Big Doses

One morning last week in Orangeburg, N. Y.'s huge Rockland State Hospital, 23 of its 4,700 patients stood fidgeting in line, with sleeves rolled up to their elbows waiting for their weekly injections of neoarsphenamine. Nurse Catherine Irvine handed Dr. Samuel Louis Leffel a syringe of bright yellow fluid, and he jabbed the needle into the prominent elbow vein of the Negro standing before him. Then he moved down the line, gave injections to the next four patients. As he poised a needle above the sixth arm, the Negro fell to the floor in convulsions. Just as he sobbed his last breath, the woman behind him dropped dead.

Quickly nurse and doctor gave the other three patients intravenous injections of epinephrin as an antidote, but they had already turned pale, were staggering and clutching their throats. Two died, and one lay dangerously ill. They had all been given large doses of powerful arsphenamine (salvarsan, or 606, best treatment for early stages of syphilis) instead of the weaker derivative, neoarsphenamine, which contains less arsenic.

Mrs. Irvine had been head of the luetic (syphilitic) clinic for five years, had pre pared thousands of injections. That morning, she ordered neoarsphenamine from the hospital's chemist, and when she received the yellow powder, did not bother to look at the label but merely mixed five-to-twelve-grain doses of the drug in dis tilled water.

Rockland's superintendent. Dr. Russell Enoch Blaisdell, suspended Mrs. Irvine and dismissed Chemist Henry Alvers, prepared himself for six Federal, State and local investigations.

Before the third and fourth Rockland patients died last week, Dr. John Robert Ross, superintendent of the Harlem Valley State Hospital at Wingdale. N. Y., re ported that Nurse Arthur Sandberg had absentmindedly given a patient one-and-a-half ounces of poisonous bromide and chloral (an effective sedative in small doses), instead of a half-ounce of epsom salts, which had been prescribed as a daily laxative. When the patient died three State and local investigating committees promptly descended upon the hospital.

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