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National
Vaping deaths: What we know about the vaping-linked disease
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Vaping deaths: What we know about the vaping-linked disease

Vaping and health risks – What you need to know

Vaping deaths: What we know about the vaping-linked disease

A sixth person has died in the United States from what health officials say is lung disease brought on by using electronic cigarettes.

Kansas Department of Health officials on Tuesday confirmed the sixth death, saying the person had a “history of underlying health issues and was hospitalized with symptoms that progressed rapidly.”

>> Read more trending news 

The person, who was not identified, had a history of using electronic cigarettes, or “vaping,” officials said.

National health authorities are cautioning those who use e-cigarettes about an illness that has sickened hundreds across the country and has been linked to the six deaths.

>> Government will propose banning flavors used in e-cigarettes

The illness, the Centers for Disease Control and Prevention and others warned, seems to have a direct link to the use of e-cigarettes and is being seen more in those using a cannabis solution in those products.

Here’s a look at what health officials are seeing, and what some think may be contributing factors to the serious illness.

How do e-cigarettes work?

An electronic cigarette, or e-cigarette, is actually a battery-powered vaporizer. The person using the e-cigarette inhales a mixture of nicotine, solvents, flavors and water that is super-heated to create a vapor.

Electronic cigarettes have been marketed as a way to help smokers quit smoking cigarettes. However, the Federal Drug Administration, the agency that regulates e-cigarettes as tobacco products, has not approved them for smoking cessation.

How many deaths have been linked to vaping? When and where?

The first reported death from a vaping-related illness was reported on Aug. 23 in Illinois. Oregon officials announced last week that a second death linked to vaping had occurred. Three more deaths were then reported in Indiana, Minnesota, California, and on Tuesday, the sixth death linked to vaping was reported out of Kansas.

Where is it happening?

Numbers on the cases of the lung disease from the CDC:
Cases:

  • As of Sept. 6, more than 450 possible cases of lung illness associated with the use of e-cigarette products have been reported to the CDC from the following 33 states and one U.S. territory: AR, CA, CO, CT, DE, FL, GA, IA, IL, IN, KS, KY, LA, MD, MI, MN, MT, NC, NE, NJ, NM, NY, OH, OR, PA, SC, TN, TX, UT, VA, VT, WI, WV, and the U.S. Virgin Islands. 
  • Five deaths have been confirmed in California, Illinois, Indiana, Minnesota, and Oregon. A sixth death was confirmed Tuesday by Kansas Health Care officials.

Causes:

  • No evidence of infectious diseases has been identified; therefore lung illnesses are likely associated with a chemical exposure. Initial published reports from the investigation point to clinical similarities among cases. Patients report e-cigarette use and similar symptoms and clinical findings. These align with the CDC health advisory released Aug. 30.
  • The investigation has not identified any specific substance or e-cigarette product that is linked to all cases. Many patients report using e-cigarette products with liquids that contain cannabinoid products, such as tetrahydrocannabinol (THC).
  • These investigations are ongoing. CDC will provide updates when more information is available.

What is causing it?

Officials at the CDC, which is working with state health departments, say they do not know for sure what is causing the disease, but that everyone suffering from the disease that they know about has a history of using e-cigarette products.

“The focus of our investigation is narrowing, and that is great news, but we are still faced with complex questions in this outbreak that will take time to answer,” said Ileana Arias, CDC acting deputy director for noninfectious diseases.

Some believe there could be a link between the disease and the use of Vitamin E in the vaping solutions, particularly solutions that contain cannabis. Nearly 84 percent of patients reported using some kind of THC product. THC, tetrahydrocannabinol, is the active chemical in cannabis.

The New York State Health Department launched an investigation into the use of Vitamin E in vaping products. According to a press release from the department, laboratory test results “showed very high levels of vitamin E acetate in nearly all cannabis-containing samples analyzed by the Wadsworth Center as part of this investigation. … As a result, vitamin E acetate is now a key focus of the Department's investigation of potential causes of vaping-associated pulmonary illnesses. Vitamin E acetate is a commonly available nutritional supplement that is not known to cause harm when ingested as a vitamin supplement or applied to the skin. However, the Department continues to investigate its health effects when inhaled because its oil-like properties could be associated with the observed symptoms.”

