baltimore area. She later got her undergraduate degree in neuroscience from amherst. Helping people was the main thing. She was just so smart, so intelligent, so thoughtful and so caring. Reporter you and your husband must have been very, very proud of her. We were. Reporter lois klein is autumns mom. We knew that she was putting her mind on her studies, and we were giving her the best education we could possibly give her, and she was taking advantage of it. Reporter med school was a certainty. Autumn announced she was heading to boston. Her mother worried the citys crime rate was too high. She said, im going to Boston University medical school. And i said, no, youre not. And she said, yes, i am. And i said, no, youre not. And she said, yes, i am. And she went to Boston University medical school. She had a mind of her own. Reporter in medical school autumn developed a romantic thing for a research colleague and he for her. Robert ferrante, bob to his friends, held a ph. D. In neuroscience and was hunting for cures to devastating brain illnesses like lou gehrigs and huntingtons diseases. He was also more than 20 years her senior, divorced with two grown kids. I simply told her that that was a little bit too old for her. I didnt think that that was the right age. Reporter but two days before graduation from med school a determined autumn, wasting no time, was walking down the aisle with her much older bridegroom. And what was your impression of him, sharon . Nice guy, a charming guy. A bit heady, you know . Reporter egghead . Yeah. Reporter nerdy . Yeah. And she kind of was and she kind of wasnt, you know. Reporter the couple made a home just outside boston. In a few years, a baby girl arrived into their hectic lives. Autumn took it in stride. A 2 00 a. M. Diaper change is nothing for her. Shes, you know i mean, a 2 00 a. M. Call from the hospital, you have to come in to take care of this patient, you know, shes used to that. Reporter the new mother was becoming a soughtafter specialist in neurological ailments in women. Because of her expertise, she was interviewed for an educational video distributed by the discovery channel. Women with epilepsy really need to be started on a seizure medication in advance of pregnancy. Reporter but autumn was growing frustrated with boston. And professionally she felt as though shed crested there. Thats when pittsburgh loomed into view. In 2011 the university of pittsburgh and its renowned sister Medical Center offered an ideal career move. For bob, a new research lab. For autumn, a chance to head her own department. Autumn was not just a rising star. She was a shooting star. She was nationally recognized as a leader in her field at a very young age. Reporter but still, something was gnawing at her, a kind of emotional vacuum. She wanted to have another child. By now had her early 40s, she was taking fertility treatments, hormone injections. But nothing was happening. Was it really eating away at her, that she wasnt getting pregnant, time was going by . Yes. And, you know, just speaking from experience, fertility treatments are the loneliest place a woman will ever go. Reporter looking back, her mom, lois, recognizes now some worrisome signs, changes in her daughter. I kind of saw that she wasnt herself too much anymore, that she was kind of a little what do you call it kind of a little down maybe here and there. Reporter then in early 2013 the couple tried a new approach to the baby problem. A fertility doctor thought the bodybuilding supplement known as creatine just might help autumn get pregnant. As it turned out, her husband bob had been using the stuff in his research. So on april 17th autumn klein seemed ready to give creatine a try. She texted her husband that day, i ovulate tomorrow. He answered, perfect timing. Creatine. Smiley face. These are Hospital Security camera pictures that show autumn throughout the day and leaving work late that night. Ten minutes later she was home. And minutes after that her husband, bob ferrante, was on the phone to 911. Allegheny county 911, whats the address of your emergency . Hello. Hello. Please, please, please reporter his wife slumped on the Kitchen Floor, gasping for breath. The dispatcher asked the husband what he was seeing. I think my wife is having a stroke. Reporter paramedic steve mason and his partner arrived at the ferrante home to find a woman in very bad shape. She was lying on her back on the Kitchen Floor. Her eyes were open, and she was unresponsive. Reporter an hour after walking home from the Medical Center where she worked, dr. Autumn klein, seen here in hospital surveillance footage, was back as a gravely ill patient in its emergency room. And whatever was happening to her was a medical mystery to the team trying to keep her alive. Then they saw the blood. So neon red, so out of their experience. When we come back, autumn is surrounded by some of the best doctors in the country. But no doctor can work miracles. To them, this was out of this world. Just couldnt make any sense out of it. Maybe someone else could. Dr. Autumn klein had been rushed by ambulance to the e. R. Of the university of pittsburgh Medical Center after slumping to the Kitchen Floor of her home. We thought that there was definitely a possibility of a stroke. And we knew that she was in critical condition. Reporter now the trauma team surrounding her was trying desperately to keep her vital signs going. Alan jennings, at the time a reporter