Around 8:15 p.m. Feb. 19, 1994, a woman named Gloria Ramirez was brought to the emergency room of Riverside General Hospital in Riverside, California while suffering from the effects of cervical cancer. What happened next landed Ramirez a place in the medical history books forever.
Ramirez was wearing shorts and a T-shirt, and although she was still conscious Ramirez could only answer questions with brief and sometimes incomprehensible responses. In terms of her health, she was taking short, rapid breaths and her heart was beating too quickly for its chambers to fill with blood causing her blood pressure to drop. Symptoms such as these are normally seen in elderly patients, and yet Ramirez was 31.
To help her, medical staff gave her Valium, Versed and Ativan to sedate her and lidocaine and Bretylium to slow her heartbeat. Meanwhile, Ramirez was having air forced into her lungs using an Ambu-bag, but nothing was working. Opting to instead try a defibrillator on her heart, the staff removed her shirt and pressed the electrodes to her chest, which is when the staff noticed an oily sheen covering Ramirez’s body and a fruity, garlicky odor which seemed to come from Ramirez’s mouth.
One of the nurses, Susan Kane, drew blood from Ramirez’s right arm, when Kane noticed a chemical smell coming from Ramirez’s blood, similar to ammonia. After a syringe was filled with Ramirez’s blood, both a medical resident and a doctor noticed manila-colored particles floating in the blood.
Then, Kane turned towards the door of the trauma room and began to sway, before someone gently guided her to the floor as she said her face felt like it was burning. As Kane was wheeled away on a gurney, medical resident Julie Gorchynski left the room and sat at a nurse’s desk. Before she could even say how she was feeling, Gorchynski slumped over and was also wheeled away on a gurney. Gorchynski began shaking intermittently and would stop breathing, take a few breaths, then stop breathing again.
In the trauma room, a third person passed out, and then woke up unable to control their limbs. Several other stafff members said they were feeling sick, which prompted the hospital to declare an emergency and move all of the emergency room patients to the parking lot outside the hospital. A skeleton crew of four people remained inside to try and save Ramirez’s life, but despite drugs and electric shocks Ramirez was pronounced dead at 8:50 p.m. Two staff members moved Ramirez’s body to an isolation room; one of whom, Sally Balderas, began retching and felt a burning sensation on her skin.
Overall, 23 of the 37 emergency room staff suffered at least one symptom from being exposed to Ramirez. Kane eventually started flailing and kicking while her skin continued to burn, while Gorchynski (the most severe victim) spent two weeks in intensive care and suffered from apnea, hepatitis, pancreatitis and avascular necrosis, a condition where bone tissue is starved of blood and begins to die.
Around 11 p.m., a Riverside County HAZMAT team arrived at the hospital looking for a volatile toxicant which may still be in the air of the emergency room. In particular, the HAZMAT team was searching for toxins such as hydrogen sulfide, also known as sewer gas, or phosgene, which can be used either to prepare ordinary chemicals or as a chemical warfare weapon. Fortunately, the HAZMAT team found nothing in the air that would indicate what was making people sick.
Unfortunately, the Riverside County Coroner had to perform an autopsy on Ramirez using airtight moon suits in a sealed examining chamber. But several days after taking blood and tissue samples, the Coroner had to seek help from the Forensic Science Center at the Lawrence Livermore National Laboratory.
Ramirez’s sister, Maggie Ramirez Garcia, said he sister was treated like a “toxic monster” and her body wasn’t released to the family until nine weeks later, even though the official cause of death was kidney failure due to cervical cancer. Eventually the Coroner chalked up the mysterious fumes as the “smell of death,” while the California Department of Health Services claimed some of the medical staff had succumbed to mass hysteria.
But what caused Ramirez’s body to become toxic enough to cause an emergency at a hospital and make several medical staff severely ill?
Eventually the Lawrence Livermore National Laboratory determined dimethyl sulfone was present in Ramirez’s blood, which they believed was a sign Ramirez had been using dimethyl sulfoxide (or DMSO), a non-FDA approved anti-inflammatory drug which is believed by some people to be a cure-all. The DMSO may have oxidized into dimethyl sulfone when the doctors gave Ramirez oxygen, and when the doctors drew blood the dimethyl sulfone could have turned into possibly deadly dimethyl sulfate crystals when exposed to the cool air.
Although the Ramirez family had an attorney file a medical malpractice and wrongful death suit against the county, the Riverside County Coroner corroborated the laboratory’s conclusion, saying the crystals in the blood, Ramirez’s body’s oily sheen and the medical staff’s symptoms were all signs of exposure to dimethyl sulfate.