6-Month Probe Fails to Solve Mystery of Hospital Fumes : Investigation: State’s industrial hygienists cannot find source of disabling odor. Some in emergency room may have fallen victim to mass hysteria, report says.

Concluding a six-month investigation, the state’s occupational safety office said Monday it found nothing at Riverside General Hospital which could account for the notorious “mystery fumes” that hospitalized six people and led to the evacuation of the emergency room in February.

Industrial hygienists with the state’s Department of Industrial Relations concluded that some of the 12 emergency room attendants who complained of nausea, headaches, dizziness and other symptoms during the incident may have fallen victim to mass hysteria after the first emergency room workers collapsed.

But at least three of the most seriously injured were definitely affected by something, a Cal/OSHA investigator concluded--but a source of the toxic fumes could not be identified.

Each of the three people who are believed by Cal/OSHA to have fallen ill from the mystery agent--a doctor, a nurse and a respiratory therapist--complained of smelling an ammonia-like odor in blood drawn from cancer patient Gloria Ramirez. The 31-year-old mother of two was brought to the hospital with breathing and heart distress and died within minutes of her arrival there.

Contributing to the ongoing mystery was a finding by a Cal/OSHA consulting laboratory that an unidentified chemical compound derived from ammonia was detected in the bag containing Ramirez’s body, and in air samples taken during the autopsy.

But Cal/OSHA officials said they could not determine if the unidentified compound could be related to the Feb. 19 incident.

No evidence was found that the mystery fumes were generated by the hospital’s use or storage of chemicals, drugs or cleaning supplies, or were generated by the hospital’s ventilation or sewage disposal systems, Cal/OSHA concluded.

Tam Smalstig, a state industrial hygienist, reported that in the case of three of the emergency room workers, “the type, severity and duration of the most severe symptoms . . . support that this was an involuntary physiologic reaction to some agent and event.”

Symptoms exhibited by the other affected hospital personnel “may have been the result of unintentional exaggeration by the stress or anxiety” of the moment, she said.

The Riverside County coroner’s office concluded that Ramirez died of cardiac dysrhythmia and acute renal (kidney) failure brought on by cervical cancer.

The county’s spokesman could not be reached for comment on the Cal/OSHA report.

The most seriously injured person, Dr. Julie Gorchynski, filed a $6-million claim against the county last week, claiming that her injuries, including loss of blood to her knees, are linked to the event.

Ramirez’s family has filed a wrongful death claim against Riverside County, claiming the hospital was responsible for the fumes that, the family contends, contributed to her death.

The state Department of Health Services is expected to issue its own report this week, but spokeswoman Lynda Frost said she doubted any additional light would be shed on the cause.