Anemia Drug Recalled After Allergic Reactions; 3 Patients Died

The suppliers of a new drug to treat anemia in patients undergoing kidney dialysis have recalled all lots of the product after reports that it had caused severe allergic reactions, including some that were fatal.

Affymax and Takeda Pharmaceutical, which jointly market the drug, Omontys, or peginesatide, announced the recall late on Saturday, and the notice was also posted by the Food and Drug Administration.

The F.D.A. said in a news release on Sunday that it had received 19 reports of anaphylaxis, a severe allergic reaction, and that three of the patients had died, while others required prompt medical intervention or hospitalization.

Approved last March, Omontys broke the lucrative monopoly Amgen had since 1989 on treating anemia in dialysis clinics. While it is not clear yet what the recall means for the future of Omontys, it could help sales of Amgen’s drug, Epogen.

Affymax and Takeda said that hypersensitivity reactions have been fatal in 0.02 percent of the roughly 25,000 patients treated with Omontys since its approval. That would suggest there have been five deaths, a slight discrepancy from the F.D.A. figures that was not explained. Over all, the companies said, about 2 of every 1,000 patients had a hypersensitivity reaction.

The companies and the F.D.A. said the reactions occurred within 30 minutes of patients receiving their first dose by intravenous administration. No problems have been reported with subsequent doses, which are given once a month. Still, the companies and the F.D.A. advised that Omontys use be discontinued even by patients who have already had more than one dose.

The big question is whether this will cause the drug to be withdrawn from the market. It is possible that doctors can act to avert or lessen allergic reactions on the first dose. It is also possible the problems are confined to certain dialysis centers.

A spokeswoman for Affymax said executives would not comment further until a conference call for securities analysts on Monday morning. Omontys is the only marketed product for Affymax, which is based in Palo Alto, Calif., and licensed commercialization rights to Takeda, Japan’s largest pharmaceutical company.

Reports of severe allergic reactions have been accumulating, and the Omontys label warns of them, as does the Epogen label.

This month, Fresenius Medical Care North America, the nation’s largest dialysis provider, halted a pilot program testing Omontys, in part because of these allergic reactions. The company said in a memorandum that it had treated 18,000 patients with the drug and would now analyze the data.

“To date, we have seen infrequent allergic reactions in our patient population receiving their first dose of Omontys,” said the Feb. 13 memo by Fresenius’s chief medical officer and its associate chief medical officer. They recommended that patients already taking Omontys continue and said dialysis centers could also put new patients on it.

The memo was made public in a regulatory filing by Affymax.

Sales of Omontys for the nine months it was on the market were $34.6 million, compared with $1.5 billion for Epogen. Still, Affymax executives have said Omontys was gaining momentum because of its less-frequent dosing, lower cost and the desire of some dialysis center owners for an alternative to Amgen.

Dr. Daniel W. Coyne, a kidney specialist at Washington University in St. Louis, said that unless the problem was because of contamination, “this could easily lead to withdrawal of drug approval.” He said that “two in 10,000 deaths on first exposure is unacceptable, compared to nothing like this” with Epogen.

Dr. Ajay K. Singh, a kidney specialist at Brigham and Women’s Hospital in Boston, said that the recall should result in “minimal disruption” because centers could use Epogen or another Amgen drug, Aranesp. But he said it might be hard for Affymax and Takeda, which is based in Osaka, to show the safety of their drug without a huge study.

Amgen’s Epogen is a synthetic version of the human protein erythropoietin, or EPO, which stimulates the body to produce oxygen-carrying red blood cells. Omontys is not EPO, but binds to the same receptor in the body.

Sales of Amgen’s Epogen have been declining because of changing financial incentives for dialysis clinics and because of safety concerns, particularly those related to blood clots and heart attacks. EPO has also become known for secretly being used by athletes like Lance Armstrong.

The next competition to Epogen could come from Roche’s Mircera, a form of EPO, in mid-2014. Biosimilars, or near-generic forms of Epogen, could reach the market after Amgen’s last patent expires in 2015.

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Athletes cash in on California's workers' comp

SACRAMENTO — In his seven-year career with the Denver Broncos, running back Terrell Davis, a former Super Bowl Most Valuable Player, dazzled fans with his speed and elusiveness.

At the end of his rookie year in 1995, he signed a $6.8-million, five-year contract. Off the field he endorsed Campbell's soup. And when he hung up his cleats, he reported for the National Football League Network and appeared in movies and TV shows.

