Gloria Cecilia Ramirez (January 11, 1963 – February 19, 1994) was a woman from
Riverside, California
Riverside is a city in and the county seat of Riverside County, California, United States, in the Inland Empire metropolitan area. It is named for its location beside the Santa Ana River. It is the most populous city in the Inland Empire and ...
, who was dubbed "the Toxic Lady" or "the Toxic Woman" by the media when several hospital workers became ill after exposure to her body and blood. She had been admitted to the
emergency department while suffering from late-stage
cervical cancer
Cervical cancer is a cancer arising from the cervix. It is due to the abnormal growth of cells that have the ability to invade or spread to other parts of the body. Early on, typically no symptoms are seen. Later symptoms may include abnormal ...
. While treating Ramirez, several hospital workers fainted and others experienced symptoms such as shortness of breath and muscle spasms. Five workers required hospitalization, one of whom remained in an
intensive care unit
220px, Intensive care unit
An intensive care unit (ICU), also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU), is a special department of a hospital or health care facility that provides intensi ...
for two weeks.
Shortly after arriving at the hospital, Ramirez died from complications related to cancer. The incident was initially considered to be a case of
mass hysteria
Mass psychogenic illness (MPI), also called mass sociogenic illness, mass psychogenic disorder, epidemic hysteria, or mass hysteria, involves the spread of illness symptoms through a population where there is no infectious agent responsible for c ...
. An investigation by
Lawrence Livermore National Laboratory
Lawrence Livermore National Laboratory (LLNL) is a federal research facility in Livermore, California, United States. The lab was originally established as the University of California Radiation Laboratory, Livermore Branch in 1952 in response ...
proposed that Ramirez had been self-administering
dimethyl sulfoxide
Dimethyl sulfoxide (DMSO) is an organosulfur compound with the formula ( CH3)2. This colorless liquid is the sulfoxide most widely used commercially. It is an important polar aprotic solvent that dissolves both polar and nonpolar compounds ...
as a treatment for pain, which converted into
dimethyl sulfate
Dimethyl sulfate (DMS) is a chemical compound with formula (CH3O)2SO2. As the diester of methanol and sulfuric acid, its formula is often written as ( CH3)2 SO4 or Me2SO4, where CH3 or Me is methyl. Me2SO4 is mainly used as a methylating agen ...
, an extremely poisonous and highly carcinogenic
alkylating agent
Alkylation is the transfer of an alkyl group from one molecule to another. The alkyl group may be transferred as an alkyl carbocation, a free radical, a carbanion, or a carbene (or their equivalents). Alkylating agents are reagents for effecting ...
, via a series of chemical reactions in the emergency department. This theory has been endorsed by the Riverside Coroner's Office and published in the journal ''
Forensic Science International
''Forensic Science International'' is a peer-reviewed academic journal of forensic science. The journal was established in 1972 and is published by Elsevier. The journal occasionally published supplements from 1999 onwards, but these supplements ...
''.
Emergency department visit
About 8:15 p.m. on the evening of February 19, 1994, Ramirez, suffering from severe
heart palpitations
Palpitations are perceived abnormalities of the heartbeat characterized by awareness of cardiac muscle contractions in the chest, which is further characterized by the hard, fast and/or irregular beatings of the heart.
Symptoms include a rap ...
, was brought into the emergency department of
Riverside General Hospital
The Houston Negro Hospital is the original name of a hospital in Houston, Texas. Upon the completion of an expansion project to add an extra wing to the hospital in 1961, the entire facility was renamed Riverside General Hospital. in
Riverside
Riverside may refer to:
Places Australia
* Riverside, Tasmania, a suburb of Launceston, Tasmania
Canada
* Riverside (electoral district), in the Yukon
* Riverside, Calgary, a neighbourhood in Alberta
* Riverside, Manitoba, a former rural mu ...
, by
paramedic
A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research.