with nbcs pittsburgh affiliate wpxi, covered the story. He recounted what doctors later said about that night. She had this blank stare in her eyes. Barely a pulse. Reporter and they didnt know what had happened to her . No, they didnt. Reporter autumn was struggling to breathe. And then in comes the ventilator. Reporter the ventilator, the machines are now taking over. The machines taking over to keep her alive so they can until they can determine what in the world was going on. Reporter at some point, alan, did they realize that this is one of their own . This is that brilliant, young doctor that works in the womens neurology unit . They did at one point. I dont know that they would have treated anyone any differently, but she was one of them. One of the team. Reporter when autumns husband, medical researcher bob ferrante, arrived in the trauma room, he tried to give the team some of his wifes medical history. He explained shed been on fertility hormones. She had headaches, fainting spells, and that she generally was expressing that she hadnt been feeling well. Reporter he told the e. R. Doctors he thought his wife had suffered a stroke, though diagnostic tests said otherwise. By then bob ferrante had already called his father and motherinlaw at their home near baltimore with the bad news. Autumns mother lois klein said they got in the car immediately to drive through the night to pittsburgh. She was counting out the exits. And i said, please, let me get to frederick. Then, please, let me get to hagerstown. Please let me get to hancock and please let me get to pittsburgh. Reporter back in the e. R. , a resident trying to rally autumns failing body stuck an i. V. Into her and node something quite odd her blood in his tube showed shocking red. And the oebs of that doc at the bedside that this blood is too red. Why am i seeing blood this brilliantly red saturation . To them this was out of this world. Just couldnt make any sense out of it. Reporter eventually, autumn went into cardiac arrest. Doctors managed to bring her back, barely. They actually took turns doing chest compressions to try to get some reaction from her, to try to get her heart moving and pumping again. Reporter another doctor reviewed autumns symptoms and ordered up a test. He wanted a toxicology screen of her blood. Hours passed. Her blood was being pumped into a machine that was doing the oxygenating work of her heart and lungs. At some point word had reached her cousin, sharon, now living in Washington State. Sharon talked by phone to autumns frantic husband bob and was grateful for his medical background. He was calling his colleagues. You know, he knows this neurologist or this person, this, you know great. Use your resources. You know, i had no idea what was going on. Reporter eventually, though, autumn lost brain function. By the time her parents finally made it to the hospital, they could see there was little hope for their daughter. They had a lot of tubes and things hooked up to her. And i held her hand, and i talked to her. And i told her, you heal everybody elses brain. Why cant you heal your own . Reporter sharon wanted desperately to fly out from Washington State to see autumn, but her aunt lois told her to wait. Thats my other half in that hospital bed. I need to be there. Reporter doctors managed to keep autumn alive for two full days. At some point sharon could tell that autumns grieving husband had run out of hope. And he did say to me, im going to go spend the last night with the love of my life. And at the time i thought, its not over yet. Reporter but in the e. R. Suite, everyone knew it was. Autumns little girl was brought to her bedside. She made some comment to somebody about, i dont think mommys ever going to come home again. Reporter on the third day after shed been wheeled into the e. R. , autumns exhausted colleagues pronounced her dead and turned off the machines keeping her alive. A lot of my life feels like it doesnt make sense without her. You know, she was there for everything. Reporter autumns husband and family now had Funeral Plans to make and even darker days to get through, but one person wasnt done with the mysterious case of autumn klein. His work was just Getting Started. Dr. Todd luckasevic, associate medical examiner for allegheny county, performed the autopsy on autumn. It was regarded as a sudden, unexpected death. Reporter which meant the county needed to figure out why this otherwise Healthy Woman was dead. There was no reason to suspect fertility hormones, vitamins or supplements like creatine could have led to her collapse. Her brain showed no signs of a stroke. Though an examination of the heart did reveal an abnormally shaped heart valve. Its a congenital anomaly found in approximately 2 of the population. Reporter does it lead to early death . Not in your 40s. You need to be symptomatic. Reporter at the conclusion of autumn kleins autopsy, the medical examiner was perplexed as to what killed this woman. Im not seeing anything. Im seeing a healthy white female, that for all intents and purposes, should be alive. Reporter on the form that asked for cause of death, dr. Luckasevic wrote pending, no definitive answer. But in a few days time he would have more information. The bloodwork was back from the lab. Autumn klein had suffered a very unnatural death. Coming up what exactly had killed autumn . I was shocked. And i couldnt say anything. Or is the question who . And im an arborist