Fewer health care options for illegal immigrants

ALAMO, Texas (AP) — For years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital — the most expensive setting for those covering the cost.

The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.

To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.

But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.

When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.

And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.

In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."

The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states — including Texas, Florida and New Jersey — hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.

Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.

Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.

A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.

California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.

The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.

And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.

If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.

Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.

The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.

"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."

Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.

There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.

Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.

For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.

"They always attended to me," she said, "even though it's slow."

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Sherman can be followed on Twitter at https://twitter.com/chrisshermanAP .

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U.S. to send missiles, troops to Turkey

INCIRLIK AIR BASE, Turkey (Reuters) - U.S. Defense Secretary Leon Panetta signed an order on Friday to send two Patriot missile batteries to Turkey with 400 American personnel to operate them, in a move by NATO members to bolster Turkey's defenses against the threat of Syrian missiles.

The order was signed shortly before Panetta arrived on an unannounced visit to Turkey to meet American troops stationed at the Incirlik Air Base, the last stop on a week-long trip that took him to Afghanistan and Kuwait.

"The purpose of this deployment is to signal very strongly that the United States, working closely with our NATO allies, is going to support the defense of Turkey, especially with potential threats emanating from Syria," spokesman George Little said.

NATO-member Turkey has repeatedly scrambled jets along the countries' joint frontier and responded in kind when shells from the Syrian conflict came down inside its borders, fanning fears that the civil war could spread to destabilize the region.

The widely expected U.S. move follows similar steps by Germany and the Netherlands, which also said they will send two Patriot batteries. The three countries are the only NATO nations with the most modern type of Patriots.

Little declined to say where the U.S. batteries would be located and said the systems would be deployed to Turkey for an unspecified amount of time.

"We expect them to be deployed in the coming weeks," Little said.

NATO approved Turkey's request for air defense batteries on December 4, in a move meant to calm its fears of coming under missile attack, possibly with chemical weapons, from Syria.

The Patriot system is designed to intercept aircraft or missiles. NATO says the measure is purely defensive, but Russia, Syria and Iran have criticized the decision, saying it increases regional instability.

(Reporting by Phil Stewart; Editing by Nick Tattersall; Editing by Janet Lawrence)

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Afghan suicide bomber wounds 14 in Kandahar attack

KANDAHAR, Afghanistan (AP) — An Afghan official says a suicide bomber on a motorcycle has wounded three NATO troops and 11 civilians in an attack against the main gate of Kandahar Airfield, the main U.S. military base in the south.

Javeed Faisal, who is a spokesman for the provincial governor, said the attack took place just after nightfall Thursday and targeted the gate that provides access to the military side of the city's airport.

Suicide attacks are not uncommon in Kandahar, the birthplace of the Taliban.

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iPad mini deemed a ‘game changer,’ outgrew Kindle Fire by nearly 50%

Smaller tablets in the 7-inch range have been on the market for more than two years now, but it looks like it took Apple (AAPL) just one month to vault to the top of the category. Mobile advertising firm Millennial Media recently published the findings of a study pitting the iPad mini against Amazon’s (AMZN) popular Kindle Fire, which has been an extremely popular iPad alternative since it first launched last year. According to Millennial, iPad mini usage grew about 50% faster during early November than the Kindle Fire did immediately following its successful launch last year, as measured by ad impressions served by the firm’s network.

Millennial found that impressions served to the iPad mini in early November grew at an average daily rate of 28%. In the weeks following the Kindle Fire’s launch last year, usage of Amazon’s tablet grew roughly 19% each day.

“In the first weeks after the iPad mini went on sale, we saw an average daily growth in impressions of 28 percent. Last holiday season, Amazon launched the Kindle Fire to much anticipation, Millennial Media’s Matt Mills wrote on the company’s blog. “As a comparison, we saw Kindle Fire impressions grow at an average daily rate of 19 percent in the first two weeks after it went on sale last year. So, by our math it looks like Apple could have itself another massive holiday season.”