Not all ambulance personnel are p ...
s. She was extremely confused and was suffering from
tachycardia
Tachycardia, also called tachyarrhythmia, is a heart rate that exceeds the normal resting rate. In general, a resting heart rate over 100 beats per minute is accepted as tachycardia in adults. Heart rates above the resting rate may be normal ( ...
and
Cheyne–Stokes respiration
Cheyne–Stokes respiration is an abnormal pattern of breathing characterized by progressively deeper, and sometimes faster, breathing followed by a gradual decrease that results in a temporary stop in breathing called an apnea. The pattern repe ...
.
The medical staff injected her with
diazepam
Diazepam, first marketed as Valium, is a medicine of the benzodiazepine family that acts as an anxiolytic. It is commonly used to treat a range of conditions, including anxiety, seizures, alcohol withdrawal syndrome, muscle spasms, insomnia, ...
,
midazolam
Midazolam, sold under the brand name Versed among others, is a benzodiazepine medication used for anesthesia and procedural sedation, and to treat severe agitation. It works by inducing sleepiness, decreasing anxiety, and causing a loss of ...
, and
lorazepam
Lorazepam, sold under the brand name Ativan among others, is a benzodiazepine medication. It is used to treat anxiety disorders, insomnia, trouble sleeping, Psychomotor agitation, severe agitation, active Epileptic seizure, seizures including ...
to sedate her. When it became clear that Ramirez was responding poorly to treatment, the staff tried to
defibrillate her heart; at that point several people saw an oily sheen covering Ramirez's body, and some noticed a fruity,
garlic
Garlic (''Allium sativum'') is a species of bulbous flowering plant in the genus ''Allium''. Its close relatives include the onion, shallot, leek, chive, Welsh onion and Chinese onion. It is native to South Asia, Central Asia and northe ...
-like odor that they thought was coming from her mouth.
Registered nurse Susan Kane drew blood from Ramirez's arm and noticed an
ammonia
Ammonia is an inorganic compound of nitrogen and hydrogen with the formula . A stable binary hydride, and the simplest pnictogen hydride, ammonia is a colourless gas with a distinct pungent smell. Biologically, it is a common nitrogeno ...
-like smell coming from the
tube
Tube or tubes may refer to:
* ''Tube'' (2003 film), a 2003 Korean film
* ''The Tube'' (TV series), a music related TV series by Channel 4 in the United Kingdom
* "Tubes" (Peter Dale), performer on the Soccer AM television show
* Tube (band), a ...
.
She passed the tube to Julie Gorchynski, a
medical resident
Residency or postgraduate training is specifically a stage of graduate medical education. It refers to a qualified physician (one who holds the degree of MD, DO, MBBS, MBChB), veterinarian ( DVM or VMD) , dentist ( DDS or DMD) or podiatrist ...
, who noticed manila-colored particles floating in the blood. At this point, Kane
fainted
Syncope, commonly known as fainting, or passing out, is a loss of consciousness and muscle strength characterized by a fast onset, short duration, and spontaneous recovery. It is caused by a decrease in blood flow to the brain, typically from ...
and was removed from the room. Shortly thereafter, Gorchynski began to feel
nausea
Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the ...
ted. Complaining that she was lightheaded, she left the trauma room and sat at a nurse's desk. A staff member asked her if she was okay, but before she could respond she also fainted. Maureen Welch, a
respiratory therapist
A respiratory therapist is a specialized healthcare practitioner trained in critical care and cardio-pulmonary medicine in order to work therapeutically with people who have acute critical conditions, cardiac and pulmonary disease. Respirato ...
who was assisting in the trauma room, was the third to pass out. The staff was then ordered to evacuate all emergency department patients to the parking lot outside the hospital. Overall, 23 people became ill and five were hospitalized.
