Concluding the most sensational medical investigation in local history, the Riverside County coroner’s office announced Friday that Gloria Ramirez died of kidney failure as a result of cervical cancer--and the fumes that sickened the emergency room staff tending her probably were simply the smell of death.
Chief Deputy County Coroner Dan Cupido said no “external toxins” were found in her body, after an unprecedented autopsy and follow-up testing and analyses by some of the most prestigious government medical and science laboratories in the country.
The coroner’s office had speculated that given the bizarre events surrounding her death, Ramirez died of other than natural causes. But Friday, County Coroner Scotty Hill said Ramirez died of natural causes.
The specific cause of death, he said, was “cardiac dysrhythmia due to acute renal failure due to cervical carcinoma.”
Hill said his investigators did not specifically set out to try to find the source or nature of the fumes that sickened the hospital staff, and he said Friday, “I don’t know if we’ll ever have that answer.”
But he did rule out the possibility that Ramirez, wittingly or otherwise, may have been poisoned by a toxic substance that might have contaminated those who tried to keep her alive.
“Exhaustive toxicological studies have not identified any external toxic substances that would have contributed to her death,” Hill said.
Cupido said the so-called “mystery fumes” were most likely the residues of a dying person.
“There are some mechanisms that occur with the disease process that may cause certain odors to be produced,” Cupido said. “We feel we have identified a source . . . as probably having come from the remains of Gloria Ramirez.”
Some of the staff treating Ramirez said the woman’s blood, drawn into a syringe, smelled of ammonia. Cupido said that odor was consistent with “the chemical changes that may occur during a person’s dying process, in relation to some of the anatomic findings we found.”
The fact that such odors could be so strong as to affect so many medical personnel so extensively may be unprecedented, Hill acknowledged.
“This is the first (such incident), possibly throughout the entire United States or the world,” Hill said. “We have received numerous calls of possibly similar cases, but none that are specific or identical to the circumstances surrounding this case.”
Other agencies, including Cal/OSHA--which investigates workplace injuries and other health and safety issues--have not completed their investigations into the incident. A Cal/OSHA spokesman said its report is expected to be completed by mid-May.
Among the labs that assisted the county in the autopsy were Lawrence Livermore National Laboratory, the U.S. Food and Drug Administration and the California Department of Justice.
David Garcia, Ramirez’s brother-in-law and spokesman for the family, said he did not believe the coroner’s conclusions.
“This serves their purpose, so the county won’t be responsible for whatever happened to Gloria,” he said. “This is a travesty of justice.”
Ron Schwartz, the attorney for the Ramirez family, said he was confused that it took so long--10 weeks--to determine the cause of the death. “This type of cause of death would normally be identified within a few days of death,” he said. “Why it took them 10 weeks to come up with this, I don’t know.”
The coroner’s office promised to notify the family of the cause of Ramirez’s death before public release of the information, and it did--10 minutes before the Friday afternoon news conference began.
Schwartz said that if the fumes that apparently sickened the six emergency room attendants were nothing more than the organic odors created in the dying process, it did little to explain why some of the hospital staff--most notably Dr. Julie Gorchynski--became so ill.
Six people treating Ramirez complained of varying degrees of dizziness after smelling a syringe after it was used to draw blood from Ramirez. Gorchynski was the most seriously affected; she has been hospitalized for the loss of blood circulation to her knees and has undergone surgery to try to correct it. She and others have also complained of continuing breathing difficulties.
Neither Gorchynski nor her family could be reached for comment.
Hill, who with Cupido answered questions in a curt fashion at Friday’s news conference, said his office spent “hundreds of thousands of dollars” on the investigation. He said it burdened his overworked and understaffed personnel who, since Ramirez’s death, have had to deal with 1,000 other deaths.
But Hill said the Ramirez case is finally closed as far as he is concerned.