Mills called the iPad mini a “game changer” and said he expects “a massive amount” of iPad mini tablets to be given as gifts this holiday season.

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'Lincoln,' gets a leading 7 Globe nominations

BEVERLY HILLS, Calif. (AP) — Steven Spielberg is bringing new glory to Abraham Lincoln.

The Civil War epic "Lincoln" leads the Golden Globes with seven nominations, among them best drama, best director for Spielberg and acting honors for Daniel Day-Lewis, Sally Field and Tommy Lee Jones.

Tied for second-place Wednesday with five nominations, including best drama are the Iran hostage-crisis thriller "Argo" and the slave-turned-bounty-hunter tale "Django Unchained."

Other best-drama nominees are the shipwreck story "Life of Pi" and the Osama bin Laden manhunt thriller "Zero Dark Thirty."

Nominated for best musical or comedy were: the British retiree adventure "The Best Exotic Marigold Hotel"; the Victor Hugo musical "Les Miserables"; the first-love tale "Moonrise Kingdom"; the fishing romance "Salmon Fishing in the Yemen"; and the lost-soul romance "Silver Linings Playbook.

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Dozens sue pharmacy, but compensation uncertain

NASHVILLE, Tenn. (AP) — Dennis O'Brien rubs his head as he details ailments triggered by the fungal meningitis he developed after a series of steroid shots in his neck: nausea, vomiting, dizziness, drowsiness, blurred vision, exhaustion and trouble with his speech and attention.

He estimates the disease has cost him and his wife thousands of dollars in out-of-pocket expenses and her lost wages, including time spent on 6-hour round trip weekly visits to the hospital. They've filed a lawsuit seeking $4 million in damages from the Massachusetts pharmacy that supplied the steroid injections, but it could take years for them to get any money back and they may never get enough to cover their expenses. The same is true for dozens of others who have sued the New England Compounding Center.

"I don't have a life anymore. My life is a meningitis life," the 59-year-old former school teacher said, adding that he's grateful he survived.

His is one of at least 50 federal lawsuits in nine states that have been filed against NECC, and more are being filed in state courts every day. More than 500 people have gotten sick after receiving injections prepared by the pharmacy.

The lawsuits allege that NECC negligently produced a defective and dangerous product and seek millions to repay families for the death of spouses, physically painful recoveries, lost wages and mental and emotional suffering. Thirty-seven people have died in the outbreak.

"The truth is the chance of recovering damages from NECC is extremely low," said John Day, a Nashville attorney who represents several patients who have been sickened by fungal meningitis.

To streamline the process, attorneys on both sides are asking to have a single judge preside over the pretrial and discovery phases for all of the federal lawsuits.

This approach, called multidistrict litigation, would prevent inconsistent pretrial rulings and conserve resources of all parties. But unlike a class-action case, those lawsuits would eventually be returned to judges in their original district for trial, according to Brian Fitzpatrick, a law professor at Vanderbilt University Law School in Nashville.

Even with this approach, Fitzpatrick noted that federal litigation is very slow, and gathering all the evidence, records and depositions during the discovery phase could take months or years.

"Most of the time what happens is once they are consolidated for pretrial proceedings, there is a settlement, a global settlement between all the lawyers and the defendants before anything is shipped back for trial," he said.

A lawyer representing NECC, Frederick H. Fern, described the consolidation process as an important step.

"A Boston venue is probably the best scenario," Fern said in an email. "That's where the parties, witnesses and documents are located, and where the acts subject to these complaints occurred."

Complicating efforts to recover damages, attorneys for the patients said, NECC is a small private company that has now recalled all its products and laid off its workers. The company's pharmacy licenses have been surrendered, and it's unclear whether NECC had adequate liability insurance.

Fern said NECC has insurance, but they were still determining what the policy covers.

But Day says, "It's clear to me that at the end of the day, NECC is not going to have sufficient assets to compensate any of these people, not even 1 percent."

As a result, many attorneys are seeking compensation from other parties. Among the additional defendants named in lawsuits are NECC pharmacist and co-founder Barry Cadden; co-founder Greg Conigliaro; sister company Ameridose and its marketing and support arm, Medical Sales Management.