A
skeleton crew
A skeleton crew is the minimum number of personnel needed to operate and maintain an item such as a business, organization, or ship at its most simple operating requirements. Skeleton crews are often utilized during an emergency and are meant to ...
stayed behind to stabilize Ramirez. At 8:50 p.m., after 45 minutes of
CPR
Cardiopulmonary resuscitation (CPR) is an emergency procedure consisting of chest compressions often combined with artificial ventilation in an effort to manually preserve intact brain function until further measures are taken to restore spont ...
and
defibrillation
Defibrillation is a treatment for life-threatening cardiac arrhythmias, specifically ventricular fibrillation (V-Fib) and non-perfusing ventricular tachycardia (V-Tach). A defibrillator delivers a dose of electric current (often called a ''coun ...
, Ramirez was pronounced dead from
kidney failure
Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as eit ...
related to her cancer.
Investigation
The county health department called in California's
Department of Health and Human Services
The United States Department of Health and Human Services (HHS) is a cabinet-level executive branch department of the U.S. federal government created to protect the health of all Americans and providing essential human services. Its motto is ...
, which put two scientists, Drs. Ana Maria Osorio and Kirsten Waller, on the case. They interviewed 34 hospital staff who had been working in the emergency department on February 19. Using a standardized questionnaire, Osorio and Waller found that the people who had developed severe symptoms, such as loss of consciousness, shortness of breath, and muscle spasms, tended to have certain things in common. People who had worked within two feet of Ramirez and had handled her intravenous lines had been at high risk. But other factors that correlated with severe symptoms did not appear to match a scenario in which fumes had been released: the survey found that those afflicted tended to be women rather than men, and they all had normal blood tests after the exposure. They believed the hospital workers suffered from
mass hysteria
Mass psychogenic illness (MPI), also called mass sociogenic illness, mass psychogenic disorder, epidemic hysteria, or mass hysteria, involves the spread of illness symptoms through a population where there is no infectious agent responsible for c ...
.
Gorchynski denied that she had been affected by mass hysteria and pointed to her own medical history as evidence. After the exposure, she spent two weeks in the
intensive care unit
220px, Intensive care unit
An intensive care unit (ICU), also known as an intensive therapy unit or intensive treatment unit (ITU) or critical care unit (CCU), is a special department of a hospital or health care facility that provides intensi ...
with breathing problems. She developed
hepatitis
Hepatitis is inflammation of the liver parenchyma, liver tissue. Some people or animals with hepatitis have no symptoms, whereas others develop yellow discoloration of the skin and whites of the eyes (jaundice), Anorexia (symptom), poor appetite ...
and
avascular necrosis
Avascular necrosis (AVN), also called osteonecrosis or bone infarction, is death of bone tissue due to interruption of the blood supply. Early on, there may be no symptoms. Gradually joint pain may develop which may limit the ability to move. C ...
in her knees. Riverside Coroner's Office contacted
Lawrence Livermore National Laboratory
Lawrence Livermore National Laboratory (LLNL) is a federal research facility in Livermore, California, United States. The lab was originally established as the University of California Radiation Laboratory, Livermore Branch in 1952 in response ...
to investigate the incident. Livermore Labs postulated that Ramirez had been using
dimethyl sulfoxide
Dimethyl sulfoxide (DMSO) is an organosulfur compound with the formula ( CH3)2. This colorless liquid is the sulfoxide most widely used commercially. It is an important polar aprotic solvent that dissolves both polar and nonpolar compounds ...
(DMSO), a solvent used as a powerful degreaser, as a home remedy for pain. Users of this substance report that it has a garlic-like taste.
Sold in gel form at hardware stores, it could also explain the greasy appearance of Ramirez's body.
The Livermore scientists theorized that the DMSO in Ramirez's system might have built up owing to urinary blockage caused by her kidney failure.
Oxygen administered by the paramedics would have combined with the DMSO to form
dimethyl sulfone
Methylsulfonylmethane (MSM) is an organosulfur compound with the formula (CH3)2SO2. It is also known by several other names including methyl sulfone and dimethyl sulfone (DMSO2). This colorless solid features the sulfonyl functional group and is ...
