HEALTHDoctors warned to stay alert for threats from toxic agentsIndustrial chemicals are found everywhere, and so is the potential for poisonings by accidental exposure, terrorists or others.By Susan J. Landers, amednews staff. Feb. 9, 2004. Washington -- Carl Flynn, MD, a family physician in Caribou, Maine, a small city of 6,000 tucked into the nation's far northeast corner, never expected an act of terrorism to strike close to home. But it did. In what could be the largest arsenic poisoning case ever in the United States, one person died and 15 others were hospitalized last April when the coffee at a church social in nearby New Sweden was spiked with this deadly substance. It is believed that the poisonings were carried out by a respected member of the congregation, but the suspect killed himself shortly after the incident. The case remains open. Dr. Flynn and other local physicians were ultimately able to handle the emergency with help from the state toxicologist, who was preparing a supply of antidote in kits for shipment to all state hospitals as part of a bioterrorism readiness effort. Instead, the toxicologist pulled out the arsenic antidote and sent it directly to Dr. Flynn. But getting to this step -- pinpointing the appropriate treatment -- was puzzling. Dr. Flynn remembers sitting with two other physicians, heads bent over textbooks as they wondered, "What are we going to put these people on?" As it turned out, there is little information on what happens when people drink a large amount of arsenic all at once. The textbooks weren't helpful and are now being rewritten using the Maine patients as case studies. The most important lesson learned from this incident is that physicians must keep their guard up, said Dr. Flynn. "Physicians need a high index of clinical suspicion that there could be something going on." [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2004 American Medical Association. All rights reserved.
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