Founded in 2006 by Cadden and Conigliaro, Ameridose would eventually report annual revenue of $100 million. An NECC spokesman didn't respond to a request for the pharmacy's revenue.

While Federal Drug Administration regulators have also found contamination issues at Westborough, Mass.-based Ameridose, the FDA has said it has not connected Ameridose drugs to infection or illness.

Under tort law, a lawsuit has to prove a defendant has a potential liability, which in this case could be anyone involved in the medical procedure. However, any such suit could take years and ultimately may not be successful.

"I would not be surprised if doctors, hospitals, people that actually injected the drugs, the people that bought the drugs from the compounding company, many of those people will also be sued," said Fitzpatrick.

Plaintiffs' attorneys said they're considering that option but want more information on the relationships between the compounding pharmacy and the hundreds of hospitals and clinics that received its products.

Day, the attorney in Tennessee, said the clinics and doctors that purchase their drugs from compounding pharmacies or manufacturers could be held liable for negligence because they are in a better position to determine the safety of the medicine than the patients.

"Did they use due care in determining from whom to buy these drugs?" Day said.

Terry Dawes, a Michigan attorney who has filed at least 10 federal lawsuits in the case, said in traditional product liability cases, a pharmaceutical distributor could be liable.

"We are looking at any conceivable sources of recovery for our clients including pharmaceutical supply places that may have dealt with this company in the past," he said.

Ten years ago, seven fungal meningitis illnesses and deaths were linked to injectable steroid from a South Carolina compounding pharmacy. That resulted in fewer than a dozen lawsuits, a scale much smaller than the litigations mounting up against NECC.

Two companies that insured the South Carolina pharmacy and its operators tried unsuccessfully to deny payouts. An appellate court ruled against their argument that the pharmacy willfully violated state regulations by making multiple vials of the drug without specific prescriptions, but the opinion was unpublished and doesn't set a precedent for the current litigation.

The lawsuits represent a way for patients and their families recover expenses, but also to hold the pharmacy and others accountable for the incalculable emotional and physical toll of the disease.

A binder of snapshots shows what life is like in the O'Briens' rural Fentress County, Tenn., home: Dennis hooked up to an IV, Dennis in an antibiotics stupor, bruises on his body from injections and blood tests. He's had three spinal taps. His 11-day stay in the hospital cost over $100,000, which was covered by health insurance.

His wife said she sometimes quietly checks at night to see whether her husband of 35 years is still breathing.

"In my mind, I thought we were going to fight this and get over it. But we are not ever going to get over it," said Kaye O'Brien.

Marjorie Norwood, a 59-year-old grandmother of three who lives in Ethridge, Tenn., has spent just shy of two months total in the hospital in Nashville battling fungal meningitis after receiving a steroid injection in her back. She was allowed to come home for almost a week around Thanksgiving, but was readmitted after her symptoms worsened.

Family members are still dealing with much uncertainty about her recovery, but they have not filed a lawsuit, said their attorney Mark Chalos. He said Norwood will likely be sent to a rehabilitation facility after her second stay in the hospital rather than return home again.

Marjorie Norwood's husband, an autoworker, has taken time off work to care for her and they depend on his income and insurance.

"It doesn't just change her life, it changes everyone else's life around her because we care about her and want her to be happy and well and have everything that she needs," said her daughter, Melanie Norwood.

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McAfee returns to U.S., admits to playing the 'crazy card'

John McAfee's month-long international run from police through two Central American nations ended with a flight to Miami, where the businessman who says he abandoned his fortune admitted to playing the "crazy card."

As a gaggle of media waited near several exit doors at the airport Wednesday night, federal authorities whisked the founder of McAfee anti-virus software off the plane and into a van.

"They said, 'Mr. McAfee, please step forward,'" McAfee, 67, later told ABC News exclusively overnight at a Miami Beach hotel. "I was met by a dozen or maybe fewer officers. I said, 'Am I arrested?' They said, 'No, sir, I am here to help you.' That felt the best of all."