So it may surprise Californians to find out that in 2011, Davis got a $199,000 injury settlement from a California workers' compensation court for injuries related to football. This came despite the fact Davis was employed by a Colorado team and played just nine times in California during an 88-game career, according to the NFL.

Davis was compensated for the lifelong effects of multiple injuries to the head, arms, trunk, legs and general body, according to California workers' compensation records.

He is not alone.

Over the last three decades, California's workers' compensation system has awarded millions of dollars in benefits for job-related injuries to thousands of professional athletes. The vast majority worked for out-of-state teams; some played as little as one game in the Golden State.

All states allow professional athletes to claim workers' compensation payments for specific job-related injuries — such as a busted knee, torn tendon or ruptured spinal disc — that happened within their borders. But California is one of the few that provides additional payments for the cumulative effect of injuries that occur over years of playing.

A growing roster of athletes are using this provision in California law to claim benefits. Since the early 1980s, an estimated $747 million has been paid out to about 4,500 players, according to an August study commissioned by major professional sports leagues. California taxpayers are not on the hook for these payments. Workers' compensation is an employer-funded program.

Now a major battle is brewing in Sacramento to make out-of-state players ineligible for these benefits, which are paid by the leagues and their insurers. They have hired consultants and lobbyists and expect to unveil legislation next week that would halt the practice.

"The system is completely out of whack right now," said Jeff Gewirtz, vice president of the Brooklyn Nets — formerly the New Jersey Nets — of the National Basketball Assn.

Major retired stars who scored six-figure California workers' compensation benefits include Moses Malone, a three-time NBA most valuable player with the Houston Rockets, Philadelphia 76ers and other teams. He was awarded $155,000. Pro Football Hall of Fame wide receiver Michael Irvin, formerly with the Dallas Cowboys, received $249,000. The benefits usually are calculated as lump-sum payments but sometimes are accompanied by open-ended agreements to provide lifetime medical services.

Players, their lawyers and their unions plan to mount a political offensive to protect these payouts.

Although the monster salaries of players such as Los Angeles Lakers guard Kobe Bryant and Denver Broncos quarterback Peyton Manning make headlines, few players bring in that kind of money. Most have very short careers. And some, particularly football players, end up with costly, debilitating injuries that haunt them for a lifetime but aren't sufficiently covered by league disability benefits.

Retired pros increasingly are turning to California, not only because of its cumulative benefits but also because there's a longer window to file a claim. The statute of limitations in some states expires in as little as a year or two.

"California is a last resort for a lot of these guys because they've already been cut off in the other states," said Mel Owens, a former Los Angeles Rams linebacker-turned-workers' compensation lawyer who has represented a number of ex-players.

To understand how it works, consider the career of Ernie Conwell. A former tight end for the St. Louis Rams and New Orleans Saints, he was paid $1.6 million for his last season in 2006.

Conwell said that during his 11-year career, he underwent about 18 surgeries, including 11 knee operations. Now 40, he works for the NFL players union and lives in Nashville.

Hobbled by injuries, he filed for workers' compensation in Louisiana and got $181,000 in benefits to cover his last, career-ending knee surgery in 2006, according to the Saints. The team said it also provided $195,000 in injury-related benefits as part of a collective-bargaining agreement with the players union.

But such workers' compensation benefits paid by Louisiana cover only specific injuries. So, to deal with what he expects to be the costs of ongoing health problems that he said affect his arms, legs, muscles, bones and head, Conwell filed for compensation in California and won.

Even though he played only about 20 times in the state over his professional career, he received a $160,000 award from a California workers' compensation judge plus future medical benefits, according to his lawyer. The Saints are appealing the judgment.

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Major Banks Aid in Payday Loans Banned by States

Major banks have quickly become behind-the-scenes allies of Internet-based payday lenders that offer short-term loans with interest rates sometimes exceeding 500 percent.

With 15 states banning payday loans, a growing number of the lenders have set up online operations in more hospitable states or far-flung locales like Belize, Malta and the West Indies to more easily evade statewide caps on interest rates.

While the banks, which include giants like JPMorgan Chase, Bank of America and Wells Fargo, do not make the loans, they are a critical link for the lenders, enabling the lenders to withdraw payments automatically from borrowers’ bank accounts, even in states where the loans are banned entirely. In some cases, the banks allow lenders to tap checking accounts even after the customers have begged them to stop the withdrawals.