The FDA has not said that Vitamin E is definitely the cause of the disease, and has not eliminated other chemicals used in vaping.

“We’re all wondering if this is new or just newly recognized,” the CDC’s Dana Meaney-Delman said Friday.

If Vitamin E is the problem, how is it causing the illness?

Some believe that the oil in Vitamin E or perhaps a thickener in the vaping solution could be triggering the problem.

According to Michelle Francl, a chemistry professor at Bryn Mawr College, vitamin E acetate becomes a vapor when it is heated, but when it cools, Francl told The Washington Post, it returns to its original state.

The compound returns to an oil form when it reaches the lungs, Francl explained, where it can cause the problems being seen across the country.

Once the oil is heated hot enough to vaporize, it can potentially decompose, and “now you’re breathing in who-knows-what,” Francl said.

Dr. J. Taylor Hays, director of the Nicotine Dependence Center at Mayo Clinic, is also warning that vaping includes chemicals, not just water.

"The key thing for people to know is vaping is not water vapor. It is a complex solution of chemicals that have been changed from their original state because they’ve been heated to high temperatures. And although these components are considered safe for ingestion, the flavorings, like cinnamon, the vehicles, like vegetable glycerin, they are not safe for heating and inhaling because the chemical constituents have changed."

What are the symptoms of the pulmonary disease believed linked to vaping?

According to the CDC:

Patients in the CDC investigation have reported symptoms such as:

  • cough, shortness of breath or chest pain
  • nausea, vomiting, diarrhea
  • fatigue, fever, weight loss

Some patients have reported that their symptoms developed over a few days, while others have reported that their symptoms developed over several weeks. A pulmonary infection does not appear to be causing the symptoms, which have generally not improved with antibiotic treatment alone.

What are health care officials, others doing?

The CDC has told doctors to ask patients about e-cigarettes.

The American Medical Association has urged the public to avoid the use of e-cigarette products until a cause of the outbreak of pulmonary disease is discovered.

"The AMA recommends anyone who has recently used e-cigarette products to seek medical care promptly if they experience any adverse health effects, particularly coughing, shortness of breath or chest pain," Dr. Patrice Harris, the association's president, said in a written statement Monday.

The FDA has warned not to buy products “off the street.” 

Last week, Michigan banned flavored e-cigarettes.

Billionaire Michael Bloomberg’s Bloomberg Philanthropies announced Tuesday that it would spend $160 million over three years to try to ban flavored e-cigarettes.

“It is time to stop vaping,” Kansas Department of Health and Environment Secretary Dr. Lee Norman said in a statement. “If you or a loved one is vaping, please stop. The recent deaths across our country, combined with hundreds of reported lung injury cases, continue to intensify. I’m extremely alarmed for the health and safety of Kansans who are using vaping products and urge them to stop until we can determine the cause of vaping-related lung injuries and death.”

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The Latest Headlines You Need To Know