He eventually snuck out of the airport in a cab and headed to South Beach. After walking down famed Ocean Drive to the bewilderment of tourists and eating sushi, his first meal in three days, he sat down with ABC News and admitted to playing the "crazy card" and says he is broke.

"I have nothing now," McAfee said. He claims he left everything behind in Belize, including $20 million in investments and about 15 properties. "I've got a pair of clothes and shoes, my friend dropped off some cash."

Just hours earlier, the self-made millionaire was deported by Guatemalan police who forced him aboard his U.S.-bound flight away from the home and the two women he said he loves. After he arrived on South Beach, he said, a mysterious "Canadian friend" ordered another man he'd never met to drop off a wad of fresh $5 bills that McAfee later displayed to ABC News, pulling them from his coat pocket.

He says he left his fortune, including a beachfront compound, behind after his neighbor Greg Faull was found shot to death in Belize on Nov. 10.

Belize officials said he isn't a suspect, but when they asked to question him, McAfee disguised himself and ran.

After three weeks ducking authorities in Belize, by hiding in attics, in the jungle and in dingy hotels, he turned up in Guatemala Dec. 3.

Barely a day later he was detained for entering the country illegally. As Guatemala officials grappled with how to handle his request for asylum and the Belize government's demand for his deportation, McAfee fell ill. The mysterious illness, described by his attorney alternately as a heart ailment or a nervous breakdown, led to a scene with reporters chasing his ambulance down the narrow streets of Guatemala City and right into the emergency room, where McAfee appeared unresponsive.

He now says it was all a ruse:
"It was a deception but who did it hurt? I look pretty healthy, don't I?"

He says he faked the illness in order to buy some time for a judge to hear his case and stay his deportation to Belize, a government he believes wants him dead. When asked whether he believes Belize officials where inept, he didn't mince words.

"I was on the run with a 20-year-old girl for three and a half weeks inside their borders and everyone was looking for me, and they did not catch me," he said. "I escaped, was captured and they tried to send me back. Now I'm sitting in Miami. There had to be some ineptness."

The man who many believe only wants attention answered critics who called his month-long odyssey and blog posts a publicity stunt by simply saying, "What's a better story, millionaire mad man on the run. You [the media] saved my ass. Because you paid attention to the story. As long as you are reporting, it is hard to whack somebody that the world is watching."

He denies any involvement in his neighbor's death but adds that he is not particularly concerned about clearing his name. He is focused on getting his 20-year-old and 17-year-old girlfriends out of Belize and says he has no idea what he'll do next, where he'll live or how he'll support himself.

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Panetta in Afghanistan to meet with Karzai

KABUL, Afghanistan (AP) — U.S. Defense Secretary Leon Panetta, who has flown to Afghanistan for talks with President Hamid Karzai, says President Barack Obama will decide in the next few weeks how many U.S. troops will after the combat mission ends there.

Panetta arrived Wednesday on an unannounced visit to Kabul to consult with top military commanders as well as confer with Karzai.

The visit comes at a difficult juncture in the Western coalition's efforts to shift more security responsibilities to Afghan forces so the combat mission can end in December 2014.

While security has generally improved lately, the Afghan government's ability to effectively govern and to root out corruption is in great doubt. Peace talks with the Taliban are on a back burner.

Speaking to reporters earlier Wednesday in Kuwait, Panetta did not reveal what options Obama is considering, but officials have said he may settle on a figure between 6,000 and 10,000 troops. There currently are about 66,000 U.S. troops in Afghanistan.

The post-2014 mission is expected to focus on counterterrorism and advising Afghan security forces.

Before flying to Afghanistan, Panetta spoke to about 100 U.S. service members inside an aircraft hangar at a desert base west of Kuwait City. He thanked them for their service and emphasized that the U.S. is winding down its involvement in lengthy wars.