“Without the assistance of the banks in processing and sending electronic funds, these lenders simply couldn’t operate,” said Josh Zinner, co-director of the Neighborhood Economic Development Advocacy Project, which works with community groups in New York.

The banking industry says it is simply serving customers who have authorized the lenders to withdraw money from their accounts. “The industry is not in a position to monitor customer accounts to see where their payments are going,” said Virginia O’Neill, senior counsel with the American Bankers Association.

But state and federal officials are taking aim at the banks’ role at a time when authorities are increasing their efforts to clamp down on payday lending and its practice of providing quick money to borrowers who need cash.

The Federal Deposit Insurance Corporation and the Consumer Financial Protection Bureau are examining banks’ roles in the online loans, according to several people with direct knowledge of the matter. Benjamin M. Lawsky, who heads New York State’s Department of Financial Services, is investigating how banks enable the online lenders to skirt New York law and make loans to residents of the state, where interest rates are capped at 25 percent.

For the banks, it can be a lucrative partnership. At first blush, processing automatic withdrawals hardly seems like a source of profit. But many customers are already on shaky financial footing. The withdrawals often set off a cascade of fees from problems like overdrafts. Roughly 27 percent of payday loan borrowers say that the loans caused them to overdraw their accounts, according to a report released this month by the Pew Charitable Trusts. That fee income is coveted, given that financial regulations limiting fees on debit and credit cards have cost banks billions of dollars.

Some state and federal authorities say the banks’ role in enabling the lenders has frustrated government efforts to shield people from predatory loans — an issue that gained urgency after reckless mortgage lending helped precipitate the 2008 financial crisis.

Lawmakers, led by Senator Jeff Merkley, Democrat of Oregon, introduced a bill in July aimed at reining in the lenders, in part, by forcing them to abide by the laws of the state where the borrower lives, rather than where the lender is. The legislation, pending in Congress, would also allow borrowers to cancel automatic withdrawals more easily. “Technology has taken a lot of these scams online, and it’s time to crack down,” Mr. Merkley said in a statement when the bill was introduced.

While the loans are simple to obtain — some online lenders promise approval in minutes with no credit check — they are tough to get rid of. Customers who want to repay their loan in full typically must contact the online lender at least three days before the next withdrawal. Otherwise, the lender automatically renews the loans at least monthly and withdraws only the interest owed. Under federal law, customers are allowed to stop authorized withdrawals from their account. Still, some borrowers say their banks do not heed requests to stop the loans.

Ivy Brodsky, 37, thought she had figured out a way to stop six payday lenders from taking money from her account when she visited her Chase branch in Brighton Beach in Brooklyn in March to close it. But Chase kept the account open and between April and May, the six Internet lenders tried to withdraw money from Ms. Brodsky’s account 55 times, according to bank records reviewed by The New York Times. Chase charged her $1,523 in fees — a combination of 44 insufficient fund fees, extended overdraft fees and service fees.

For Subrina Baptiste, 33, an educational assistant in Brooklyn, the overdraft fees levied by Chase cannibalized her child support income. She said she applied for a $400 loan from Loanshoponline.com and a $700 loan from Advancemetoday.com in 2011. The loans, with annual interest rates of 730 percent and 584 percent respectively, skirt New York law.

Ms. Baptiste said she asked Chase to revoke the automatic withdrawals in October 2011, but was told that she had to ask the lenders instead. In one month, her bank records show, the lenders tried to take money from her account at least six times. Chase charged her $812 in fees and deducted over $600 from her child-support payments to cover them.

“I don’t understand why my own bank just wouldn’t listen to me,” Ms. Baptiste said, adding that Chase ultimately closed her account last January, three months after she asked.

A spokeswoman for Bank of America said the bank always honored requests to stop automatic withdrawals. Wells Fargo declined to comment. Kristin Lemkau, a spokeswoman for Chase, said: “We are working with the customers to resolve these cases.” Online lenders say they work to abide by state laws.

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Gunfire and deadly crash rattle the Las Vegas Strip

LAS VEGAS — A spectacular predawn crash on the Strip — triggered when bullets fired from a black Range Rover peppered a Maserati — hit this resort city right between the eyes. In the end, three people were dead and a major intersection under lockdown during a three-state manhunt for the shooters, leaving even casino veterans used to the extraordinary scratching their heads.

The mayhem was sparked, witnesses told police, by a quarrel early Thursday at a hotel valet stand.