  • The man who helped bring the NBA's Magic to Orlando is leading an effort to do the same thing with professional baseball. During a news conference at Dubsdread Golf Course Wednesday, Orlando Magic co-founder Pat Williams said he wants a Major League Baseball expansion team to come to Orlando. He announced the team would be called the Orlando Dreamers.  In an Interview on Orlando's Evening News with Tony Marino,  Williams said from Walt Disney to John Young to thousands of people that move to Orlando each month, the city is about dreamers. 'We're the largest market that doesn't have a Major League Baseball team or an NFL team,' Williams said. He said that professional baseball has not worked well in Miami or Tampa but that he is convinced the Orlando market would be different.  Williams said he called the MLB commissioner’s office Wednesday and left a message about his plan. He encourage people to answer two simple questions at OrlandoDreamers.com, to help gauge interest.
  • The man whose toddler granddaughter plummeted from a cruise ship window in Puerto Rico this summer appeared in court Wednesday with an attorney and translator present. According to CBS News, no evidence was released. The court is expected to pick a trial date on Dec. 17.  >> Read more trending news  Puerto Rican authorities charged Salvatore Anello, 50, was charged in October with negligent homicide in the July 7 death of 18-month-old Chloe Wiegand of Granger, Indiana. A judge set Anello's bond at $80,000. Chloe and her family were aboard Royal Caribbean's Freedom of the Seas when Anello placed her on a railing by an 11th-floor window, believing glass would be behind her, he told authorities. But the window was open, and Chloe fell through, the Sun Sentinel reported. The girl struck a concrete dock and died, officials said. The Wiegand family's attorney, Michael Winkleman, blasted the charges and said Royal Caribbean should have 'followed proper safety guidelines for windows,' NBC News reported. 'These criminal charges are pouring salt on the open wounds of this grieving family,' he told the news outlet. 'Clearly, this was a tragic accident, and the family's singular goal remains for something like this to never happen again.' In a July 22 interview with 'Today,' Chloe's mother, Kimberly Wiegand, said she and her husband, South Bend police Officer Alan Wiegand, believed that Royal Caribbean had put their safety at risk. 'We obviously blame them for not having a safer situation on the 11th floor of that cruise ship,' she said at the time. 'There are a million things that could've been done to make that safer.' The family also was pursuing legal action against the cruise line, 'Today' reported. Royal Caribbean released a statement in July saying the company was 'deeply saddened by this incident, and our hearts go out to the family,' according to 'Today.
  • The kidnapping of an 8-year-old Texas girl that was captured by a doorbell camera in May is once again in the public eye, in large part due to body camera footage released Monday by police that depicts the girl’s equally dramatic rescue by officers. The video shows Fort Worth police officers rushing the room at WoodSpring Suites, located in the nearby suburb of Forest Hill, where kidnapper Michael Webb had taken the girl and sexually assaulted her. Webb, a homeless man who was convicted in September of kidnapping, was sentenced Thursday to life in federal prison with the possibility of parole, according to court records. U.S. Attorney Erin Nealy Cox, who prosecuted the case for the Northern District of Texas, said last week that it took jurors less than 10 minutes to find Webb, 51, guilty of snatching the girl from her mother’s arms around 6:38 p.m. May 18 as they took a walk in the Ryan Place neighborhood of Fort Worth. Officers found the girl about eight hours later, hidden in a plastic bin of dirty laundry in Webb’s hotel room. Cox said in a statement that federal prosecutors are grateful for the judge’s decision to sentence Webb to life in prison. “My hope is that this family and this community will find solace in knowing that he will never be able to harm another little child again,” Cox said. >> Read more trending news  Investigators credited civilians, one of whom was identified by ABC News as a pastor familiar with the child’s family, with first spotting Webb’s vehicle in the hotel parking lot and calling for help. “I’d like to give you all a hand, as citizens in this community, for pulling together the way you did,” Joel Fitzgerald, then the Fort Worth’s police chief, said at a news conference following the girl’s safe recovery. A Forest Hills police sergeant, Richardson Wolfe, was later fired for discounting those same civilians’ concerns, despite the fact that they were correct, Forest Hills police Chief Dan Dennis said in June. “They had located what was correctly the suspect’s vehicle. He basically discounted that,” Dennis said, according to the Fort Worth Star-Telegram. “He looked at the suspect vehicle as unrelated and essentially tried to talk them out of it being the right vehicle. “Fort Worth showed up and took that same evidence and, within minutes, was breaching the door.” Wolfe also failed to find the girl when he searched Webb’s hotel room more than two hours before her rescue. The sergeant was called to the