On the evening of February 19, 1994, Gloria Ramirez, 34, was brought by paramedics to the emergency room at Riverside (CA) General Hospital. Ramirez, who some weeks earlier had been diagnosed with metastatic cervical cancer, was admitted in respiratory and cardiac distress.

Approximately 15 minutes after her arrival, she went into full cardiac arrest. 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. Dr. Julie Gorchynski, the senior medical resident, went to Nurse Kane's aid. After seeing to her needs, Dr. Gorchynski noted a strange odor, 'took a deep whiff' of the syringe and passed out. Four 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 occurred where ER staff became ill from fumes emitted by a patient, the hospital assumed that this was a case of toxic contamination, sealed the ER, evacuated all patients and affected staff (who by now numbered somewhere between 8 and 11, including clerks) and brought in the County decontamination unit.

Ms. Ramirez died in the ER, after the staff tried to resuscitate her for about 35-45 minutes. The official cause of death was kidney failure due to metastasized cancer. Her body was placed in a sealed body bag and sent to the county coroner for autopsy in a special sealed unit.

Condemned as the source of the mysterious fumes, Gloria Ramirez achieved immortality as the "toxic lady."

Many tests, hypotheses and lawsuits were to follow, but an explanation was found--by no less than the famed Lawrence Livermore National Laboratory--nearly nine months later. Naturally, the solution to the mystery, not being nearly as exciting as stating the mystery itself, was not well publicized. Dimethyl sulfate, which is cited in scientific literature as a chemical warfare agent, was created by an unusual confluence of chemical reactions.

It is believed that Ramirez used DMSO (dimethyl sulfoxide) a sort of wonder drug for relieving various arthritic aches and pains. DMSO is metabolized to become dimethyl sulfone, which was found in her system, likely produced by the administration of oxygen by paramedics.

When attendants drew blood from Ramirez in the emergency room, the relatively sudden and sharp drop in the temperature of her blood--from body temperature to the cool air of the hospital-- could have created dimethyl sulfate, the lethal compound. Her body temperature was too high to allow creation of the deadly compound internally.

Witnesses at the time said they saw crystals in the syringe containing Ramirez's blood, and scientists now believe those crystals were the source of the mystery fumes.

The step of creating the lethal toxin from the benign dimethyl sulfone was performed at Lawrence Livermore

The scientists noted that virtually every known side effect of dimethyl sulfate--short of death--was exhibited by those who smelled Ramirez's blood. Likewise, virtually every symptom displayed by the attendants was consistent with exposure to the toxin.

Also, DMSO can appear oily, which is consistent with the presence of an "oily sheen" on Ramirez's body that some witnesses said they saw.

The death of a patient, the poisoning of health care workers, and a prestigious scientific inquiry. Just another day in the ER.