The Strange Case Of The Toxic Lady

At 8:15 PM local time on February 19, 1994, paramedics brought 31 year-old Gloria Ramirez to the emergency room at Riverside General Hospital in California, pictured below. While the medical professionals who worked on Ramirez did what they could to keep her alive, they were ultimately unsuccessful, and 45 minutes later, Ramirez, suffering from late stage cervical cancer, died. This is a story which, sadly, occurs daily in hospitals around the world.

rgh - the strange case of the toxic lady

But Ramirez's case was special. During her forty-five minutes in the ER, three of the people who worked on her ended up losing consciousness and passing out. In total, 23 of the 37 people working in the ER that night fell ill, to one degree or another, with five requiring hospitalization. The events were serious enough -- and scary enough -- to spur Riverside General to evacuate its ER into the parking lot.

The details show how quickly this all unfolded. Ramirez came into the ER disoriented from her disease with a slower than normal heartbeat and irregular breathing patterns -- at this point, all reasonable symptoms given her disease. She was given sedatives as doctors and nurses continued with varied treatment, including defibrillation. Along the way, the medical staff began to notice some odd details. Ramirez's body had a soft luster to it, as if she had a thin layer of oil on her skin. Her breath smelled garlicky. And when registered nurse Susan Kane went to draw blood from Ramirez, she noticed an ammonia-like smell coming from the tube.

Kane nevertheless drew blood from her patient and passed the vial onto Dr. Julie Gorchynski, who noticed another peculiarity -- the presence of manila specks in the blood. Before either could comment as to why it was there, Kane passed out. Gorchynski started to feel ill, and sat down -- and then she, too, fainted. Soon after, respiratory therapist Maureen Welch, who was also in the room (and per one report, also smelled the ammonia odor), also lost consciousness.

What was causing the fainting spells? At first, investigators called it a case of mass hysteria -- noting that not everyone was affected by the so-called Toxic Lady, and that those who were most seriously afected merely fainted. But that did not add up as other details came in. To start, Kane, being the first to pass out, could not have done so in reaction to the others losing consciousness. As for Dr. Gorchynski, she argued that, as applied to her at least, mass hysteria was the wrong answer: her history of being cool under pressure; the fact that she and others developed other physical ailments (such as avascular necrosis in her knee); and of course, the slew of odd things going on with Ramirez's body chemistry. And many others who fell ill did not have the same fainting spells.

With mass hysteria not a viable cause, to date, no one is sure what caused this slew of reactions. The best guess? A seemingly impossible combination of reactions and coincidences, turning Ramirez's failing kidneys -- the ultimate cause of her death -- into the source of poisonous gas.

Dimethly sulfoxide, or DMSO, is a home pain remedy -- one which lab tests suggest Ramirez may have ingested (although her family denies it). Because her kidneys were failing, however, it is possible that DMSO may have built up in her body over time. DMSO is harmless but does indeed cause a garlicky smell, consistent with the observations noted above.

When the paramedics arrived to Ramirez's call of distress on the night of Ramirez's hospitalization and death, they -- as is standard -- gave her oxygen. As the theory goes, some of this oxygen may have bonded with the DMSO, forming DMSO2 -- dimethly sulfone -- which crystallizes at room temperature. This explains the manila specks in Ramirez's blood. DMSO2, however, could not have caused the fainting spells, but DMSO4 -- dimethly sulfate -- could have. DMSO4 is a poisonous gas, one which could have caused some of the ER staff to fall ill. And it's possible that when ER technicians administered the shocks to her system via defibrillation, they also caused the DMSO2 to recombine into DMSO4.

Because Ramirez's autopsy was not performed until months after her death, leading the body to decompose too much, we can't be sure what happened. And because the conversion of DMSO2 to DMSO4 has never before been seen within the human body, there is a very good chance that this theory is meritless. The mystery of the Toxic Lady will continue on for decades more, if not longer.


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