For APRIL 2003 issue

SCIENCE IN CRIME DETECTION-115

Murder in a capsule

‑Dr. Anil Aggrawal

A few days back in a detective serial over the TV, it was shown how a clever lady kills her husband by opening his capsules and filling them with some poison. The unsuspecting husband – who is a movie director - takes the capsule, while shooting a film, and dies immediately thereafter. Ironically when he dies he was trying to explain a dying scene to a new and upcoming actress. Everybody thinks that he was acting so realistically, while the fact was that he had died actually!

This incident strongly reminded me of a real incident which occurred almost 20 years earlier – in 1982. This incident occurred in Chicago, Illinois, USA, in 1982, in which seven persons – two males and five females – died within a span of three days – from 29 September 1982 till 1 October 1982. The cause of death was most strange. They had all taken a very common medicine for headache – Tylenol, which is nothing but paracetamol, which comes by the name of Crocin in our country. An interesting related fact is that Chicago is the city where the first pilot poison center began operation in the United States. It was started in the year 1953, almost 30 years before this bizarre episode.

How did they die? Well, the mechanism was similar to that seen in that detective episode mentioned above. Someone had opened the capsules and laced them with cyanide. Who did it and why he did it, nobody knows it till now.

The first victim, a 12 year old schoolgirl, died at six o’clock in the morning on 29 September, 1982. Waking up with a sore throat in one of Chicago’s peaceful northwestern suburbs, she had taken an analgesic at her father’s suggestion before dropping lifeless to the floor. A few hours later, in an adjoining verdant suburb, tragedy struck again. A young Polish born post office worker, who had taken the day off to play with his children, took some Tylenols for his aching chest, collapsed, had a convulsion, and died. At the house that evening the grief stricken relatives assembled, neighbors brought coffee, doughnuts, and aspirin, but the family had their own extra strength Tylenol, containing 500 mg of paracetamol, which they passed around. The deceased man’s wife took a capsule, so did his brother, and both died within minutes. When the doctors at the local hospital suddenly found themselves confronted with three bodies they first surmised that some dreadful epidemic had broken out. But that night two firemen discussing the day’s events remembered the paramedics indicating in their report that the young girl had taken Tylenol. Somehow they put two and two together: “This is a wild stab,” said one of them, “but maybe it is the Tylenol.”

By the next morning the tests had clearly established that the capsules, all from lot number 2880, contained some 65 mg of potassium cyanide, well above the lethal dose, and the necropsies confirmed that the victims had died from cyanide poisoning. But it was too late to avert other tragedies. On the same day a young woman suffering from headaches also died, as did a young mother in another suburb who had just given birth to her third child. Soon panic spread through the area as officials warned the people against taking Tylenol, but a seventh fatality occurred the next day when an air stewardess was found dead in her apartment with poisoned capsules in her bathroom. The following table illustrates all fatalities.

S.no. Victim Sex Date and time

A 12 year old schoolgirl F 29 September 1982, 6 am

A young Polish born post-office worker, who had taken the day off to play with his children M 29 September 1982, few hours later

Above man’s wife F 29 September 1982, in the evening

Above man’s brother M 29 September 1982, in the evening

A young woman suffering from headaches F 30 September 1982

A young mother who had just given birth to her third child F 30 September 1982

An air stewardess F 1 October 1982

At midnight the mayor held a press conference urging Chicagoans to bring in all Tylenol capsules in their possession. The next day the federal authorities recalled the lots in question; the manufacturer, Johnson and Johnson, offered refunds for the capsules and announced a $100,000 reward for any information that might solve the mystery. The public was warned not to inhale or even touch the capsules because cyanide is absorbed through the skin. Throughout the city trucks rushed supplies of amyl nitrite to emergency rooms. The newspapers disseminated information about cyanide poisoning, and soon everybody knew that the symptoms were vomiting and headache, tingling in the throat, an almond odour on the breath, flushing, and a cherry red coloration of the mouth and lips. Soon the poison centres were swamped with calls: “I have just taken Tylenol, will I die ?”; television stations had their most exciting day since the attempt on Mr Reagan’s life (On March 30, 1981 – exactly one and a half years earlier - John Hinckley, Jr. had attempted to assassinate President Reagan. As the President and several members of his staff walked out of the Washington Hilton Hotel at 2:25 PM Hinckley shouted for the President to look at him then he shot six bullets in the President’s direction). Similarly the stories about the Palestinian camps were quietly relegated to the back pages of the newspapers.

