Breath of Death

A hospital uses laughing gas for oxygen

The patient in the shiny new emergency ward of Suburban General Hospital in Norristown, Pa., inexplicably began to turn blue last month while presumably breathing oxygen. To his horror, Dr. Leonard Becker discovered that the tube labeled OXYGEN was actually pumping nitrous oxide to his patient. After a preliminary investigation, hospital authorities last week admitted that mislabeled pipe connections for the anesthetic gas "may have" caused as many as five deaths in the hospital since Suburban opened its wing almost eight months ago. In all, some 300 patients were apparently dosed with nitrous oxide by mistake.

The full death toll is not yet known. It will not be until several investigations --by the hospital and state and local health authorities--are concluded and their findings made public. But last week relatives and friends of those who died in the hospital during the period before the mix-up was discovered were both stunned and resentful. Housewife Evelyn Erskine, whose 61-year-old mother died suddenly last January after treatment of a respiratory condition, filed the first of many expected lawsuits that could eventually reach millions of dollars. "They had Mother on oxygen, and they were having problems," she says. A doctor came out to discuss the treatment. Mrs. Erskine recalls, "By the time the doctor went back in, she had died."

Nitrous oxide, popularly known as laughing gas, is usually not harmful. But in excessive doses, it slows down the heart, reducing the body's ability to consume oxygen, and is thus especially dangerous to victims of heart attacks and emphysema. Rather than producing sharply different symptoms, it is likely to exaggerate the difficulties that such patients are already suffering--a medical fact cited by Suburban General as one explanation of the delay in discovering the mixup. Whatever its cause, the grim Suburban story is by no means unique. In June jurors awarded a record $7 million in damages to the family of Carolyn Ann Lord, who died from being given nitrous oxide instead of oxygen at the Southmore Medical Center in Pasadena, Texas. Four years ago, 14 deaths resulted from a similar incident in Sudbury, Ont. That led Canada to create strict new national regulations governing the testing of such hospital pipes. The U.S. has no similar regulation.

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