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Indian sitar virtuoso Ravi Shankar dies at 92

NEW DELHI (AP) — With an instrument perplexing to most Westerners, Ravi Shankar helped connect the world through music. The sitar virtuoso hobnobbed with the Beatles, became a hippie musical icon and spearheaded the first rock benefit concert as he introduced traditional Indian ragas to Western audiences over nearly a century.

From George Harrison to John Coltrane, from Yehudi Menuhin to David Crosby, his connections reflected music's universality, though a gap persisted between Shankar and many Western fans. Sometimes they mistook tuning for tunes, while he stood aghast at displays like Jimi Hendrix's burning guitar.

Shankar died Tuesday at age 92. A statement on his website said he died in San Diego, near his Southern California home with his wife and a daughter by his side. The musician's foundation issued a statement saying that he had suffered upper respiratory and heart problems and had undergone heart-valve replacement surgery last week.

Indian Prime Minister Manmohan Singh also confirmed Shankar's death and called him a "national treasure."

Labeled "the godfather of world music" by Harrison, Shankar helped millions of classical, jazz and rock lovers discover the centuries-old traditions of Indian music.

"He was legend of legends," Shivkumar Sharma, a noted santoor player who performed with Shankar, told Indian media. "Indian classical was not at all known in the Western world. He was the musician who had that training ... the ability to communicate with the Western audience."

He also pioneered the concept of the rock benefit with the 1971 Concert For Bangladesh. To later generations, he was known as the estranged father of popular American singer Norah Jones.

His last musical performance was with his other daughter, sitarist Anoushka Shankar Wright, on Nov. 4 in Long Beach, California; his foundation said it was to celebrate his 10th decade of creating music. The multiple Grammy winner learned that he had again been nominated for the award the night before his surgery.

"It's one of the biggest losses for the music world," said Kartic Seshadri, a Shankar protege, sitar virtuoso and music professor at the University of California, San Diego. "There's nothing more to be said."

As early as the 1950s, Shankar began collaborating with and teaching some of the greats of Western music, including violinist Menuhin and jazz saxophonist Coltrane. He played well-received shows in concert halls in Europe and the United States, but faced a constant struggle to bridge the musical gap between the West and the East.

Describing an early Shankar tour in 1957, Time magazine said. "U.S. audiences were receptive but occasionally puzzled."

His close relationship with Harrison, the Beatles lead guitarist, shot Shankar to global stardom in the 1960s.

Harrison had grown fascinated with the sitar, a long-necked string instrument that uses a bulbous gourd for its resonating chamber and resembles a giant lute. He played the instrument, with a Western tuning, on the song "Norwegian Wood," but soon sought out Shankar, already a musical icon in India, to teach him to play it properly.

The pair spent weeks together, starting the lessons at Harrison's house in England and then moving to a houseboat in Kashmir and later to California.

Gaining confidence with the complex instrument, Harrison recorded the Indian-inspired song "Love You To" on the Beatles' "Revolver," helping spark the raga-rock phase of 60s music and drawing increasing attention to Shankar and his work.

Shankar's popularity exploded, and he soon found himself playing on bills with some of the top rock musicians of the era. He played a four-hour set at the Monterey Pop Festival and the opening day of Woodstock.

Though the audience for his music had hugely expanded, Shankar, a serious, disciplined traditionalist who had played Carnegie Hall, chafed against the drug use and rebelliousness of the hippie culture.

"I was shocked to see people dressing so flamboyantly. They were all stoned. To me, it was a new world," Shankar told Rolling Stone of the Monterey festival.

While he enjoyed Otis Redding and the Mamas and the Papas at the festival, he was horrified when Hendrix lit his guitar on fire.

"That was too much for me. In our culture, we have such respect for musical instruments, they are like part of God," he said.

In 1971, moved by the plight of millions of refugees fleeing into India to escape the war in Bangladesh, Shankar reached out to Harrison to see what they could do to help.

In what Shankar later described as "one of the most moving and intense musical experiences of the century," the pair organized two benefit concerts at Madison Square Garden that included Eric Clapton, Bob Dylan and Ringo Starr.

