Massengill's Elixir Sulfanilamide: The Scramble to Confiscate (9)

California

The FDA's San Francisco station oversaw the confiscation of elixir that was distributed from the Massengill Company's branch, located at 240 Fourth Street. Of the nearly 30 gallons shipped from Bristol, more than 4 gallons, mostly in pint containers, had been distributed between September 23 to October 13 to a dozen pharmacies, several physicians offices, and one hospital. A few shipments went to nearby Oakland but most were dispersed to small towns scattered throughout the middle of the state. Two pints each were also sent to Meeker, Colorado, and Eugene, Oregon, thereby establishing interstate commerce of the product from Massengill's San Francisco warehouse. An initial inventory by the FDA revealed that only 2 pints had been returned as a result of the company's recall telegrams [1].

At the Livermore General Hospital, which had received 1 pint of elixir, only 1 patient had been given the medicine—the son of staff physician, Dr. William E. Judson. What follows is probably one of the most complete case reports by the FDA of the effects of Massengill's product and that of contemporary medical treatment [2].

This son, a student in the University of California and member of the football squad, came home from school on the ninth of October with a sore throat that was diagnosed by his father as of streptococcic origin. In order to be positive a smear was made of the throat on Sunday morning, the 10th, and analyses run for the elimination of diphtheria, which was found to be negative.

Upon diagnosis of a streptococcic throat condition Dr. Judson, who had had some previous experience with the Massengill Sulphanilamide ampules [intended for intramuscular administration] and with negative results, decided to administer the Elixir Sulphanilamide orally and a course of three teaspoons at 12:00, 4:00, and 8:00 P.M. in treatment was started at noon on October 10th. The midnight dosage was reduced to 2 teaspoonsful and on Monday a full course of treatment of two teaspoonsful each was inaugurated. On Monday night early the stomach rebelled and throughout Tuesday the patient was nauseated but did not vomit. He complained of his head, stating that it did not feel right and that his mind was not clear. The urine on Tuesday was quite scanty.

On Wednesday morning the patient was in an almost comatose condition and Dr. Judson became greatly alarmed because he could not account for these symptoms. He ordered a continuing treatment of hot packs with frequent hot drinks, continuing this treatment throughout Wednesday afternoon and Wednesday night. On Thursday the treatment began to yield satisfactory results and the alarming symptoms cleared up but even up to the time of my interview with Dr. Judson on October 22nd he states that the boy was still in a very weak condition, showing a continued lassitude and dullness. It was also stated that he had lost about 20-lbs. weight and because of the weakened condition was still out of school. Dr. Judson stated that the feeling of nausea continued for approximately one weeks time and that at times the son complained of severe pains in the joints.

Insofar as other medication was concerned Dr. Judson stated that on Thursday the patient was thoroughly purged with Pluto water and that for several days beginning about Thursday the 14th, administration of salicylates was made for the joint pains. No other medication was used. Dr. Judson states that he feels the son is now out of danger and on the road to recovery but he is still naturally somewhat worried because of the publicity that the Elixir has received in connection with the deaths of certain patients having been treated with it. Dr. Judson is firmly convinced in his own mind that the alarming symptoms developed by his son after the administration of this drug were directly brought on and caused by the treatment.

The only death due to Elixir Sulfanilamide in California occurred in Fresno. Five-year-old Orvin Kutz, Jr, (son of Orvin, Sr, and Cecilia) consumed a total of 1 ounce from a 2-ounce prescription. Initially Orvin's clinical condition, characterized by a streptococcal sore throat and high fever, improved rapidly with treatment, but within 12 hours, he repeatedly vomited and became listless. Ten days later he developed anuria with uremic encephalopathy and died October 20 [3,4]. On November 30, Orvin would have celebrated his sixth birthday. 

1. FDA correspondence. Letter from R. B. Bork to Chief, San Francisco Station. October 19, 1937.

2. FDA correspondence. Letter from R. B. Bork to Chief, San Francisco Station. October 26, 1937.

3. FDA correspondence. Letter from J. O. Clarke to P. B. Dunbar. November 20, 1937.

4. FDA correspondence. Letter from W. G. Campbell to Mrs. O. C. Kutz. May 25, 1938.

Photograph "Windmills and Golden Hills 2016" outside of Livermore, CA, by "CatDancing" at Flickr.