scene after someone who noticed Webb -- and the young victim -- at the hotel called the front desk and told the clerk they thought he was the man being sought by Fort Worth authorities. The clerk, who called police, pointed Wolfe and another officer to Webb’s third-floor room, the Star-Telegram reported. After officers knocked for several minutes, Webb eventually opened the door. “Michael Webb was less than cooperative, but after several minutes, the officers were permitted to step into the room and look,” according to a statement to the Star-Telegram. “Upon entry into the room, the officers made visual inspection of the areas of the room that appeared to be large enough to conceal the missing child. They did not locate any other occupants inside the room. “With no one located and no other information available, the officers cleared the scene.” Dennis said in June that Wolfe’s failure to find the girl during that first sweep of the room was not a factor in his termination, according to WFAA in Dallas. The search had been a reasonable one, the chief said. Instead, his termination stemmed from his response to the tip from the pastor, which the news station said Dennis described as “woefully incompetent” and displaying “shocking ineptitude.” Forest Hills officers, including Wolfe, were the first to return to the hotel shortly after 2 a.m. after receiving the tip about Webb’s car in the parking lot. Fort Worth officers arrived about six minutes later and took over, since the kidnapping took place in their jurisdiction. “The child was located with Michael Webb a short time later,” the release to the newspaper said. Dennis said Wolfe could not remain on the force after his handling of the tip that led to the girl’s rescue. “After looking at all of it, I wouldn’t have wanted him to respond to the call if it was my 8-year-old, so I can’t keep him on staff,” Dennis said. ‘We got her! We got her!’  The body camera footage released Monday shows the officers’ remarkable discovery. The video, which was obtained by multiple media outlets, begins with the officer wearing the camera racing toward the hotel in a police cruiser. As he approaches the scene, he does so without activating the car’s lights and sirens. His partner asks why. “If this guy’s looking out the windows, I’m not trying to let him see that we’re rolling around,” the officer responds. Once at the hotel, the officer is seen hurrying inside and asking a woman who appears to be a hotel housekeeper if she has the room information for Room 333, where Webb was staying. “I need it real fast,” he tells the woman, which sends her running into a small office, where she pulls Webb’s registration paperwork from a filing cabinet. The officer determines the man in the room matches the description of the wanted kidnapper. He takes the paperwork back outside, where some of his fellow officers are using flashlights to search the ground for clues. According to prosecutors, the officers had confirmed the presence in the parking lot of the car suspected in the abduction. Blood was visible on the front passenger seat, they said. The officer recording the search is seen handing a colleague the hotel paperwork, asking her to hold on to it. Meanwhile, other officers are already closing in on Webb upstairs. After obtaining a police shield, the officer with the body camera is seen running up several flights of stairs to the third floor, where a team waits outside Room 333. Webb and the girl are on the other side of the door. “Fort Worth PD, open the door,” an officer is heard calling as he knocks repeatedly, getting no answer. After several seconds, an officer gives the command, “Ram it.” As one officer kicks at the door and another readies a metal battering ram, Webb calls from the other side: “Hold on.” “Open the door! Open the door! Fort Worth Police Department! Open the door!” an officer yells. Webb doesn’t respond, so the officer with the ram begins striking the door. “Hold on, man, I’m getting dressed,” Webb calls. “Open the God-(expletive) door!” an officer yells back. The officer with the ram hits the door a fourth and final time as Webb tells officers he’s opening the door. “Hands. Let me see your hands,” an officer tells him as the door swings open. “Step out here. Step out.” “God (expletive),” Webb mutters, sounding annoyed, as the officers grab him and begin to pull him into the hallway, naked except for a pair of white socks. Two officers force him onto the ground and handcuff him as the rest swarm into the hotel room, guns drawn, in search of the girl. “Blood on the bed,” an officer notes as the beam of a police flashlight illuminates the room. A moment later, success. “Hey, here she is! Here she is!” an officer exclaims. The girl is seen rising from the plastic bin as the officer squats down to pick her up. Her small arms encircle his neck. “Got her! We got her! We got her!” another officer calls out in the video. Watch the footage below, courtesy of WFAA. Warning: The video may be difficult for some viewers. As the officers, out of breath but jubilant, radio in the news that the girl has been found and Webb is in custody, she is heard asking them about her clothes. “Don’t worry about your clothes,” an officer tells her. The officer wearing the body camera finds a towel to wrap around the girl. “Here you go, baby,” the