The two vehicles left the Aria resort hotel and were heading north on Las Vegas Boulevard at 4:20 a.m., an hour when the casino marquees shine brightly but the gambling thoroughfare is largely empty. At Harmon Avenue, occupants inside the Range Rover opened fire on the Maserati, police said.

The silver-gray sports car, which was struck several times, sped into the intersection at Flamingo Road, ramming a Yellow cab. The taxi exploded, killing the driver and a passenger. Four other vehicles in the intersection were also involved in the crash and explosion, but officers offered no details.

"Omg Omg Omg that car just blew up!" one witness tweeted shortly after the crash, posting a photo of the wreckage. "God Bless their Souls! Omg!"

The driver of the Maserati died later at a hospital, police said. A passenger in the vehicle received minor injuries and was being interviewed by investigators. At least three others were also injured.

Police in Nevada, California, Arizona and Utah were on alert for the distinctive black Range Rover SUV, described as having dark-tinted windows, black rims and out-of-state paper dealer plates.

"We are going to pursue these individuals and prosecute them," Clark County Sheriff Doug Gillespie said at an afternoon news conference. "This act was totally unacceptable. It's not just tragic but unnecessary — the level of violence we see here in Las Vegas and across America."

Authorities had not publicly identified the dead. But a Las Vegas television station late Thursday identified the taxi driver as Michael Boldon, 62, who the station said had recently moved here from Michigan to care for his 93-year-old mother.

The victim's son, who drives a limousine, told Fox News 5 that he last talked with his father after 3 a.m., and later called his cellphone shortly after the crash to warn him to avoid the Strip. But there was no answer.

The station also identified the driver of the Maserati as Ken Cherry, a rap artist from Oakland who also is known as "Kenny Clutch." The station quoted family members identifying Cherry as the driver. An Internet video of a Cherry song called "Stay Schemin" shows two men in a vehicle on the Strip.

Police had more questions than answers.

"It began with a dispute at a nearby hotel and spilled onto the streets," said Capt. Chris Jones of the Las Vegas Police Robbery and Homicide Division.

The morning's events threw the Strip into disarray all day. The gambling boulevard's busiest and best-known intersection was cordoned off by yellow police tape until nightfall, keeping traffic and curious pedestrians away from the carnage. Even skywalks were blocked off.

While slot machines beeped and card games continued inside casinos around the accident scene — including the Bellagio, Caesars Palace and Paris Las Vegas — hotel bell captains were fielding questions from tourists who had awakened to news of the crash and the Strip shutdown. The alleys and side streets between nearby hotels were clogged with pedestrians who inched along on narrow sidewalks, past delivery doors, many making their own paths between the landscaped bushes and palm trees.

Even casino industry workers were thrown into turmoil. Hotel maids and dealers who finished their midnight shifts after dawn were left without bus service home. "I'm stranded," said Tiruselam Kefyalew, 25, a maid. "What a day to leave my cellphone at home."

Limousine drivers who normally prowl the city's gambling core improvised detours. Some said the police blockade would cost them $500 or more in lost business and tips.

"Most people understand, but you have your complainers," said Jim DeSanto, a limo driver who waited for fares outside Bally's casino. "Those people will complain, even when everything is perfect."

Well after noon, guests peered out nearby hotel windows and others leaned into the street to glimpse the crime scene.

"Hey, honey, it must have happened right here," one man told his wife as they left Caesars around noon. The tourist, who would only say that he had arrived from Tampa, Fla., the previous evening, had looked out his hotel window at 4:30 to see a vehicle in flames.

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Well: Savory Pie Recipes for Health

Pie is an indulgence often saved for holiday time. But this week Martha Rose Shulman shows us how to bake a pie and eat it too, without the guilt. She offers savory vegetable pies, showcased in whole grain crusts. She writes:

This week I slowed down and made pies: savory ones filled with vegetables … I used a number of different crusts for my winter pies. My favorite remains the whole wheat yeasted olive oil crust that I have used before in this column, but I also worked with a simple Mediterranean crust made with a mix of whole wheat flour, all-purpose flour and olive oil. And for those of you who are gluten-free, I made another foray into gluten-free pastry and produced one I liked a lot, which was a mix of buckwheat flour, millet flour and potato starch. It had a strong nutty flavor that worked well with a very savory, very vegan, tofu and mushroom “quiche.” They are all simple to mix together and easy to roll or press out. And if you don’t feel like dealing with a crust, just use Greek phyllo. The important things, after all, are the savory vegetables inside.

Here are recipes for a pie crust and four savory winter vegetable pies.

