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By Camilla Cracchiolo RN
copyrighted 1995, may be freely reproduced for non-profit purposes.
I. Who Was The Toxic Lady?
The 'toxic lady' (as the Internet has perhaps unfairly dubbed her)
was a 31 year old woman in Riverside, California named Gloria Ramirez.
Her body may or may not have emitted toxic fumes which made several
doctors and nurses in the emergency room of Riverside General Hospital
very ill. She was the mother of two children and had been diagnosed with
metastatic cervical cancer 6 weeks before the famous event leading
to her name.
II. What happened?
On the evening of Feb. 19, 1994, Ms. Ramirez was brought by paramedics to
the emergency room at Riverside General Hospital. She was admitted in
respiratory and cardiac distress, and went into full cardiac arrest about 15
minutes after arrival. 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 cold. A doctor (Julie Gorchynski, the senior
medical resident) went to Nurse Kane's aid. After seeing to her
needs (probably by making sure she did not get a head injury from
falling), Dr. Gorchynski noted a strange odor, 'took a deep whiff' of
the syringe and passed out. 4 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.
Since other cases have occured where ER staff became ill from fumes
emitted by a patient (usually from people who have ingested pesticides,
although this can also be a risk to staff working in hyperbaric oxygen
chambers with people with carbon monoxide poisioning) the hospital
assumed that this was a case of toxic contamination, sealed the ER and
evacuated all patients and affected staff (who by now numbered somewhere
between 8 and 11, including clerks) and brought in the County
decontamination unit.
III. What happened to Gloria Ramirez during all this?
Ms. Ramirez died in the ER, after the staff tried to rescusitate her for
about 35 -45 minutes. The official cause of death was kidney
failure due to metasticized cancer. Her body was placed in a sealed
body bag and sent to the county coroner for autopsy in a special
sealed unit.
IV. Why is this case so unusual?
Because despite the apparently genuine and severe illnesses of the ER
staff, no satisfactory toxin that could have caused their illnesses has
been found. This has led to speculation as to whether mass hysteria
could have caused the symptoms experienced by the ER staff. Opinions
are still divided as to the cause of the incident.
V. Well, if a toxin from Gloria Ramirez didn't cause these
problems, what else could have?
The main alternative explanation is that there was some toxin in the
ER and that possibly the hospital covered this up. The hospital has
been cited before for improper waste disposal down drains. However,
they were inspected by nine different city, state and federal agencies
after this incident. While cited for some violations in other
parts of the hospital, no violations were found that affected the
ER.
The 'it's the hospital's fault' scenario is favored by Gloria Ramirez's
family, who have filed a lawsuit against Riverside General saying that
the fumes came from the hospital and also caused Ms. Ramirez's death.
The hospital, I'm afraid, did not handle matters well with the
Ramirez family. First, the hospital suggested that Ms. Ramirez
tried to kill herself by ingesting pesticides. This was not an
unreasonable initial theory given the situation (which looked very
much like pesticide poisoning.) However, it was ill thought out to
say this before preliminary lab results were back, since the Ramirez
family, like most people of Mexican descent in the area, are devout
Catholics. To allege suicide is to allege a very serious sin to
these folks.
To top this off, the County then hung on to Ms. Ramirez's body for
several months and at one point improperly stored it, resulting in
gross decomposition. The Ramirez family had to sue to get the body
back for burial, but by then it was unfit for showing. They had
wanted an open casket ceremony so her children could see her face
and properly say goodbye. I'd be mad too, if I were them.
Maureen Welch, RT
(affected fourth)
____________________________
paramedic intern | |
(not mentioned as | head |
affected, gender| |
unknown) | | unnamed nurse,
| | unknown if and
| | how affected
| |
unnamed nurse | EXAM TABLE |
| |
| | Dr. Mark Thomas
Thomas
| | (affected third)
| |
| |
| foot |
Susan Kane RN |___________________________| Dr. Gorchynski
(drew blood, passed out first) (took over drawing
blood, passed out
second)