with ipg e in the sierras. The drought in california has killed trees on a massive scale. Any of those trees that fail into power lines could cause a wildfire or a power outage. Public safety is the main goal of our program. Thats why were out removing these hundreds of thousands of hazard trees. Having tools and Technology Gives us a huge edge to identify hazard trees. My hope is that the work were performing allows that these forests can be sustained and enjoyed by the community in the future. Together, were building a better california. Two days after allegheny countys associate medical examiner performed his autopsy on autumn klein, the phone rang. The voice on the other end was from the hospital. Autumns blood tests were back. Dr. Todd luckasevic was startled to hear what the lab found. Lethal, deadly amount of cyanide. Reporter what did that tell you . That told me that i have a cause of death now. Reporter cyanide. The poison of the nazi death camps and the Jonestown Massacre of the 70s. Lethal, fastkilling stuff, not a common cause of death. Ive done approximately 3,500 cases in my career, and this is my first case of cyanide poisoning. Reporter the labs toxicology work found cyanide levels of 3. 35 milligrams per liter in autumns blood. So this is a lot of cyanide. That is correct. Reporter still, he needed to confirm the results with his own tests. He wanted to reexamine autumns remains to see if he could find cyanide in other parts of her body. But by then he had released it to the funeral home. So heres an easy solution. You go back to the body and you take a second look. Would love to. When we got the phone call on tuesday that she had a lethal level of cyanide in her blood, i called immediately the funeral home, and she had already been cremated. Reporter but the m. E. Still had samples of autumns blood. Its toxicology unit performed its own test for cyanide. Analyst alesia smith added a simple solution to the blood. If cyanide was present in the sample, it would turn the center well of this disc purple. She and luckasevic demonstrated what they found. This example that we used today is very representative of autumn kleins sample. Its almost identical. Reporter sure enough, the sample changed color. Her color change was a deep, kind of dark purplishpink. And it was obviously positive for cyanide. Reporter does that saturation of color tell you you got a lethal amount . Oh yes, definitely. Any amount, even the one milligram per liter, even the light pink color change means theres cyanide there, a significant, toxic, if not lethal amount of cyanide present. Reporter autumn klein had died of cyanide poisoning, no question about it, he said. He grew even more confident when he reviewed the details of how she had collapsed and suffered. Cyanide, once ingested, can quickly starve the body of oxygen. So oxygens on the blood, but its not being utilized by the body. Reporter it was the trapped oxygen that had turned the blood in autumns veins that vivid red. He also considered the 911 call. As her husband is begging for help, autumn could be heard moaning in the background. Now shes, like, having a seizure, like shes jesus christmas, sweetheart reporter luckasevic says that was likely autumn struggling to breathe, another important sign that cyanide was in her system. He knew he had a bizarre death on his hands and immediately contacted the police. I call the detectives, and i let them know, cause of death is cyanide poisoning. You need to help me with the manner of death. Reporter he wanted to know if autumn had committed suicide or been poisoned, in other words murdered. There was a note on my desk saying that the Coroners Office had a woman come in who had a lethal level of cyanide in her system. Reporter cyanide poisoning. Yes. Reporter how many of those have you seen in your career . This is my first one. Reporter soon autumns mom was given the news about the blood results. She then called her niece, sharon king, out in washington. She said, are you sitting down . I was like, okay. Then she said it was cyanide. Reporter just like that. And i was shocked. And i couldnt say anything. I couldnt catch my breath. Reporter when autumns colleague dr. Karen roos heard about it, she knew right away her friend had suffered an agonizing death. As a medical professional, i know about how people die of cyanide poisoning, and i couldnt dwell on that. Reporter and just as in an old Agatha Christie cozy murder mystery about a cyanide poisoning in the village, the inspector was about to call. Pittsburghs senior investigators were en route to talk to Robert Ferrante. Did he have any idea how cyanide found its way into the bloodstream of his late wife . Coming up a husbands theory of how and why his wife died. So what did he say . Why would she do this to herself . What was he suggesting . And did he know something that police didnt . Its time for the biggest sale of the year with the new sleep number 360 smart bed. It senses your every move and automatically adjusts on both sides to keep you effortlessly comfortable. And snoring. Does your bed do that . The new 360 smart bed is part of our biggest sale of the year where all beds are on sale. And right now the sleep number queen c2 mattress now only 699. Ends sunday five days after doctors turned off the machines on dr. Autumn klein, Pittsburgh Police detectives made their way to the threestory brick house where she made a home with her daughter and husband, m