Whole Wheat Mediterranean Pie Crust: A simple Mediterranean crust made with a mix of whole wheat flour, all-purpose flour and olive oil.

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Mixed Greens Galette With Onions and Chickpeas: A tasty way to use bagged greens in a dish with Middle Eastern overtones.

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Goat Cheese, Chard and Herb Pie in a Phyllo Crust: A garlicky mix of greens and your choice of herbs inside a crispy phyllo crust.

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Tofu Mushroom ‘Quiche’: A vegan dish with a deep, rich flavor.

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Winter Tomato Quiche: Canned tomatoes can be used in the off season for a delicious dinner.

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Fed Officials Debate Bank’s Losses Once Economy Mends

The Federal Reserve’s plans for the eventual wind-down of its economic stimulus campaign could provoke a political reaction that will make it more difficult to control inflation, a current Fed official and a former Fed governor said Friday.

Peter Newcomb/Reuters

James Bullard, president of the St. Louis Fed, sees political fallout from coming losses.

Pat Greenhouse/The Boston Globe

Eric Rosengren, head of the Boston Fed, noted 400,000 jobs would be added this year.

Kevin Lamarque/Reuters

Jerome Powell, a Fed governor, said the bank would resist any pressure from Congress.

When the economy grows stronger, the Fed plans to sell some of its vast holdings of Treasury and mortgage-backed securities. The Fed also plans to pay banks to leave some money on deposit with it to limit the pace of new lending.

And that could prove an awkward combination. The Fed faces the possibility of large losses as it sells off securities, which could force the central bank to suspend annual payments to the Treasury Department for the first time since the 1930s, even as it would be increasing the amounts paid to the banking industry for its cash holdings at the Fed to control inflation.

“That sounds like a recipe for political problems,” said James Bullard, president of the Federal Reserve Bank of St. Louis. He described the predicament as one reason the Fed might consider limiting its plans for additional asset purchases.

But Eric S. Rosengren, president of the Federal Reserve Bank of Boston, said that concerns about potential losses needed to be weighed against the benefits of asset purchases. The Fed holds almost $3 trillion in Treasuries and mortgage bonds, and it is adding about $85 billion a month in an effort to cut unemployment.

Mr. Rosengren, a leading advocate of the purchases, said Boston Fed research showed asset purchases this year could help create about 400,000 new jobs.

“That’s what the Federal Reserve should really be caring about, what’s happening with the dual mandate with and without” the asset purchases, Mr. Rosengren said. “When I think about the costs, I have to weigh that against the benefits,” he said at the US Monetary Policy Forum in New York on Friday.

By law, the Fed sends most of its profits to the Treasury, and in recent years those profits have soared as the Fed has collected interest on its investments. Last year, the central bank contributed $89 billion to the public coffers — essentially refunding a significant portion of the federal government’s annual borrowing costs.

The purpose of the investment portfolio is to hold down borrowing costs for businesses and consumers. As the economy revives, the Fed has said it will begin selling some of those holdings. But it faces potential losses on those sales because interest rates would be rising. Security prices, which move inversely to rates, would be falling, and the government would be issuing new debt at the higher rates, making the low-yield bonds that the Fed holds less valuable.

Estimating the potential losses requires a wide range of assumptions on Fed policy, economic growth and interest rates. A Fed analysis published last month, which assumed that interest rates rose to 3.8 percent later this decade, estimated that the central bank might record losses of $40 billion and suspend contributions to the Treasury for four years beginning in 2017. If rates rose by another percentage point, however, the analysis estimated that losses would triple. An independent analysis published on Friday foresaw losses of around $20 billion and a suspension of payments for only three years.

The Fed can afford to lose money because it can simply print more. It would record a liability, and pay down the debt as profits rebounded.

But there are signs that the Fed’s political opponents would seize on any losses as evidence of economic malpractice. And such that criticism could come at a vulnerable moment: central banks are never popular when they are raising interest rates.

Representative Jim Jordan, an Ohio Republican, cited the potential losses in an open letter this week to the Fed chief, Ben S. Bernanke, requesting more information on what he called “the potentially devastating consequences from any unwind.”

Jerome H. Powell, a Fed governor, insisted Friday that the central bank would not allow its course to be influenced by such political pressure.

“We’re independent for a reason,” he said. “Congress has given us a job to do.”

Some supporters of current Fed policy also argue that an economic revival would inoculate the central bank against criticism, in part because the government’s coffers would be filling even without the Fed’s contributions.

