A year and a half after Cindy Pogyor said goodbye to her husband as he lay dying from the lung cancer that had spread to his brain, the box arrived at her home outside Pittsburgh.
It was a Philips Respironics breathing machine — a replacement for the same ones he had used every night for seven years.
She reached into the container, pulled out the device, and tossed it into the garage.
Her 72-year-old husband, Bruce, never knew that his machine along with millions of others had been pulled from the shelves because of a dangerous flaw, one that the company and the federal government said could cause severe injuries and even death.
In June 2021, eight months after Bruce died, Philips Respironics had announced that foam placed inside the devices to insulate sound was breaking down under heat and moisture and potentially releasing highly toxic fumes into the lungs of sleeping patients.
Now, living alone in a ranch home at the end of a quiet street in Elizabeth Township, she said she wrestles with wrenching questions over whether the machine — built in a Philips factory just miles from their home — caused the disease that led to years of painful surgeries and treatments.
For months, Ms. Pogyor watched her husband of nearly 50 years slowly waste away, even as he used the DreamStation continuous positive airway pressure machine — or CPAP — that he thought was helping to sustain his life.
“We relied on the usage of [those machines], not knowing that it could be harmful,” said the 75-year-old widow, who is represented by a Pittsburgh law firm in litigation against Philips that alleges the company knew of the hazards years before it yanked the devices from the market. “How could they?”
At the start of the recall, Philips said the potential health risks of the devices could lead to serious injury “which can be life threatening” and then later backed off that disclosure, saying that further testing did not show any long-term danger.
But the Food and Drug Administration has called into question several of the company’s tests and says it has received at least 385 reports of deaths of people who used the machines in what experts say could be one of the deadliest recalls of medical devices in U.S. history.
For the past year, Ms. Pogyor says she has been on a mission to gather details about the dangers of the machine — and how she can be a voice for her husband, who never knew anything about them.
The couple met more than 60 years ago when both were in the fifth grade in West Mifflin — her curly hair catching his attention, she said.
They married while he finished his studies at what is now Robert Morris University, and later moved to Elizabeth in 1975 to build their lives around their extended family and friends.
Ms. Pogyor worked for Trans World Airlines, while her husband launched a career in food sales. Even in the years they lived paycheck to paycheck, they would scrounge up money to travel, often visiting family in Southern California and spending countless hours at the beach.
“We did everything together,” she said.
In their retirement, the couple didn’t slow down. They held season tickets for the Pittsburgh Pirates, visited casinos to play keno, and attended musicals like “The Buddy Holly Story” and “Jersey Boys” at the Benedum Center for the Performing Arts.
Though they never had their own children, they embraced their nieces and nephews like they were their own.
After his diagnosis of sleep apnea in 2012, he used his DreamStation machine faithfully and cleaned it regularly, at times with an ozone cleaner — a substance that Philips blames for much of the problem with the foam.
But even the FDA, which has been highly critical of Philips over its handling of the recall, says the breakdown is due to the foam, and not the ozone cleaner.
In 2018, during a scan of his heart, doctors found spots on his lungs. At first, they thought he had pneumonia and treated him with antibiotics. When the spots didn’t go away, a lung biopsy confirmed it was cancer.
Slowly, week by week, the disease broke him down. During a period after radiation, he passed out eight times in five months, his wife recalled.
He would sometimes collapse in public without warning and could no longer take part in activities that he loved, like golf, his favorite sport since he was 12.
“He wasn’t able to do anything at all,” said Ms. Pogyor.
His family struggled to cope. Known as “Uncle Smooth” — a name that stuck when he was waxing a car with his nephew — he could no longer attend family dinners or other events. Before, he rarely missed his nephew’s football games.
“My kids just adored him,” said Joyce Tarabrella, his sister who lives just a block away.
In time, the disease metastasized and spread to other parts of his body. In his last month, Mr. Pogyor underwent brain surgery. Initially, recovery was going well, and he was set to stay at UPMC East in Monroeville for about three weeks.
But he died Oct. 26, 2020, just three days before he was scheduled to go home.
In June 2021, less than a year after his death, the company issued the massive recall for its breathing devices. Ms. Pogyor said she remembers receiving a notification in the mail. She dismissed it.
“It was like my husband’s past,” she said.
Then she got another one, and then a third.
The final notification pushed her to go online and learn more about the foam and potential health risks. “Possible toxic and carcinogenic effects,” the company said in its recall announcement. She felt horrified, angry, by what she read.
Not only was her husband’s first CPAP machine filled with the problem foam, but a second one he began using in 2019 was also fitted with the same material.
“They knew of this situation for years and failed to act, notify the public,” Ms. Pogyor said.
In May 2022, she received the new DreamStation machine, a replacement meant for her husband.
“My husband’s deceased, why are you even sending this?” she recalled saying at the time.
All these months later, she said she’s left to think about a life that feels unfinished, cut short.
She said she still talks to her husband every day. From time to time, she looks through a folder full of keepsakes, including the birthday cards he crafted out of envelopes when he became sick and couldn’t drive anymore. He always wanted to give her something.
On what was to be their 50th wedding anniversary, she flipped through their old photos, just like they used to do together each year. Nearby was the camouflage urn holding his ashes at her bedside and the framed wedding photos behind it.
“You can be in a room full of people and still feel alone,” she said. “You don’t realize how much noise the house makes when you’re the only one in it.”
Ultimately, she says she will devote whatever time it takes to make sure her husband’s case and those of others are heard.
“I thought I had to be a voice for him,” she said. “He was one that didn’t back down, you know; he had always pushed me to speak my mind. And I thought I had to do that for him.”
Jordan Anderson: email@example.com
Pittsburgh Post-Gazette: Michael Wereschagin, assistant managing editor of investigations and data; Jordan Anderson, reporter
Northwestern University’s Medill Investigative Lab: Molly Burke, Margaret Fleming, Susanti Sarkar, Nicole Tan, Claire Gardner, Bridgette Adu-Wadier and Grant Schwab