officer says as he hands the towel to a colleague. They then head down the hotel stairwell with the girl. “Come here, sweetheart,” the officer says as he holds the door to the stairwell open. “You’re OK,” the officer carrying the girl says. “Yeah,” she responds. “You’re safe, we got you,” the officer continues as they begin their descent. “You’re going to be OK,” the officer filming the incident says. As they arrive in the parking lot of the hotel, the officers order two men in the parking lot to stand back. One of them is later identified as the girl’s father, who is on the phone telling someone where his daughter had been found. According to ABC News, the pastor who called in the tip about Webb’s car was also at the scene when the girl was brought out. A brazen daylight kidnapping  Officers wrapped Webb in a sheet and took him to the police station where, in a three-hour recorded statement, he admitted to kidnapping and raping the girl. According to the Star-Telegram, FBI Special Agent Chris Thompson and Fort Worth Police Detective Amy Heise asked Webb early in the interview if he knew why he was there. “A little girl,” he responded. “That little girl.” Webb initially lied to the investigators, claiming he’d been paid $1,000 by a man named Nick to abduct and sexually assault the 8-year-old, the newspaper reported. He came clean about two hours into the interview, telling Thompson and Heise they deserved the truth because they had “been nice to (him) considering what the (expletive) he did.” Crying at times, Webb told the investigators he arrived at the hotel with the girl around 8:30 p.m. after spending a couple of hours in the car in an empty church parking lot. He made her stay hidden on the front passenger floorboard of the vehicle, court records indicate. Webb admitted in his confession that he threatened the girl in an effort to keep her from telling police what he’d done to her. “What did you say to scare her, Michael?” Heise asks in the video. “I told her if she said anything, I would do something to her parents,” Webb says, sobbing. The girl told investigators that same threat is what kept her quiet the first time police showed up at the kidnapper’s hotel room looking for her. Webb’s federal public defender, John Stickney, attempted in September to get his confession thrown out, alleging that his client had not slept in three days and was not lucid enough the morning of May 19 to waive his right to speak without a lawyer present. Following a hearing that included testimony from Thompson, U.S. District Judge Reed O’Connor denied the motion, the Star-Telegram reported. During the trial, Webb’s lawyers did not cross-examine any of the prosecution’s witnesses or call any of their own. According to the newspaper, they urged jurors to ignore the emotions brought up by the testimony regarding the girl’s sexual assault. Stickney argued during his closing that the government failed to produce evidence that Webb was participating in interstate commerce during the crime, one of the elements that must be proven under the federal law against kidnapping. Court records in the case cite the hotel’s proximity to the interstate, making it a popular stopover for interstate travelers, as proof of that element of the kidnapping charge. Webb, who used Google maps on his cellphone to find the hotel, also drove along Interstate 35 and Interstate 20 to get there. “The cellphone, the internet and the interstate highways were used to facilitate and to further the commission of the offense because they helped Webb reach the hotel by the most direct route,” the documents say. The records and media reports describe how Webb, who was driving a gray Ford 500 registered to his mother, approached his victim and her mother twice as the pair walked along 6th Avenue in Fort Worth the evening of the abduction. According to the Star-Telegraph, the girl’s mother, who was not named to keep her daughter from being identified because of the sexual assault, testified at Webb’s September trial that he asked her upon his first approach if she wanted to get high. He also asked if she liked money, the woman said. Webb drove off but returned a short time later. That time, he got out of the car and grabbed her daughter, pushing the girl into the car through the driver’s door before climbing in after her. The girl’s mother tried to climb onto his lap to hit the brakes, but Webb was able to push her out of the car and speed away. In his confession, portions of which have been made public, Webb tells Thompson and Heise he “scoped (the neighborhood) out pretty good” in advance. Still, he said, he must have missed at least one witness. “When I pushed the woman and grabbed her, I heard somebody screaming. I heard somebody screaming,” Webb says in the video. That portion of the abduction was captured on a doorbell camera across the street from the scuffle. In the grainy footage, the girl’s mother can be seen falling to the asphalt as Webb drives off with her daughter. She gets up and runs down the street, screaming for help. “Help me! Help me, please!” the girl’s mother screams. “My daughter just got kidnapped!” Watch footage from the doorbell camera below, courtesy of ABC News. The homeowner of the home with the camera can be seen stopping in his yard and watching in alarm as the woman runs down the