Foul play suspected

From the beginning foul play was suspected, all evidence suggesting that someone had tampered with the capsules. Investigators noted that the capsules had been unevenly handled, some being filled carefully, others not, as if this were the work of several people or of one person passing through different moods. While detectives tried to obtain finger prints from the capsules the governor of Illinois declared that surely this was the work of a madman, and the newspapers reported that police were questioning several disgruntled shop assistants and were looking for a man arrested earlier for stealing Tylenol from a suburban store.

Some people promptly commented on the need to have all over the counter drugs sold in bottles with an inner seal, for after all “they can seal a bottle of antifreeze.” Others said that they would rather live with a headache than take analgesics. It was noted that cyanide could be freely purchased from hobby stores and chemical supply houses, being widely used for plastics, photography, metal plating, galvanizing, metallurgical processes, and even pesticides. Commentators wondered how on earth one would ever find the culprit since the capsules, produced in Pennsylvania and Texas, were distributed widely through wholesale companies before being sent to individual stores. And several lotteries announced that they would accept no more bets on 2880, the notorious lot number of the fatal capsules.

At the weekend more than 1000 mourners assembled for the funeral of the three Polish born victims, the new Archbishop of Chicago officiating and other priests addressing the congregation in Polish. There were reports that Chicago Poles had sent hundreds of Tylenol packages to needy relatives in Poland. Across the border in Canada authorities moved promptly to ban the product.

Surprisingly, after this incident, lot of similar incidents either began occurring, or were recalled from the past.

Reports came from California that a young butcher had developed convulsions from capsules containing a sub lethal dose of strychnine. It was also remembered that in August 1982, a man had burnt his mouth after taking a laxative adulterated with sodium hydroxide and that a year earlier six people had had eye injuries from drops laced with acid and chlorine. During the ensuing weeks there would be scattered reports of people sustaining injuries from contaminated eye drops or mouth washes. Many people thought their toothpaste smelt oddly or their antacids tasted strangely in what pharmacists described as over the counter fear or the Tylenol syndrome. And at a football match some 200 spectators who had drunk soda developed mass hysteria, perhaps from hyperventilation, shouting and complaining of nausea, dizziness, numbness, and chills.

In Chicago police reopened the case of a Philadelphia student who had died earlier from cyanide poisoning. Detectives spent all night on the phone with a Canadian psychic who went into long distance trances whenever he was asked a question. Several doctors reported raised cyanide concentrations in their patients, presumably from smoking. One suspect had five unregistered guns in his possession but was otherwise guiltless. A man wondered if the dead squirrels in his yard could have been killed by cyanide. A housewife thought that a man selling cider was the killer because during fermentation the cider had “kicked” a hole in the plastic container. A suburban man threatened to poison all the patients in a hospital unless he received a ransom of $8000, and a similar incident took place later in New Jersey. Another “extortion plot” for $100 000, first thought to be a hoax, eventually led to a nationwide hunt for a bearded man who had once been implicated in a gruesome dismemberment murder. Amid reports that another bottle of MC 2880 Tylenol had been recovered near the store where the air stewardess had bought hers, police produced a surveillance photograph showing the bearded man watching the young woman checking out the capsules but later announced that the picture was too blurred to reveal any “positive evidentiary matter.” And a reporter predicted that the killer would not be a crazed lunatic with raving eyes but a mild mannered man for whom the defense would invoke the insanity plea.

Protective legislation stimulated

In the Chicago city council the mayor introduced an ordinance requiring internal seals for drugs, cosmetics, and even drug samples, allowing 90 days for implementation and threatening dire sanctions. In Washington Secretary Schweiker said that the poisonings were at the top of his agenda and ordered his staff to work on legislation. Manufacturers doubted whether they could meet a short deadline and warned that confusion would ensue if every municipality enacted its own standards of packaging. Someone wrote that he wanted no seals at all because he could not open bottles with safety caps when he had a headache in the middle of the night. Someone else said that more people died from road accidents but that nobody thought of making cars inaccessible. There was also the question of how far one should go with safety requirements, given that the consumers would have to bear the cost.

Chicago newspapers were quick in observing that the publicity was a godsend to officials running for re-election and thought that many were overly melodramatic. Criticizing the politicians’ tendency to fan rather than calm public hysteria, they suggested that the candidates had all but distributed campaign buttons at the victims’ funerals. But they also recalled that protective legislation had often been stimulated by such disasters as the adulteration of quinine for the US military (stationed in Mexico during US-Mexico war) in 1848, the trouble over opium in baby syrup at the turn of the century, the 1937 sulphanilamide tragedy in which 197 people died (diethylene glycol, a sweet syrupy substance had been used as a vehicle for sulphanilamide preparations for children, but it was very toxic), and the 1962 thalidomide episode that caused the malformation of 8000 babies.

