Ex-Patient Reports Two Earlier Cases of Hospital Fumes

Several weeks before mysterious fumes forced the evacuation of the Riverside General Hospital emergency room, a patient had to evacuate his own room after noxious fumes overcame him and his wife, the man said Thursday.

Dennis Weiss, a 52-year-old cancer patient, said the stench was so strong it made him vomit before he covered his face with a blanket and his wife fled for help.

The nurse who responded remarked that such odors were not unusual, and blamed it on nurses on higher floors who dump various liquids into the hospital’s plumbing system, Weiss said.

Two days later, chemical fumes again filled his room, Weiss said--and for a second time, he and his visiting wife and daughter had to leave it until the air cleared.

Weiss reported the incidents to the attorney representing the family of Gloria Ramirez, the 31-year-old woman who died in the Riverside General Hospital emergency room Feb. 19 after mysterious fumes sickened six attendants and caused the evacuation of the emergency room.

State investigators said Thursday that the hospital’s plumbing system is a primary focus of their inquiry into the source of the fumes.

State and county public health experts have not yet determined the source of the fumes or what caused the death of Ramirez, who had cancer. She had gone to the hospital complaining of breathing difficulties and went into cardiac arrest.

The affected emergency room attendants said they got dizzy, and several collapsed and required hospitalization, after smelling an ammonia-like odor when a sample of the woman’s blood was drawn into a syringe. The chief emergency room physician said he did not notice an odor, but detected crystals in the blood sample.

As his colleagues began to collapse around him, the physician, Dr. Humberto Ochoa, noticed liquids in the drain of an emergency room basin and flushed it, Riverside County spokesman Tom DeSantis said. “He was trying to rule it out as a possibility, right at the scene,” DeSantis said. “That’s normal procedure.”

When the Riverside City Fire Department’s hazardous-materials team tested the emergency room air several hours after the incident, they found nothing unusual.

Ronald Schwartz, a Newport Beach attorney representing the Ramirez family, said Weiss gave a sworn declaration detailing his encounter with fumes at the hospital. Weiss’ experience, Schwartz said, suggests that the hospital, and not Ramirez, was the source of the mystery fumes.

A spokesman for Cal/OSHA, the state job safety agency, said Thursday that Riverside General Hospital was cited in 1990 and 1991 for a series of violations of exposure standards relating to the use of ethylene oxide, an extremely toxic gas that is used for sterilizing instruments.

In the 1990 violations, the hospital was cited for not providing adequate respirators for use by staff members working with ethylene oxide, and for an inadequate system of alerting people to its presence.

The same violations were cited the following year, said Cal/OSHA spokesman Rick Rice. This time, because of the recurrence, the violations were deemed “willful and serious.”

“In the hierarchy of Cal/OSHA violations, those are up near the top,” Rice said.

Six other serious citations relating to the handling of ethylene oxide at the hospital were made in 1991 before the problem was resolved the following year, he said.

Additionally, the hospital was cited in 1991 and 1992 for failing to maintain annual inspection records of its ventilation system, Rice said.

In the Ramirez case, Rice said, Cal/OSHA investigators are focusing on the hospital’s plumbing system and method of disposing of chemicals.

In many California communities, the state’s Department of Health Service monitors how hospitals dispose of their hazardous waste. But counties have the option of enforcing such state laws at the local level and, in the case of Riverside General Hospital, the monitoring is done by the county’s Environmental Health Department.

Jack McGurk, who heads the state health department’s biomedical waste management branch, said there is concern about how hospitals dump chemicals--whether they are cleaning agents or dated medicines.

“In some cases, there might not be a (disposal) problem. But, if you’re cleaning the commode with one kind of cleaner, then drop Clorox in somewhere else, the two are incompatible and you can have something happen right then and there.

“These are things that a hospital’s housekeeping staff should or would want to know about--how are they disposing mop water, or cleaners and, on top of that, chemicals, solutions and outdated medicines.”

Dennis and Jenny Weiss said their first encounter with noxious odors at Riverside General occurred Jan. 13, during his five-day stay for chemotherapy treatment on the hospital’s third floor.

“I heard the sink gurgling and then there was a horrible smell,” Jenny Weiss said. “It was an awful smell, a toxic smell, and I knew if I stayed in the room any longer, I’d get sick.”

Her husband said: “I’ve worked with chemicals all my life, but I can’t describe what this was. I’ve never smelled anything like it.”

Two days later, the same thing happened. Weiss said he told nurses, “You’d better call a plumber.”

The family did not formally complain to the hospital, or to the county of Riverside, which operates the hospital. But after hearing of the Ramirez incident , the family contacted attorney Schwartz.

DeSantis said Thursday that he could not comment on the Weiss incident, nor could he immediately determine if there was any history of complaints of foul fumes at the hospital.