street. Webb’s car speeds off in the distance. The girl’s mother was equally frantic in her 911 call, which was obtained by ABC News. “A car, a gray car, just drove off. I think it was a handicap. He just kidnapped my daughter,” the panic-stricken woman tells the dispatcher. “He dragged me off the street and kidnapped my daughter.” The woman pleads with the dispatcher, describing the abductor as a scary man who had been harassing them. She says police need to find her daughter, now. “Please,” she tells the dispatcher. “I can’t let her be gone! Please!” A critical clue  Thompson, who works on the FBI’s Crimes Against Children and Human Trafficking Task Force, told ABC News the doorbell camera that caught the tail end of the abduction was a lucky break. The camera is not designed to record any random movement in the street, like a car driving past. It kicked on when the homeowner stepped outside. “The person who owned the home, essentially, accidentally activated the Ring doorbell at that time,” Thompson told the network. The footage, which gave investigators a look at the kidnapper’s vehicle, was crucial. “The Ring doorbell video was the only piece of video that was available for this particular case. It was absolutely critical,” the FBI agent said. The girl’s mother was also able to give detectives a description of the man who snatched her daughter. News of the abduction spread quickly through Fort Worth-area media, leading several members of the community to aid in the search for the missing girl. Heise, who led her department’s investigation, also reached out to the FBI and the Department of Homeland Security for assistance. Heise told ABC News each moment that went by without word of the girl’s whereabouts and safety felt heavy. “It felt like time was flying by and that I was moving so slow, and that I just could not move fast enough,” Heise told the network. “Because I knew we needed to move fast, and it just felt like I just couldn't get it done.” The detective said she was in a “state of shock” when she learned the girl had been found alive. “I was working as hard as I could to find this little girl, and I just couldn't believe that we had done it,” Heise said. “And in that moment, I just felt a great sense of gratitude to the community, because they did this. They did this. It wasn't us.” Matthew DeSarno, special agent in charge of the FBI’s Dallas field office, said following Webb’s September conviction that he was proud of the collaboration of all those involved in the case, including his agency’s Child Exploitation Task Force and the Fort Worth Police Department’s Major Case Unit Task Force. He also thanked the citizen volunteers, who he said “worked tirelessly” to help bring the victim home to her family. “The critical role volunteer searchers and other members of the public played in recovering the victim cannot be overstated, and the FBI is grateful for their assistance,” DeSarno said. Following Webb’s sentencing Thursday, DeSarno said law enforcement and area residents took a dangerous predator off the streets. “Today’s sentence sends an important message to all predators,” the agent said. “We will not allow any crime against children to go unpunished.”
  • When a red-tailed hawk became trapped in a net at Orlando’s Top Golf on Wednesday morning, firefighters decided to “wing it” and come up with a unique rescue plan. “It just goes to show that when our firefighters come to work, they don’t know what the day will bring,” said Mike Jachles with Orange County Fire and Rescue. Around 8 a.m. workers at Top Golf on Universal Blvd. noticed a hawk caught in a net about 50 feet up at the end of a driving range.  Orange County Fire and Rescue reached out to SeaWorld and the Orange County Convention Center to help in their operation. “The plan was devised to send some of the SeaWorld workers up in a lift that the Orange County Convention Center brought over,” Jachles said.  “They had to work for several minutes to free the hawk.  They got a hold on him, brought him down to the ground and got him in a cage.” Firefighters were waiting on the ground with a tarp as a backup plan in case the hawk fell, but it didn’t happen. “Fortunately it had a good outcome,” Jachles said. The red-tailed hawk was taken back to SeaWorld for their veterinarians to check out.  They told Jachles they’d give the bird fluids and eventually release it in the area from where it was rescued. “This is definitely one of the more peculiar animal rescue calls,” Jachles admitted. (App users tap here to see the video) (Tap here for video)
  • Committing fraud against a veteran could become an “aggravated” white-collar crime next year. Florida's Chief Financial Officer Jimmy Patronis announced his support of The Florida Veterans Protection Act at the University of Central Florida this morning. “When you take advantage of one of our veterans, we’re going to take the level of the law and make it as punitive as we can for those individuals,” Patronis said. The bill, filed in September, would enhance the sentence of a fraudster who victimizes 10 or more veterans to obtain $50,000 or more to a first-degree felony. If approved in January, the bill would become law on Oct. 1 2020.  Florida is home nearly 1.5 million veterans who, according to Patronis, are twice as likely to be the victim of fraud.

