PITTSBURGH — The meeting Wednesday afternoon in the offices of forensic pathologist Dr. Cyril Wecht reaffirmed that a Renfrew woman died from the H1N1 virus.

Wecht, the former Allegheny County medical examiner, was hired by the family of Deborah Spangler, who died earlier this month, to perform an autopsy.

"This was a 45-year-old woman in perfect health, and that's what makes this case significant," Wecht said. "The autopsy revealed evidence of the viral infection as well as a secondary, bacterial infection."

Wecht and Dr. Bruce Dixon, director of the Allegheny County Health Department, confirmed H1N1 with complications as the cause of death.

Spangler visited Butler Memorial Hospital on Sept. 7 with flu-like symptoms and was sent home, Wecht said.

By the time she returned on the morning of Sept. 10, her symptoms had considerably worsened, and a chest X-ray revealed "lung complications," but it was already too late. She died about 6 p.m. that day.

"Mrs. Spangler's case was not unique, but highly atypical," Wecht said.

The hospital cannot legally discuss whether Spangler was treated at all on Sept. 7 before being sent home, or, in retrospect, whether the hospital staff performed adequately in her overall treatment, said John Righetti, a spokesman for Butler Health System.

Spangler's death was the second H1N1-linked fatality in Pennsylvania. The other was a 27-year-old Allegheny County man whose name was not released.