The concert, which spawned an album and a film, raised millions of dollars for UNICEF and inspired other rock benefits, including the 1985 Live Aid concert to raise funds for famine relief in Ethiopia and the 2010 Hope For Haiti Now telethon.

Ravindra Shankar Chowdhury was born April 7, 1920, in the Indian city of Varanasi.

At the age of 10, he moved to Paris to join the world famous dance troupe of his brother Uday. Over the next eight years, Shankar traveled with the troupe across Europe, America and Asia, and later credited his early immersion in foreign cultures with making him such an effective ambassador for Indian music.

During one tour, renowned musician Baba Allaudin Khan joined the troupe, took Shankar under his wing and eventually became his teacher through 7 1/2 years of isolated, rigorous study of the sitar.

"Khan told me you have to leave everything else and do one thing properly," Shankar told The Associated Press.

In the 1950s, Shankar began gaining fame throughout India. He held the influential position of music director for All India Radio in New Delhi and wrote the scores for several popular films. He began writing compositions for orchestras, blending clarinets and other foreign instruments into traditional Indian music.

And he became a de facto tutor for Westerners fascinated by India's musical traditions.

He gave lessons to Coltrane, who named his son Ravi in Shankar's honor, and became close friends with Menuhin, recording the acclaimed "West Meets East" album with him. He also collaborated with flutist Jean Pierre Rampal, composer Philip Glass and conductors Andre Previn and Zubin Mehta.

"Any player on any instrument with any ears would be deeply moved by Ravi Shankar. If you love music, it would be impossible not to be," singer Crosby, whose band The Byrds was inspired by Shankar's music, said in the book "The Dawn of Indian Music in the West: Bhairavi."

Shankar's personal life, however, was more complex.

His 1941 marriage to Baba Allaudin Khan's daughter, Annapurna Devi, ended in divorce. Though he had a decades-long relationship with dancer Kamala Shastri that ended in 1981, he had relationships with several other women in the 1970s.

In 1979, he fathered Norah Jones with New York concert promoter Sue Jones, and in 1981, Sukanya Rajan, who played the tanpura at his concerts, gave birth to his daughter Anoushka.

He grew estranged from Sue Jones in the 80s and didn't see Norah for a decade, though they later re-established contact.

He married Rajan in 1989 and trained young Anoushka as his heir on the sitar. In recent years, father and daughter toured the world together.

The statement she and her mother released said, "Although it is a time for sorrow and sadness, it is also a time for all of us to give thanks and to be grateful that we were able to have him as part of our lives."

When Jones shot to stardom and won five Grammy awards in 2003, Anoushka Shankar was nominated for a Grammy of her own.

Shankar himself won three Grammy awards and was nominated for an Oscar for his musical score for the movie "Gandhi." His album "The Living Room Sessions, Part 1" earned him his latest Grammy nomination, for best world music album.

Despite his fame, numerous albums and decades of world tours, Shankar's music remained a riddle to many Western ears.

Shankar was amused after he and colleague Ustad Ali Akbar Khan were greeted with admiring applause when they opened the Concert for Bangladesh by twanging their sitar and sarod for a minute and a half.

"If you like our tuning so much, I hope you will enjoy the playing more," he told the confused crowd, and then launched into his set.

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Nessman reported from Bangkok. Associated Press writer Julie Watson in San Diego contributed to this report.

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DA investigating Texas' troubled $3B cancer agency

AUSTIN, Texas (AP) — Turmoil surrounding an unprecedented $3 billion cancer-fighting effort in Texas worsened Tuesday when its executive director offered his resignation and the state's chief public corruption prosecutor announced an investigation into the beleaguered agency.

No specific criminal allegations are driving the latest probe into the Cancer Prevention and Research Institute of Texas, said Gregg Cox, director of the Travis County district attorney's public integrity unit. But his influential office opened a case only weeks after the embattled agency disclosed that an $11 million grant to a private company bypassed review.