Washington Insider

  • Ambassador Gordon Sondland drew stern rebukes from Republican lawmakers on Wednesday as he told impeachment hearings that President Donald Trump's personal lawyer had made clear that in order for the new leader of Ukraine to get a White House meeting with the President, then Ukraine would have to announce investigations sought by Mr. Trump. 'Mr. Giuliani's requests were a quid pro quo,' Sondland said, as U.S. Ambassador to the European Union said it became clear to him that the President ultimately had been holding up military aid to Ukraine to leverage those same investigations as well. 'We did not want to work with Mr. Giuliani,' Sondland added. While Sondland repeatedly acknowledged that no one - including President Trump - had told him the aid for Ukraine was tied to any investigations wanted by Mr. Trump, the Ambassador said he ultimatley felt that was the bottom line. 'That was my presumption,' Sondland said. Seemingly caught off guard by Sondland's testimony - which more sharply alleged that there was a clear effort to condition aid to Ukraine for a series of investigations than his previous deposition testimony - Republicans ultimately took the gloves off, and took after the President's own ambassador. 'You really have no testimony today that ties President Trump to a scheme to withhold aid from Ukraine in exchange for these investigations,' said Rep. Mike Turner (R-OH). 'Other than my own presumption,' Sondland interjected, further aggravating Turner, his voice growing more strident by the minute. 'Do you know what hearsay evidence is ambassador?' Turner asked. 'Do you know what made up testimony is?' GOP lawmakers mocked Sondland's earlier statement that he presumed the aid-for-investigations effort was true, when he said he realized 'two plus two equals four.' 'Two presumptions plus two presumptions does not equal even one fact,' said Rep. Brad Wenstrup (R-OH). Earlier, GOP counsel Stephen Castor sought to undercut Sondland's testimony, rattling off a series of items which Sondland did not have to back up his presumption. 'You don't have records, you don't have notes, because you didn't take notes, you don't have a lot of recollections,' Castor said.  'I mean, this is like the trifecta of unreliability, isn't that true?' Castor asked, who did not gain the agreement of Sondland.  'What I'm trying to do today is use the information I have to be as forthcoming as possible,' said Sondland. Republicans also complained openly to Sondland about why he did not use a quote from the President - which Sondland had used in a text message - denying any kind of quid pro quo. 'Do you know what a quid pro quo is?' asked Rep. Jim Jordan (R-OH), who said Sondland should have made that one of the first items in his lengthy opening statement. Ironically, at the start of the hearing, the top Republican on the Intelligence Committee, Rep. Devin Nunes (R-CA), warned the Oregon hotel developer that he faced a difficult day. 'Ambassador Sondland, you are going to be smeared,' Nunes declared. But the roughest treatment for Sondland actually came from the GOP, and not from Democrats. Here is the link to my live updates on today's hearing.