Meanwhile the business world lost no time in speculating how this disaster would affect the fortunes of Johnson and Johnson and their subsidiary McNeil Laboratories. It was recalled that in 1975, under the pressure of competition, the company had switched Tylenol from being a drug marketed only to the medical profession to one advertised to the public. By spending more than $85m in advertising they had increased their sales to over $400m a year, capturing 37% of a $1 billion a year industry, well ahead of Anacin, Bayer’s Aspirin, Bufferin, and Excedrin. With Americans taking each day some 90 million aspirin and 400 million paracetamol tablets the prize was well worth fighting for, so that competing companies were coming up with ever newer formulations and claims, and there were also constant legal battles over the veracity of advertisements on which aspirin was the best and which analgesic the gentlest. In the wake of the cyanide tragedy the other manufacturers first maintained a suitably compassionate posture, promising not to increase advertising or “make news related adjustments,” because it was not their policy to capitalize unfairly on the misfortunes of their competitors. Johnson and Johnson, in addition to posting the reward and offering refunds, moved to destroy 22 million capsules at a retail value of $80m, halted further production of the product, and allowed customers to exchange their Tylenol capsules for tablets. Notwithstanding these offers, a suburban woman promptly filed a class action suit for $600m on behalf of Tylenol users, claiming that the capsules had been manufactured defectively and packaged negligently. Relatives of the victims also filed suits for $10-15m damages, but the FDA quickly exonerated the manufacturers, and the American College of Legal Medicine likewise announced that neither the manufacturers nor the distributors were culpable, and that because someone was injured did not mean that someone had to pay. For Johnson and Johnson, however, despite all efforts, their sales dropped dramatically, their share of the market declining from 37% to 7% as other manufacturers moved in to fill the vacuum.

Copy cat crimes

Meanwhile, from all parts of the country came reports of further possible “me too” or “copy cat crimes.” In Denver a man was in critical condition after taking three Excedrins contaminated with mercuric chloride; and a bottle of extra strength Anacin was found to contain the anticoagulant and rat poison warfarin, while other Anacin containers were also believed to have been tampered with. Then a policeman in Florida was taken to hospital after drinking orange juice from a can injected with an insecticide, and a frozen chocolate pie was discovered to contain a tranquillizer. In Chicago and many other communities the councils banned children from trick or treating on Halloween lest they be harmed by poisoned candy. And, amid reports of pethidine in “brownies,” razor blades in hot dogs, pins in candy bars, and glass chips in apple strudel mix, the newspapers deplored the madness unleashed by the poisonings and commented that fear had stolen this year’s Halloween.

So a month went by, and the police continued to look for the murderer. In late October they found an eighth lot of cyanide laced capsules among the thousands of returned containers and discovered some promising finger prints, while the newspapers reported how the woman returning the capsules had narrowly missed becoming the eighth victim by taking Bufferin instead of Tylenol for a headache. A further lead vanished when investigations on a woman who had died in August disclosed that she had committed suicide. Then the police found another “prime suspect”; questioned again the man with the five unregistered guns; and received a letter from New York from the bearded man in hiding denying that he had anything to do with the poisoning. “Give yourself up,” retorted the attorney general, but still there was no arrest. Other suspects took lie tests; a relative of one of the victims was questioned but cleared; and as the election day neared the Illinois Republicans were hoping for a quick arrest that would bolster the chances of their candidate for attorney general.

But it was not to be; and as bleak November descended over the Windy City the assassin remained at large, a living inspiration to other would be mass murderers, and the people of Illinois, with the help of the Chicago machine, picked a Democrat attorney general. A few days later the federal government issued final regulations on how capsules and liquids were henceforth to be sealed and packaged. The Tylenol task force was scaled down; the bearded man remained in hiding; and Johnson and Johnson launched a new campaign to save their ill fated best seller. “Trust Tylenol,” they asked the public as they offered thousands of free samples in a new tamper proof package, thus saving millions of Americans from the desperate predicament of having to treat their pains and viraemias, their malaise and depression, and possibly even their ennui, with generic paracetamol.

Captions to figures:

001-003.jpg: These capsules are similar to those Tylenol Capsules, which were laced with cyanide. These capsules killed as many as seven people.

This article has (2765) words

Dr. Anil Aggrawal, M.D.

Professor of Forensic Medicine

Maulana Azad Medical College

New Delhi‑110002