On the evening
of February 19, 1994, Gloria Ramirez, 34, was brought by paramedics
to the emergency room at Riverside (CA) General Hospital. Ramirez,
who some weeks earlier had been diagnosed with metastatic cervical
cancer, was admitted in respiratory and cardiac distress.
15 minutes after her arrival, she went into full cardiac arrest.
A nurse named Susan Kane drew blood, probably for an arterial
blood gas determination, as part of the routine 'code blue'
procedure of the hospital. Nurse Kane noted a 'foul odor'
and immediately passed out. Dr. Julie Gorchynski, the senior
medical resident, went to Nurse Kane's aid. After seeing
to her needs, Dr. Gorchynski noted a strange odor, 'took
a deep whiff' of the syringe and passed out. Four other
staff then passed out, all standing right next to each other.
The paramedics who rode in the ambulance to the hospital with
Ms. Ramirez and who remained in the room, as well as one nurse
and Dr. Humberto Ochoa, the director of the ER (who came as
soon as he heard staff were keeling over in the middle of a
code) all were unaffected.
cases have occurred where ER staff became ill from fumes emitted
by a patient, the hospital assumed that this was a case of toxic
contamination, sealed the ER, evacuated all patients and affected
staff (who by now numbered somewhere between 8 and 11, including
clerks) and brought in the County decontamination unit.
died in the ER, after the staff tried to resuscitate her for
about 35-45 minutes. The official cause of death was kidney
failure due to metastasized cancer. Her body was placed in a
sealed body bag and sent to the county coroner for autopsy in
a special sealed unit.
as the source of the mysterious fumes, Gloria Ramirez achieved
immortality as the "toxic lady."
hypotheses and lawsuits were to follow, but an explanation was
found--by no less than the famed Lawrence Livermore National
Laboratory--nearly nine months later. Naturally, the solution
to the mystery, not being nearly as exciting as stating the
mystery itself, was not well publicized. Dimethyl sulfate, which
is cited in scientific literature as a chemical warfare agent,
was created by an unusual confluence of chemical reactions.
It is believed
that Ramirez used DMSO (dimethyl sulfoxide) a sort of wonder
drug for relieving various arthritic aches and pains. DMSO is
metabolized to become dimethyl sulfone, which was found in her
system, likely produced by the administration of oxygen by paramedics.
drew blood from Ramirez in the emergency room, the relatively
sudden and sharp drop in the temperature of her blood--from
body temperature to the cool air of the hospital-- could have
created dimethyl sulfate, the lethal compound. Her body temperature
was too high to allow creation of the deadly compound internally.
at the time said they saw crystals in the syringe containing
Ramirez's blood, and scientists now believe those crystals
were the source of the mystery fumes.
of creating the lethal toxin from the benign dimethyl sulfone
was performed at Lawrence Livermore
noted that virtually every known side effect of dimethyl sulfate--short
of death--was exhibited by those who smelled Ramirez's blood.
Likewise, virtually every symptom displayed by the attendants
was consistent with exposure to the toxin.
can appear oily, which is consistent with the presence of an
"oily sheen" on Ramirez's body that some witnesses
said they saw.
of a patient, the poisoning of health care workers, and a prestigious
scientific inquiry. Just another day in the ER.