-old woman's breathing labored, with her body temperature at 106 degrees. She died soon after, one of three Lodi-area residents who succumbed to the heat Sunday at Lodi Memorial Hospital.

The other victims, also admitted with high core temperatures, were a 71-year-old man and a 95-year-old woman, hospital spokeswoman Carol Farron said. She did not identify the victims because of medical privacy laws. Two other patients admitted Sunday responded to treatment and were in intensive care Monday.

At least three more patients were at Lodi Memorial Hospital's emergency room Monday afternoon suffering from heat-related conditions, Farron said.

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"They're so swamped right now," Farron said. "They had more patients than they expected, and more of them were acute."

The San Joaquin County coroner released the identities Monday of two Stockton residents whose deaths Sunday are believed to have been heat-related, and authorities in Calaveras County are investigating whether one death there Sunday was heat-related.

Joan Southern, 79, a resident at Beverly Healthcare Center, 4545 Shelley Court in Stockton, died after being taken to San Joaquin General Hospital early Sunday with heat-related symptoms. State health officers are investigating her death.

Officials had ordered the evacuation Sunday of 103 residents of the center because of a failed air conditioning system.

Also Sunday, Erzo Ivy, 90, was found dead inside his sweltering home on the 1600 block of East Eighth Street.

Stockton police say heat was probably to blame, although there is no official cause of death. Ivy's home had no air conditioning, and there were no signs of foul play, Stockton police Officer Pete Smith said.

"It was very hot inside the house," Smith said.

The man who died in Calaveras County has not been identified. He was brought to Mark Twain St. Joseph's Hospital in San Andreas about 11:30 p.m. Sunday with symptoms of hyperthermia, or abnormally high body temperature. He died a short time later, hospital spokesman Larry Cornish said.

Dr. John Connolly at Lodi Memorial said the elderly are particularly susceptible to the heat, especially if they are taking medication or have a condition that makes them vulnerable to high temperatures.

That may have been a contributing cause in Horning's death.

Her brother, Erwin, said his sister suffered from diabetes.

Connolly said diabetics are prone to dehydration, which can be exacerbated by the heat. Internal temperatures higher than 103 degrees also can cause an internal chemical imbalance that leads to cell death, he said.

"A lot of the problems older folks have is because of the medicine they're on," Connolly said. "A lot of the drugs decrease sweating, and that's our major means for cooling."

Southern's death was the first heat-related fatality at a California nursing home in six years, according to Norma Arceo, a state Department of Heath Services spokeswoman.

"I'm in shock," said Pam Anderson, Southern's daughter, who said Southern moved to the nursing home in March.

Southern, a widow with rheumatoid arthritis, had been doing well since moving to the home, Anderson said. But Southern's opinion of the facility was mixed.

Main Street Manor resident Reba Kellum, 56, says she sleeps on the linoleum of her kitchenette at night, as it’s the only place to escape the sweltering heat of her home. In the daytime, Kellum said, the apartment can reach 90 degrees.

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"Some days she liked it; some days she didn't," Anderson said.

According to Arceo, the nursing home's staff failed to notify state officials of Southern's death and of the evacuation of its other residents within 24 hours. The Department of Health Services and Stockton police are investigating the incident.

Officials at Beverly Healthcare's corporate headquarters in Fort Smith, Ark., also are looking into what happened, spokeswoman Amy Knapp said.

Knapp said the air conditioning system didn't break down until approximately 3:30 a.m., 45 minutes after police received a call from San Joaquin General Hospital that two residents were taken there with heat-related symptoms.

She said police and fire crews "came in and made the decision that if the air conditioning system was not up and running, then an evacuation would need to take place. And we agreed with that."

An unknown number of the nursing home's residents were treated at hospitals for symptoms of heat exhaustion or dehydration before being transferred to other nursing homes.

A spokeswoman at St. Joseph's Medical Center in Stockton said nine Beverly residents were taken there. One was still there Monday, in stable condition, Jerri Randrup said.

Four Beverly residents were taken to Sutter Tracy Community Hospital and later were taken to Tracy Convalescent Hospital, Sutter emergency room manager Denise Drewry said.

"They were all very stable," Drewry said. "We fed them and cleaned them up."

Nursing homes in California aren't required to have air conditioning but must maintain "comfortable and safe temperature levels," according to state law. Arceo said the nursing home should have had a backup.

"When there is an air conditioning system, yes, a backup needs to be in place," she said. "This type of incident is one too many."

Main Street Manor, which offers low-income housing to seniors and disabled people, was another trouble spot in Stockton.

Reba Kellum, 56, said her top-floor studio apartment reaches 90 degrees in the daytime with the air conditioner running.

Her nights are spent sleeping on the cool linoleum of the kitchenette, the only place that the trickle of cool air slipping through the air conditioning vent could reach.

And that's an improvement. "There weren't nothing coming out of it last year," Kellum said.

Several inmates and two staff members at Deuel Vocational Institution near Tracy were taken to hospitals for symptoms related to heat exhaustion, although none of the cases was life-threatening, said Lt. Mike Quagliar, spokesman for the facility.

Quagliar said additional shower time, ice and hydration therapies are being used to cool prison inmates as much as possible.

Sunday's deaths prompted Lodi officials Monday to open a "community cooling center" through 8:30 p.m. Monday at Hutchins Street Square. It will reopen at 8:30 a.m. today.

Free transportation was made available Monday through Lodi Dial-A-Ride. The Loel Center, a private senior center in Lodi, offered a similar service at its South Washington Street building and plans to open to anyone seeking cool shelter today from 9 a.m. to 8:30 p.m.

"We're willing to take anybody," said Tracy Williams, the Loel Center's executive director. "They don't have to be a senior. I'm not going to turn anybody away."

Ann Areida-Hintz, Lodi's senior-services coordinator, said seniors left several voice messages on her phone over the weekend asking where they could go to escape the heat.

"We had chess players here on Thursday who said they didn't feel like playing chess, but they wanted to get out of the heat," Areida-Hintz said.

Dr. Karen Furst, public-health officer for San Joaquin County, said the official death toll from the heat wave will be determined by the number of death certificates that list heat as a cause of death.

Furst added that she was meeting with other county officials late Monday to consider ways to set up cooling centers like Lodi's.

"We're still in the middle of summer, and as everyone knows, extreme temperatures come as late as September and even October," Furst said. "For friends and family members or neighbors of people who live by themselves or are shut-ins, we need to be checking with those people and help get them someplace that is air conditioned and get them access to the fluids they need."

Record staff writers Rick Brewer, Warren Lutz and Dana Nichols contributed to this report.

Contact Lodi Bureau Chief Jeff Hood at (209) 367-7427 or jhood@recordnet.com