[Warning: Hazardous chemicals present in this article. Read with caution.]

magine being so toxic that you make people around you sick?! Gloria Ramirez, also known as the ‘Toxic Lady’ died young at the age of 31 but she lives forever in the medical textbooks. On 19 February 1994, Gloria Ramirez was wheeled into the emergency room of General Hospital in the Southern California City of Riverside suffering from heart palpitations. Forty-five minutes later, Ramirez was dead and 23 out of the 37 ER staff were ill after being exposed to toxic fumes radiating from Ramirez’s body.

The circumstances of Ramirez’s death triggered one of the largest forensic investigations in history, drawing worldwide attention. No one in medical science has experienced a case such as this one. How could a dying woman radiate enough toxin to poison so many people?  The initial investigation turned up nothing – until a team of chemists from a nuclear weapons lab got involved.

Real-life medical drama

Gloria Ramirez’s cause of death was quite clear, she was in Stage 4 cervical cancer, and had gone into renal failure, which led to cardiac arrest. The Riverside ER Team was used to this type of situation and applied well-proven techniques to try to resuscitate her.

First, an IV of Ringer’s lactate solution was employed – a standard procedure for stabilizing possible blood and electrolyte deficiencies. Next, the trauma team sedated Ramirez with injections of diazepam, midazolam, and lorazepam. Thirdly they applied oxygen with an Amb-bag which forced purified air directly into Ramirez’s lungs.

This was a typical kind of day for the ER Team, with high-drama situations to deal with but nothing unusual until the medical staff in the emergency room started to pass out and become sick. The medical staff noticed an ammonia-like smell coming out of the syringe used to install a catheter in Ramirez’s arm. They also noticed strange manila-colored particles floating in the blood. Shortly after, everyone standing near the dying woman was starting to feel sick and nauseous.

The lead doctor ordered the ER evacuation and requested that all staff and patients evacuate to the open parking lot where they stripped down to their underclothes and stuffed their outer garments into hazmat bags.

A secondary trauma team geared in Personal Protection Equipment took over the situation and continue to administer CPR to Ramirez until she died. The backup trauma team seals Ramirez’s body in multi-layers of body shrouds, sealed it in an aluminum casket, and placed it into an isolated section of the morgue. They then activated a specially trained hazmat team to comb the ER for traces of whatever substance had been released and caused so many people to become ill. They found nothing.

Meanwhile, five hospital staff present in the emergency room had to be hospitalized for two weeks detoxifying in the intensive care unit.

From medical drama to legal drama

The investigation as to what happened started with a daunting and dangerous task – an autopsy of the body which by now was considered a canister of nerve gas harboring potentially lethal toxic chemicals. Three pathologists geared up in airtight moon suits performed the autopsy collecting samples of Gloria Ramirez’s blood and tissues along with air from within the shrouds and the sealed aluminum casket.

The autopsy and subsequent toxicology tests found nothing unusual. The Riverside coroner was under immense public pressure to identify the noxious substance. The hospital, the health department, and the toxicology lab spent a lot of their resources trying to find the culprit. Nothing. In desperation, it was concluded that the whole ER team was suffering from – mass hysteria!  

Some of the “imaginary” healthcare workers who were exposed to this mysterious substance and who nearly died from the exposure launched a defamation lawsuit against the hospital, the health department, and the two investigators who concocted the mass hysteria conclusion.

In desperation, the coroner’s office approached the Lawrence Livermore National Laboratories (LLNL) near San Francisco for help. They were nuclear weapons makers who turned themselves into forensic science centers after the cold war era ended.

The LLNL chemists had a breakthrough they found traces of dimethyl sulfoxide (DMSO) in Ramirez’s system, which on its own is stable and harmless. DMSO is commonly ingested by cancer patients to help with pain.

Their conclusion was as follows. Gloria Ramirez had been self-medicating with DMSO. When she experienced difficulty breathing at home, an ambulance was called, and the paramedics immediately applied oxygen. This started a chemical reaction with the DMSO already in her body system. The intense oxygenation of Ramirez added four oxygen atoms to the DMSO formula transforming it from a harmless and stable substance (dimethyl sulfoxide) to a highly toxic one (dimethyl sulfate). Mystery solved.

If you ever find yourself in an environment that becomes so toxic that it is impossible to breathe, the best thing to do is to go in the open, take a breather, analyze the situation, ask smart people for help, stay calm, and please do not fall into the mass hysteria trap!