In this three-part series, Dr. Gunther Von Hagens explores the impact that accidents and assaults have on the human body, while demonstrating what medical staff can do to try to preserve life.

Autopsy: Emergency Room - Netflix

Type: Documentary

Languages: English

Status: Ended

Runtime: 60 minutes

Premier: 2007-11-06

Autopsy: Emergency Room - Death of Gloria Ramirez - Netflix

Gloria Ramirez (January 11, 1963 – February 19, 1994) was an American woman dubbed “the Toxic Lady” 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. 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 for two weeks. She was from Riverside, California. 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. An investigation by Lawrence Livermore National Laboratory proposed that Ramirez had been self-administering dimethyl sulfoxide as a treatment for pain, which converted into dimethyl sulfate, an extremely poisonous and highly carcinogenic alkylating agent via a series of chemical reactions in the emergency department. Although this theory has been endorsed by the Riverside Coroner's Office and published in the journal Forensic Science International, it is still a matter of debate among the scientific community.

Autopsy: Emergency Room - Status of technical forensic analysis - Netflix

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 opine 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 was published by Forensic Science International. The first paper was very technically detailed and did, in fact, give 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. However, the dimethyl sulfoxide theory has come under scrutiny in the scientific community for several reasons, the primary reason being that the proposed dimethyl sulfate generation could not be replicated in laboratory trials. Also, the symptoms displayed by the nursing staff members who fell ill while caring for Ramirez are not consistent with dimethyl sulfate exposure. Another reason the dimethyl sulfate theory is unlikely is that the odor observed by the staff was described as “ammoniacal”, but dimethyl sulfate is described as having a faint odor reminiscent of that of onions. One of the letters proposed the production of toxic chloramine gas due to urine mixing with bleach in a nearby sink. This hypothesis, previously proposed to the investigators and to the medical personnel involved in the incident, was apparently never considered by all involved. The noxious effects of this gas are documented in the New England Journal of Medicine. Grant later addressed this chloramine scenario in his 1998 Response, and found it did not come close to fitting the ER incident.

Autopsy: Emergency Room - References - Netflix