Gloria Ramírez

Gloria Cecilia Ramirez (January 11, 1963 – February 19, 1994) was an American woman who was dubbed the Toxic Lady or the Toxic Woman by the media when several hospital workers became ill after airborne exposure to her body and blood. Ramirez had been admitted to the emergency room suffering from late-stage cervical cancer. While treating Ramirez, three 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 for two weeks. Ramirez herself died from complications related to her cancer shortly after arriving at the hospital.

The incident was initially considered to be a case of mass hysteria. An investigation by Lawrence Livermore National Laboratory suggested that Ramirez had been self-administering dimethyl sulfoxide (DMSO) as a pain treatment. The oxygen from the mask provided by paramedics during her transport to the hospital likely converted the DMSO into dimethyl sulfate (DMS), a highly toxic and carcinogenic alkylating agent. Although dimethyl sulfate has a very low vapor pressure at body temperature, it is believed to have transitioned to a gaseous state due to the vacuum inside the vacutainer. This theory has been endorsed by the Riverside Coroner's Office and published in the journal Forensic Science International.

Emergency department visit Prior to arriving at the emergency room, Gloria Ramirez's boyfriend Johnnie Estrada called 911 and reported that Ramirez was experiencing nausea and vomiting throughout the entire day. At about 8:15 p.m. on February 19, 1994, Gloria Ramirez, suffering from severe heart palpitations, was brought into the emergency room of Riverside General Hospital in Riverside, California, by paramedics. She was extremely confused and was suffering from tachycardia and Cheyne–Stokes respiration. Respiratory therapist Maureen Welch noted that Ramirez's age, even with her diagnosis of cervical cancer, was odd since most patients exhibiting her symptoms were elderly.

Hospital staff administered diazepam (Valium), midazolam (Versed) and lorazepam (Ativan) to sedate Ramirez, and followed up with lidocaine and Bretylium agents to address her abnormal heartrate. When it became clear that she was responding poorly to treatment, Ramirez began to go into shock, and staff tried to defibrillate her heart; at that point several medical workers saw an oily sheen covering Ramirez's body, and some noticed a fruity, garlic-like odor that they thought was coming from her mouth. Registered nurse Susan Kane drew blood from Ramirez's arm and noticed an ammonia-like smell coming from the tube.

Kane passed the tube to Julie Gorchynski, a medical resident, who noticed manila-colored (yellow-brown) crystalized particles floating in the blood. At this point, Kane began feeling a burning sensation on her face and then fainted, after she was removed from the emergency room. Shortly thereafter, Gorchynski began to feel nauseated. Complaining that she was lightheaded, she left the emergency room and sat at a nurse's desk. A staff member asked her if she was okay, but before she could respond, Gorchynski also fainted. Maureen Welch was the third to faint, after noting that the blood drawn smelled less like that from a chemo-patient and more like the ammonia odor the other staff were describing. On awakening, she could not control the movement of her limbs. The incident itself was around 30 minutes, with Gloria Ramirez's body being isolated in a separate room next to the trauma room, and later bagged and moved into an air-tight container. Livermore scientists postulated on The New Detectives 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 room, may have also contributed to a conversion from DMSO2 into DMSO4. However, many organic chemists are dismissive of this theory, citing the length of time required for a reaction like this to occur and the fact that the human body is not warm enough for the conversion to happen.

Status of technical forensic analysis

The possible chemical explanation for this incident, by Patrick M. Grant of the Livermore Forensic Science Center, has appeared in some forensic science textbooks. In one such textbook, Fundamentals of Forensic Science, the authors state that, although the hypothesized conversion of DMSO2 to DMSO4 has not previously been observed, 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.

In popular culture Buzzfeed Unsolved's The Bizarre Toxic Death of Gloria Ramirez covers the case of Ramirez's death and examines different hypotheses as to what may have caused the incidents that surrounded her death.

The Murdoch Mysteries episode "A Most Surprising Bond" is loosely based on the Ramirez case, using the DMSO hypothesis to explain how a hospital patient's blood is causing those around her to fall ill.

Gloria Ramirez's story also played a part in inspiring Stink Bomb, the second segment of the three-part film anthology Memories by Katsuhiro Otomo, where a lab technician accidentally takes an experimental drug and becomes a walking chemical weapon.

Episode 14 of season 3 of Grey's Anatomy, "Wishin and Hopin", features a patient who is based on this case. The cancer patient causes anyone who comes in contact with her to faint and require immediate medical attention due to her taking a herbal supplement, causing her blood to become toxic.