But Frederic S. Mishkin, a Columbia economist and one of the authors of the independent analysis of the Fed’s potential losses, said that was wishful thinking.

“Politicians have very short memories,” said Professor Mishkin, a former Fed governor. “They’re going to focus very much on the fact that the Fed is no longer pulling its weight in terms of producing remittances for the federal government.”

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Dorner's mentor cracked the case

It was nearing midnight when Terie Evans called police in Irvine with a hunch: An ex-Los Angeles police officer named Christopher Dorner might have killed a young Irvine woman and her fiance a few days earlier.

Evans, an LAPD sergeant who had trained Dorner, conceded that her theory was a long shot. But Dorner's name had suddenly surfaced the day before in a strange phone call. And she knew he had a connection to the woman who had been killed. It seemed too much to dismiss as a coincidence.

It wouldn't take long for Irvine detectives to realize just how valuable Evans' tip was.

Before dawn they were looking into Dorner. An investigator uncovered a rambling manifesto Dorner allegedly posted online, in which he expressed fury over his firing years earlier and laid out his plan to exact revenge by killing officers he blamed for his downfall and their family members.

The discovery sent Evans and about 50 other LAPD officers and their families either into hiding or under the protection of heavily armed guards as a massive manhunt for Dorner unfolded across Southern California.

For the eight days that Dorner eluded capture, Evans remained silent and laid low, while Irvine and Los Angeles police officials kept secret her role in identifying the suspect. Evans had been Dorner's training officer and was at the center of the incident that led to his dismissal from the force. Authorities worried it might enrage Dorner further if he knew she had once again played a lead role in determining his fate.

On Thursday, Evans spoke to The Times about what happened, and police confirmed her account. LAPD Chief Charlie Beck said he believes Evans' actions saved lives, helping detectives identify Dorner before he carried out more surprise attacks.

It began for Evans on Monday, Feb. 4 — the day after the bodies of Monica Quan and Keith Lawrence had been found riddled with bullets in their car. Evans, 47, received a message that an officer from a small department south of San Diego was trying to reach her. When she returned the call, the officer told her that he had found pieces of a large-sized police uniform, some ammunition and other items discarded in a dumpster that appeared to belong to an LAPD officer with the last name Dorner. Evans' name and other items were written in a small notebook found with the other things. The officer asked: Did Evans know this guy Dorner?

She did know him. Several years earlier, Evans and Dorner, a rookie cop, had been partners. The pairing had ended badly when Dorner accused Evans of kicking a handcuffed man .

Evans denied the allegations and an investigation cleared the 18-year veteran of wrongdoing. LAPD officials went on to fire Dorner after concluding he had fabricated the story.

"Just hearing his name was enough to make me feel sick," Evans said.

Evans hadn't been able to shake the uneasy feeling when she went to work the following evening. Before beginning her night shift, she stopped in the police station's parking lot to talk with some other officers. The conversation turned to the Irvine killings. Evans had heard about the case, but knew no details. The dead woman, one of the officers said, was the daughter of Randy Quan, a former LAPD captain-turned-lawyer who represented LAPD officers in disciplinary hearings when they ran afoul of the department.

The hair on the back of Evans' neck stood up. Another wave of the shakiness she had felt on the phone washed over her. She struggled to make sense of her thoughts. Quan. Dorner. The belongings in the dumpster.

Through her night shift, a "nagging, sinking feeling" dogged her. "I have to call Irvine PD," she recalled thinking.

"In my mind, it felt like such a long shot," Evans said. "But my gut feeling made it a lot stronger than that. I just knew. Something told me that there was some kind of a connection."

Evans called the Irvine Police Department and told a supervisor her theory: Quan had represented Dorner at his termination proceedings. What if Dorner had killed Quan's daughter and her fiance as part of a vendetta and then tossed his belongings in the dumpster before escaping across the border to Mexico?

About 1 a.m., an Irvine detective called back and Evans repeated her suspicions. A few hours later, her shift ended and Evans went home to sleep. When she awoke, a message from another Irvine detective, left early that morning, was waiting for her. Investigators were pursuing her lead and were on their way to San Diego to examine Dorner's belongings.

"At that point, I was absolutely sick," Evans said. "I thought, 'Oh my god, it really is him.' I knew no one knew where he was … I thought, 'What am I going to do?' At the time Mr. Dorner was terminated, I had a very uneasy feeling. I knew he was very upset and I had concerns that at some point he may try to contact me. So, this was just validating the bad feeling I carried with me for years. I was scared to death."