That award is the latest trouble in a tumultuous year for CPRIT, which controls the nation's second-largest pot of cancer research dollars. Amid the mounting problems, the agency announced Tuesday that Executive Director Bill Gimson had submitted his letter of resignation.

"Unfortunately, I have also been placed in a situation where I feel I can no longer be effective," Gimson wrote in a letter dated Monday.

Gimson said the troubles have resulted in "wasted efforts expended in low value activities" at the agency, instead of a focused fight against cancer. Gimson offered to stay on until January, and the agency's board must still approve his request to step down.

His departure would complete a remarkable house-cleaning at CPRIT in a span of just eight months. It began in May, when Dr. Alfred Gilman resigned as chief science officer in protest over a different grant that the Nobel laureate wanted approved by a panel of scientists. He warned it would be "the bomb that destroys CPRIT."

Gilman was followed by Chief Commercialization Officer Jerry Cobbs, whose resignation in November came after an internal audit showed Cobbs included an $11 million proposal in a funding slate without a required outside review of the project's merits. The lucrative grant was given to Dallas-based Peloton Therapeutics, a biomedical startup.

Gimson chalked up Peloton's award to an honest mistake and has said that, to his knowledge, no one associated with CPRIT stood to benefit financially from the company receiving the taxpayer funds. That hasn't satisfied some members of the agency's governing board, who called last week for more assurances that no one personally profited.

Cox said he has been following the agency's problems and his office received a number of concerned phone calls. His department in Austin is charged with prosecuting crimes related to government officials; his most famous cases include winning a conviction against former U.S. House Majority Leader Tom DeLay in 2010 on money laundering charges.

"We have to gather the facts and figure what, if any, crime occurred so that (the investigation) can be focused more," Cox said.

Gimson's resignation letter was dated the same day the Texas attorney general's office also announced its investigation of the agency. Cox said his department would work cooperatively with state investigators, but he made clear the probes would be separate.

Peloton's award marks the second time this year that a lucrative taxpayer-funded grant authorized by CPRIT instigated backlash and raised questions about oversight. The first involved the $20 million grant to M.D. Anderson Cancer Center in Houston that Gilman described as a thin proposal that should have first been scrutinized by an outside panel of scientific peer-reviewers, even though none was required under the agency's rules.

Dozens of the nation's top scientists agreed. They resigned en masse from the agency's peer-review panels along with Gilman. Some accused the agency of "hucksterism" and charting a politically-driven path that was putting commercial product-development above science.

The latest shake-up at CPRIT caught Gilman's successor off-guard. Dr. Margaret Kripke, who was introduced to reporters Tuesday, acknowledged that she wasn't even sure who she would be answering to now that Gimson was stepping down. She said that although she wasn't with the agency when her predecessor announced his resignation, she was aware of the concerns and allegations.

"I don't think people would resign frivolously, so there must be some substance to those concerns," Kripke said.

Kripke also acknowledged the challenge of restocking the peer-review panels after the agency's credibility was so publicly smeared by some of the country's top scientists. She said she took the job because she felt the agency's mission and potential was too important to lose.

Only the National Institutes of Health doles out more cancer research dollars than CPRIT, which has awarded more than $700 million so far.

Gov. Rick Perry told reporters in Houston on Tuesday that he wasn't previously aware of the resignation but said Gimson's decision to step down was his own.

Joining the mounting criticism of CPRIT is the woman credited with brainstorming the idea for the agency in the first place. Cathy Bonner, who served under former Texas Gov. Ann Richards, teamed with cancer survivor Lance Armstrong in selling Texas voters in 2007 on a constitutional amendment to create an unprecedented state-run effort to finance a war on disease.

Now Bonner says politics have sullied an agency that she said was built to fund research, not subsidize private companies.

"There appears to be a cover-up going on," Bonner said.

Peloton has declined comment about its award and has referred questions to CPRIT. The agency has said the company wasn't aware that its application was never scrutinized by an outside panel, as required under agency rules.

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Follow Paul J. Weber on Twitter: www.twitter.com/pauljweber

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