Cyanide Found in 2nd Tylenol Bottle; Warning Issued

Authorities discovered a second bottle of lethal cyanide-contaminated Tylenol in a store near New York City on Thursday. The federal Food and Drug Administration and the medicine’s manufacturer immediately advised consumers nationwide to stop taking the painkiller in capsule form.

The second bottle was taken from the shelf of a Woolworth’s store a few blocks from the Bronxville, N.Y., supermarket that sold the bottle of Extra-Strength Tylenol with the cyanide capsule that killed Diane Elsroth, a 23-year-old stenographer, last week. Police at first had labeled her homicide an isolated incident.

A third suspicious bottle was tested late Thursday by the FDA. But John A. Norris, the agency’s deputy commissioner, said the single contaminated capsule in that bottle contained “a trace amount and wouldn’t be harmful anyway.”

“It’s probably an industrial contaminant, but we’re pursuing everything, given the national crisis,” he said.

“It was so small an amount that we could barely detect it here, and that’s why we had to wait all day until we could confirm it in our Cincinnati plant,” explained George Gerstenberg, the director of the FDA’s Brooklyn office.

Assistant Director William Baker said the FBI would “re-examine the whole case” amid worries about the integrity of the product’s tamper-resistant packaging. An FDA spokesman said all three safety seals were intact on the second package and bottle of poisoned medicine, which was from a different lot and manufacturing plant than the first bottle.

In Sacramento, California state health officials began advising consumers to avoid Tylenol capsules, and notified stores to take the pain medication off their shelves.

“We are saying stop taking Tylenol capsules--and stop selling them, too,” said Stu Richardson, chief of the Food and Drug Branch of the state Health Department.

New York, Indiana, Massachusetts and Illinois were among other states taking similar action. The warnings don’t include Tylenol not in capsule form.

The bottle of pills that killed Elsroth at the home of her boyfriend in Yonkers last Saturday contained three additional poisoned capsules. Thursday, FDA scientists in a laboratory in Brooklyn, N.Y., found lethal doses of cyanide in five capsules in the second bottle of the analgesic.

“We don’t want people to panic,” said FDA Commissioner Dr. Frank E. Young. “Instead, we want them to refrain from taking Tylenol while we work this out. We especially want people who have Tylenol capsules to remove them from the reach of children and other family members so that someone doesn’t take a capsule in an unsuspecting fashion.”

The commissioner said federal investigators “still think this is a local occurrence,” but “we want to be safe rather than sorry.”

Reaction around the nation was swift. Only a little more than an hour after the first news reports reached Chicago, pharmacists at Michael Reese Hospital began moving through the floors taking all Tylenol capsules from nurses’ medical carts.

FDA scientists rushed the five capsules from the second bottle and the single suspicious capsule from the third bottle to the agency’s laboratory in Cincinnati. Chemists were comparing the cyanide from the first two bottles in an attempt to determine if the poison came from the same source.

Within 10 Days

After the first bottle was discovered, the FDA said evidence suggested the poison had been placed in the tamper-resistant bottle within the last 10 days because it would have eaten through the gelatin capsules if it had been there longer.

“Because this lot AHA-090 was different from the previous lot containing cyanide, which was ADF-916, consumers should completely avoid all Tylenol capsules in any strength in any lot until further notice,” the FDA said.

“Even though this still appears to be a local occurrence in the New York area, all consumers should, as an extra precaution, remove all Tylenol capsules from medicine cabinets to avoid use by children and family members.”

Elsroth died in the home of her boyfriend, Michael Notarnicola. Stephen Lewis, a lawyer for the Notarnicola family, said Thursday the FBI and local police had assured him “no one in the family is a suspect.”

Her death prompted stores in 34 states to remove the popular painkiller from their shelves. Chemists determined the toxicity of the cyanide that killed Elsroth to be 40% sodium cyanide and 60% potassium cyanide.

The death four years ago of seven people from cyanide-laced Tylenol capsules in the Chicago area prompted Johnson & Johnson, Tylenol’s manufacturer, and other companies to design tamper-resistant packaging.

“While the area of immediate concern is New York, we are issuing a nationwide warning in the interests of giving the public the widest possible protection,” James Burke, Johnson & Johnson’s chairman, said.

The second batch of capsules was manufactured in Puerto Rico; the first in Pennsylvania, the company said.

Elsroth, the daughter of a state police investigator, had complained that she was not feeling well, authorities said of last week’s incident. Police said Notarnicola told detectives he opened a new bottle of Tylenol and gave her the capsules early Saturday.

After her body was discovered, Notarnicola’s mother took a Tylenol capsule from the same bottle, but was unaffected. Analysis showed 21 of the bottle’s capsules were normal.

When FDA scientists examined the second bottle of poisoned Tylenol, they found the outside seal on the product was unbroken and the aluminum foil over the container’s top was intact.

Extra-Strength Tylenol, an aspirin substitute, is the nation’s best selling over-the-counter pain reliever.

John J. Goldman reported from New York and Marlene Cimons from Washington.