Contents

Q'S REPORT 

     In May 2000, a coffee vending machine was deliberately contaminated with arsenic and many individuals became acutely ill.  After considerable but rapid consultation, the toxicology team recommended that the thirty-three patients be treated with oral dmps (100mg 3x per day with food).  All patients were given medical examinations before beginning treatment. 

     After one week of treatment, arsenic levels dropped significantly.  However, serious adverse effects became apparent.  Early adverse effects were mild rashes, treated with an antihistamine.  Shortly thereafter one patient was admitted to the hospital with generalized erythematous skin rash, edema, fever, fatigue, and ulcerations of the mouth, vagina and anus.  Treatment for the remaining patients was immediately halted.

     During the following two weeks eight patients developed erythema multiform.  Four patients required hospitalization.  Two were conclusively diagnosed with Stevens-Johnson Syndrome.  One developed bullous lesion on the upper extremities.  The other had limited rash lesions but severe ulcerations of all mucous membranes.

     In all, eight of the thirty-three patients (24%) required medical attention due to the adverse effects of the dmps.  Four patients required hospitalization (12%), with two suffering from Stevens-Johnson syndrome.