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Elixir Sulfanilamide: Death in Ohio

The FDA discovered one death in Ohio during its investigation of the whereabouts of 17 pints of Elixir Sulfanilamide in the state, which had been distributed among nine physicians, five drug stores, and one hospital. The FDA learned that the overwhelming majority of these lots, specifically 15, had been returned intact to Massengill’s headquarters in Bristol, Tennessee—including one pint that had been received by veteran physician Homer G. Long of Copley. However, it was also determined that Dr. Long had obtained, on request, a two-ounce sample of elixir from a local Massengill salesman, John L. Coyner. This sample was used to treat a six-year-old girl, with fatal results.

Elixir-related deaths in Ohio (1 confirmed)

Jo Anne Cramer, the six-year-old daughter of truck driver Chester and housewife Lesta (née Taylor) from the farming township of Copley, died on October 17th at a children’s hospital in Akron. The “entire details” of this case were provided in a list of nationwide elixir-related deaths compiled by the FDA on November 20th; however, it is clear from official records that this case came to the attention of the agency much earlier—at least as early as October 22nd. In addition, the Akron Beacon Journal showcased the details of this fatality in a lengthy article, “Roundup of Fatal Remedy Is Too Late to Save Child,” which was printed on October 26th.

The FDA records and the newspaper account are largely in agreement about the particulars of the girl’s illness and death. Because Dr. Long had successfully treated a boy’s scarlatina* with sulfanilamide, he wanted to use the same remedy for the Cramer girl, who had the same condition. However, the girl could not swallow tablets. As if on cue, Coyner visited Dr. Long on October 7th, and the detail man provided a two-ounce sample of the preparation, which was then administered to the girl. (According to the Beacon Journal, Coyner cheerily replied to Dr. Long’s request for a liquid version of the antibiotic, “Why, I have some right here. It’s just the thing you want.”)

Doses of Elixir Sulfanilamide were given to the Cramer girl for three days, but she rebelled against the medication. “She cried every time she had to take a dose of it,” her mother recalled to the Beacon Journal. “She would say, “Mamma, I hate that medicine, but if you say I must take it, I will.'”

The child was admitted to a children’s hospital in Akron on October 12th. She became stuporous and died of “uremic poisoning” five days later. Her mother was “near collapse,” the paper reported, when she learned that the elixir had caused her daughter’s death. Her guilt and anguish were captured in a brief statement: “I try to think that I gave it to her unknowingly, but that doesn’t bring her back. She might still be alive if I hadn’t made her take it.”

Jo Anne was buried on October 19th in Bath Cemetery, the day that Dr. Long received Massengill’s first recall telegram. In addition to her parents, Jo Anne was survived by four sisters and one brother.

On November 17th, Jo Anne’s mother hand wrote a letter to President FDR, asking for passage of a law requiring “laboratory tests” on new medications.

Dear Sir:

Being the mother of 6 year old Jo Anne Cramer (Ohio’s only fatality) of the Elixir of Sulfanilamide, I am writing you to please get a bill in this Congress to make it a law that all manufacturers must make laboratory tests on Guinea Pigs etc. before submitting a new formula to the public for use. I hope I have made myself clear. I know this won’t help Jo Anne but we all have loved ones. If you would have stood by the bedside of your little daughter’s giving them poison medicine and realize you had killed them I am sure you would do all in your power to prevent it from happening again. Please try. Thank you.

A heart broken mother
Mrs. C. R. Cramer

The unpleasant job of replying to Mrs. Cramer was passed from the White House to the FDA Chief, Wat Campbell—who had already penned a nearly verbatim response to the mother of another elixir victim, Mrs. Maise Nidiffer of Tulsa, Oklahoma (the mother of six-year-old Joan Marlar).

My dear Mrs. Cramer:

Your letter of November 17 was received and read at the White House and immediately referred to the Food and Drug Administration. In sending the letter to me there was transmitted the President’s request that your letter be answered by us.

Believe me when I say, Mrs. Cramer, that in my thirty years in Government service I have seldom had as difficult an assignment as the President’s request to reply to you. I have read and reread your letter, and I think I realize in some measure your unending sorrow at the needless sacrifice of your child.

The President and the Department of Agriculture, and many enlightened legislators as well as representatives of the public, have been urging with the utmost earnestness for more than four years the passage of a food and drug law which will give more ample protection than our present statute. One of the first actions of both the House and the Senate when they convened for the present special session was to pass resolutions for legislation which would prevent such catastrophes in the future. The Secretary’s report was delivered to both Houses of Congress on Thanksgiving morning. I am enclosing a copy. You will note that one of the recommendations made is to set up a licensing provision under which all new drugs must be adequately tested before they are put on the market.

Of course it should not have been necessary for your child to die, and for scores of others to die from the same medicine, to arouse public sentiment to the point that proper legislation can be enacted. If it is enacted—and I sincerely believe that there are enough men in both the House and Senate who have resolved that laws will be passed which will make a repetition of this tragedy impossible—I hope it may be possible for you to derive some grain of comfort from the knowledge that this catastrophe has had a real influence in bringing about legal control which will forever guarantee against the needless sacrifice you have suffered.

With the most sincere sympathy, I am
Sincerely yours,
W. G. Campbell
Chief

* A mild case of scarlet fever, caused by infection with streptococcus.
Primary sources: Part III, Report on Elixir Sulfanilamide manufactured by S. E. Massengill Company, Bristol, Tenn. NARA, Box 935, Central District Sulfanilamide Report; letter from W. G. Campbell to Mrs. C. R. Cramer. November 17, 1937. NARA, Box 931.