On the evening of February 19, 1994, at 7:50 p.m., firefighters from Riverside, California, were called to the bedside of a woman in distress. Gloria Ramirez, 31, a mother of two, was recently diagnosed with terminal cervical cancer. In less than twenty-four hours, his death would become one of the most confusing medical cases in recent history, to the point that the American press nicknamed it “the toxic woman”says an article in Popular Mechanics.
Rushed to Riverside General Hospital, Gloria Ramirez presents classic symptoms of extreme emergency: violent nausea, vomiting, very rapid heart rate. The medical team applies standard protocols: sedation and medications intended to stabilize the heart. Everything seems to be going normally, until nurse Susan Kane inserts a urinary catheter and draws blood with a syringe.
Susan Kane first notices a distinct smell of ammonia coming from the tube. An intern, Julie Gorchynski, distinguishes curious pale yellow particles suspended in the patient’s blood. A few moments later, Susan Kane staggers and almost collapses, soon imitated by Julie Gorchynski, then by respiratory technician Maureen Welch, who ventilated the patient with a bag. Maureen Welch would later recount having lost all control of her limbs. As staff collapsed around her, Gloria Ramirez died, less than an hour after help arrived at her home.
A real medico-legal puzzle ensues when the teams take stock of this strange episode: 23 members of the hospital staff out of 37 presented symptoms – fainting, breathing difficulties, nausea, neurological disorders – after approaching the patient. The scale of the incident led the authorities to organize three successive autopsies in a specially equipped room, with full bodysuits and security procedures worthy of a disaster movie scenario.
A popular home remedy
Faced with this unexplained phenomenon, the California Department of Health first put forward the hypothesis of an episode of collective psychosis, triggered by fear and the unusual odor in the emergency room. A conclusion that several caregivers vigorously contest, given the severity of their symptoms. At the same time, Gloria Ramirez’s family points the finger at the hospital, recalling that inspections had already mentioned gas leaks coming up from the sewers into the emergency department.
Biological samples as well as the patient’s file are entrusted to the Lawrence Livermore National Laboratory (LLNL), a cutting-edge laboratory in California. The researchers put forward the following explanation: Gloria Ramirez would have used dimethyl sulfoxide (DMSO), a sulfur compound sold as a solvent or gel, which she would have applied to her skin to calm her pain. This use of a home remedy, common among cancer patients, could explain the oily film observed on his skin and the unusual odor reported by caregivers.
According to the scenario reconstructed by Livermore’s team, this DMSO would have accumulated in the blood of Gloria Ramirez. The oxygen administered by the paramedics would then have oxidized the compound to dimethylsulfone, a molecule known to crystallize at room temperature – crystals having actually been observed in the blood sampled.
Under certain conditions that are still poorly understood, part of this dimethylsulfone could have transformed into dimethylsulfate, a volatile nerve agent that is extremely dangerous at very low doses. By evaporating in the syringe or in contact with the air, it would have poisoned the personnel present in the room, causing a range of symptoms compatible with exposure to this type of substance.
However, many chemists remain skeptical, or even frankly critical. They point out that the transformation of DMSO into dimethyl sulfate requires conditions of temperature, concentration and catalysis that are not very compatible with the human body and an emergency room, and that the compound has never been directly detected in the samples analyzed. More than thirty years after the events, the scientific mystery remains unsolved.