About 1:30 p.m., Evans said she was on her way to watch her teenage son play soccer when her phone rang again. They had discovered the manifesto. "I was told my family and I were not safe."

After making sure her son was with his father — a retired cop — Evans drove around aimlessly, fearing that Dorner could be waiting for her at her home or police station. Within 20 minutes, she recalled, someone from the LAPD called to make plans for protecting her and her family.

Police say Dorner killed two officers as well as the Irvine couple, and injured three more officers in gun battles, before apparently killing himself last week in the basement of a Big Bear cabin as authorities closed in on him.

Evans has not yet returned to her home. She and police officials said Evans has continued to receive threats. In addition, someone tried to break in to her home, police said.

"I honestly don't think my life will ever be normal the way it was before. This was such an extraordinary circumstance, I don't know if I'm ever going to feel safe in my home again," Evans said. "Years from now, my family could potentially still be at risk."

joel.rubin@latimes.com

Times staff writers Christopher Goffard, Kurt Streeter and Andrew Blankstein contributed to this report.

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Living With Cancer: Arrivals and Departures

After being nursed and handed over, the baby’s wails rise to a tremolo, but I am determined to give my exhausted daughter and son-in-law a respite on this wintry evening. Commiserating with the little guy’s discomfort — gas, indigestion, colic, ontological insecurity — I swaddle, burp, bink, then cradle him in my arms. I begin walking around the house, swinging and swaying while cooing in soothing cadences: “Yes, darling boy, another one bites the dust, another one bites the dust.”

I kid you not! How could such grim phrases spring from my lips into the newborn’s ears? Where did they come from?

I blame his mother and her best friend. They sang along as this song was played repeatedly at the skating rink to which I took them every other Saturday in their tweens. Why would an infatuated grandma croon a mordant lullaby, even if the adorable one happily can’t understand a single word? He’s still whimpering, twisting away from me, and understandably so.

Previously that day, I had called a woman in my cancer support group. I believe that she is dying. I do not know her very well. She has attended only two or three of our get-togethers where she described herself as a widow and a Christian.

On the phone, I did not want to violate the sanctity of her end time, but I did want her to know that she need not be alone, that I and other members of our group can “be there” for her. Her dying seems a rehearsal of my own. We have the same disease.

“How are you doing, Kim?” I asked.

“I’m tired. I sleep all the time,” she sighed, “and I can’t keep anything down.”

“Can you drink … water?” I asked.

“A little, but I tried a smoothie and it wouldn’t set right,” she said.

“I hope you are not in pain.”

“Oh no, but I’m sleeping all the time. And I can’t keep anything down.”

“Would you like a visit? Is there something I can do or bring?” I asked.

“Oh, I don’t think so, no thanks.”

“Well,” I paused before saying goodbye, “be well.”

Be well? I didn’t even add something like, “Be as well as you can be.” I was tongue-tied. This was the failure that troubles me tonight.

Why couldn’t I say that we will miss her, that I am sorry she is dying, that she has coped so well for so long, and that I hope she will now find peace? I could inform an infant in my arms of our inexorable mortality, but I could not speak or even intimate the “D” word to someone on her deathbed.

Although I have tried to communicate to my family how I feel about end-of-life care, can we always know what we will want? Perhaps at the end of my life I will not welcome visitors, either. For departing may require as much concentration as arriving. As I look down at the vulnerable bundle I am holding, I marvel that each and every one of us has managed to come in and will also have to manage to go out. The baby nestles, pursing his mouth around the pacifier. He gazes intently at my face with a sly gaze that drifts toward a lamp, turning speculative before lids lower in tremulous increments.

Slowing my jiggling to his faint sucking, I think that the philosopher Jacques Derrida’s meditation on death pertains to birth as well. Each of these events “names the very irreplaceability of absolute singularity.” Just as “no one can die in my place or in the place of the other,” no one can be born in this particular infant’s place. He embodies his irreplaceable and absolute singularity.

Perhaps we should gestate during endings, as we do during beginnings. Like hatchings, the dispatchings caused by cancer give people like Kim and me a final trimester, more or less, in which we can labor to forgive and be forgiven, to speak and hear vows of devotion from our intimates, to visit or not be visited by acquaintances.

Maybe we need a doula for dying, I reflect as melodious words surface, telling me what I have to do with the life left to be lived: “To love that well, which thou must leave ere long.”

“Oh little baby,” I then whisper: “Though I cannot tell who you will become and where I will be — you, dear heart, deliver me.”