(DMSO
2). DMSO
2 is known to crystallize at room temperature, and crystals were observed in some of Ramirez's drawn blood.
Electric shocks administered during emergency defibrillation could have then converted the DMSO
2 into
dimethyl sulfate
Dimethyl sulfate (DMS) is a chemical compound with formula (CH3O)2SO2. As the diester of methanol and sulfuric acid, its formula is often written as ( CH3)2 SO4 or Me2SO4, where CH3 or Me is methyl. Me2SO4 is mainly used as a methylating agen ...
(DMSO
4), the highly toxic dimethyl ester of sulfuric acid, exposure to which could have caused some of the reported symptoms of the emergency department staff. The Livermore scientists postulated on ''
The New Detectives
''The New Detectives: Case Studies in Forensic Science'' (or simply ''The New Detectives'', formally "Forensic Detectives") is a documentary true crime television show that aired two to three different cases in forensic science per episode from ...
'' that the change in temperature of the blood drawn, from the 98.6 °F (37 °C) of Ramirez's body to the 64 °F (18 °C) of the emergency department, may have contributed to its conversion from DMSO
2 into DMSO
4. This, however, has not been confirmed.
Burial
Two months after Ramirez died, her badly decomposed body was released for an independent autopsy and burial. The Riverside Coroner's Office hailed Livermore's DMSO conclusion as the probable cause of the hospital workers' symptoms, while her family disagreed. The Ramirez family's
pathologist
Pathology is the study of the causes and effects of disease or injury. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in t ...
was unable to determine a cause of death because her heart was missing, her other organs were cross-contaminated with fecal matter, and her body was too badly decomposed. On April 20, 1994—ten weeks after her death—Ramirez was buried at
Olivewood Memorial Park
Riverside is a city in and the county seat of Riverside County, California, United States, in the Inland Empire metropolitan area. It is named for its location beside the Santa Ana River. It is the most populous city in the Inland Empire and i ...
in Riverside.
Status of technical forensic analysis
The possible chemical explanation for this incident by Patrick M. Grant of the Livermore Forensic Science Center is beginning to appear in basic forensic science textbooks. In Houck and Siegel's textbook, the authors state that, although some weaknesses exist, the postulated scenario is "the most scientific explanation to date" and that "beyond this theory, no credible explanation has ever been offered for the strange case of Gloria Ramirez."
Grant's conclusions and speculations about the incident were evaluated by professional forensic scientists, chemists, and toxicologists, passed peer review in an accredited, refereed journal, and were published by ''
Forensic Science International
''Forensic Science International'' is a peer-reviewed academic journal of forensic science. The journal was established in 1972 and is published by Elsevier. The journal occasionally published supplements from 1999 onwards, but these supplements ...
''.
[Grant, "Response to Letters to the Editor Concerning the Riverside 'Mystery Fumes' Incident Analysis", ''Forensic Science International'' 94: 223–230 (1998).] The first paper was technically detailed and contained two potential chemical reaction mechanisms that may possibly have formed dimethyl sulfate from dimethyl sulfoxide and dimethyl sulfone precursors. The second communication gave supplemental support for the postulated chemical scenario as well as insight into some of the sociology and vested interests inherent in the case.
See also
*
List of unsolved deaths
This list of unsolved deaths includes well-known cases where:
* The cause of death could not be officially determined.
* The person's identity could not be established after they were found dead.
* The cause is known, but the manner of death (ho ...
*
List of unusual deaths
This list of unusual deaths includes unique or extremely rare circumstances of death recorded throughout history, noted as being unusual by multiple sources.
Antiquity
Middle Ages
Renaissance
Early modern period
19th centur ...
References
{{DEFAULTSORT:Ramirez, Gloria
1994 in California
Burials at Olivewood Memorial Park
Chemical accident
Conspiracy theories in the United States
Death conspiracy theories
Death in Riverside County, California
Deaths by person in California
Deaths from cancer in California
Deaths from cervical cancer
Unsolved deaths
Urban legends