---

Susan Gubar is a distinguished emerita professor of English at Indiana University and the author of “Memoir of a Debulked Woman,” which explores her experience with ovarian cancer.

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Homeowners Still Face Foreclosure Despite Billions in Aid

A year after five of the nation’s biggest banks reached a pact with state and federal officials over claims of vast foreclosure abuses, the banks are taking credit for giving more than half a million struggling homeowners roughly $45.8 billion in relief.

But despite the banner numbers released on Thursday in a report by Joseph A. Smith, the independent overseer of the settlement, thousands of homeowners are still not getting the help they need to save their homes from foreclosure, according to interviews with housing advocates and homeowners facing foreclosure.

Just under 71,000 borrowers, or 13 percent of the total borrowers helped so far, received assistance on their primary mortgage, which has been the main source of defaults and foreclosures through the housing crisis. But more than 170,000 homeowners received assistance on their second mortgage, which typically is a home equity line of credit that borrowers can tap for cash.

Even though addressing second mortgages does offer some relief to homeowners, in a troubling number of instances the banks are not providing any help with the first mortgage, the housing advocates said. That leaves the homeowners still in jeopardy of losing their homes, while giving banks credit for restructuring loans or wiping out debt under the settlement.

“The second mortgage forgiveness is basically a loophole, which allows the banks to continue foreclosures unabated,” said Elizabeth M. Lynch, a lawyer at MFY Legal Services in New York.

Based on the monitor’s report, it is impossible to tell how many homeowners who received help on their second mortgage are still facing foreclosure on their first mortgage. Ms. Lynch and other advocates estimate that thousands of homeowners across the country are in that predicament.

Banks say they are working to assist homeowners and to fulfill all their obligations under the settlement. And Shaun Donovan, the secretary of housing and urban development, which helped broker the deal with the five banks, said on Thursday that the settlement had already “exceeded expectations.”

Mr. Smith said, “I believe we have made progress, but I know that there is much more work to be done.”

When Danette Rivera, a 38-year-old single mother, received a letter from Bank of America in July alerting her that it was forgiving her second mortgage of about $115,000, she said she was elated. Ms. Rivera said she thought the assistance would save the home in Queens she shares with her two children.

But that hope, she said, was dashed when she learned a month later that Bank of America was foreclosing on her because of her troubled first mortgage. “This house means everything to my family and I am terrified we are going to be homeless again,” Ms. Rivera said. The bank, citing customer privacy concerns, declined to comment.

At its outset, the settlement was trumpeted as a way to hold banks accountable for foreclosure abuses and help homeowners harmed when the housing bubble burst, sending the housing market to its lowest level since the Great Depression. As of early 2012, roughly four million Americans were in foreclosure since the start of 2007, with abandoned properties marring states including Arizona, California and Florida.

The deal with the five largest servicers — Ally Financial, Bank of America, Citigroup, JPMorgan Chase, Wells Fargo — arose from a sweeping investigation by the 50 state attorneys general after revelations in 2010 that banks were churning through hundreds of foreclosure documents without examining them for accuracy.

Initially, the banks resisted reducing mortgage debt, but the attorneys general insisted that debt reduction was critical to the plan. Under the terms of the settlement, the banks receive a variety of credits based on the kind of relief that they provide. For example, banks that offer short sales to homeowners earn at most 45 cents on the dollar. For extinguishing second mortgages for borrowers who are more than 180 days behind on payments, the banks receive 10 cents on the dollar.

The bulk of the relief, according to the monitor’s report, comes from short sales, which housing advocates say do not actually keep homeowners in their properties. In the sales, banks agree to let homeowners sell their houses for less than the outstanding debt owed. Short sales are among the simplest form of relief, particularly because they are a palatable alternative for the banks, which typically incur lower losses on the sales than on foreclosures. Through short sales, banks forgave about $19.5 billion in debt on an estimated 169,000 properties, according to the report. As the housing market plummeted, millions of Americans were unable to sell their homes because they had lost so much value.

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Interstate 5 reopens through the Grapevine

From Times Staff

February 20, 2013, 9:44 a.m.

The California Highway Patrol has reopened a stretch of Interstate 5 through the Grapevine that was closed earlier today because of ice.

The highway was opened to vehicles with escorts at about 9:15 a.m., said CHP Officer Ed Jacobs. The freeway was closed between Castaic and Grapevine Road about 6:35 a.m., Jacobs said.

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