Elixir Sulfanilamide: Deaths in Florida

The investigation and confiscation of Elixir Sulfanilamide in Florida was coordinated out of the FDA’s hub in Atlanta, under the direction of veteran Station Chief John J. McManus, 52.

To track down the 19 pints of Elixir Sulfanilamide distributed in Florida (to 16 drug vendors and two doctors in six communities), McManus charged Junior Sea Food Inspector Allan Rayfield, who was stationed at Jacksonville, to find lots in that city and then to move on to cover southeastern Georgia. In Florida, Rayfield received notable assistance from state health officials, specifically Phil Taylor, a supervising inspector in Tallahassee. “[T]hough not organized to do drug work,” McManus wrote in his official report, “[Taylor] gave immediate assistance both personally and through his assistants in checking shipments.”

According to McManus, Florida officers were involved in more than 75% of the state’s elixir investigations, all of which were performed in the far northern part of the state. On October 20th, all but one elixir recipient (namely, Capital Pharmacy of Tallahassee) was visited by Inspector Rayfield or state officials. In its Florida investigation, which lasted through November, the FDA learned of three deaths associated with four of six prescriptions that were dispensed in the state.

Elixir-related deaths in Florida (2 confirmed, 1 possible):

Fred L. (possibly Leroy) Williams, 35, a “colored” merchant tailor from Jacksonville, died on October 12th. Williams received his elixir prescription on October 3rd from Dr. Arthur W. Smith, as treatment for gonorrhea. Smith, also described by the FDA as “colored,” dispensed the six-ounce prescription from Jacksonville’s Gem Drug Store, which he owned. Three days later, Williams began to experience abdominal pain, and he found that he could not urinate “properly.”

Subsequent care by two other black physicians, who were unaware that Williams had taken Elixir Sulfanilamide, led to the performance of an appendectomy on October 7th. Postoperatively, however, Williams remained unable to urinate. He died four days later. The cause was attributed to acute hemorrhagic nephritis.

It is unclear how much elixir Williams drank from his six-ounce prescription. The FDA reported that “it was impossible, after diligent search, to find remainder in patient’s home” and concluded that the entire prescription had probably been consumed. A postmortem examination of Williams’s body disclosed multiple abnormalities in the kidneys, consistent with the recorded cause of death.

On April 20, 1939, Williams’s widow, Claire, filed a civil complaint against Massengill in the District Court for the Northeastern Division of the Eastern District of Tennessee (at Greeneville). According to archived court records, the plaintiff, represented by Caldwell, Brown, and O’Dell of Bristol, Tennessee, demanded $10,000 and court costs. Three months later, the case was settled out of court for an undisclosed amount.

Emanuel Cauley, 37, a “colored” laborer with the Atlantic Coast Line Railroad (also the employer of Alabaman Ewell Daughtrey), died on October 16th in Jacksonville. Like Fred Williams, Cauley received his prescription for Elixir Sulfanilamide from the Gem Drug Store. The elixir, dispensed on October 9th, was intended as treatment for a chronic, end-stage genitourinary condition, possibly gonorrhea. Cauley renewed his four-ounce elixir prescription on October 12th. He expired four days later and was buried on October 20th in Arlington, Georgia, his place of birth. On October 29th, Cauley’s treating physician told the FDA that, despite Cauley’s chronically poor health, Elixir Sulfanilamide hastened his death.

On October 14, 1939, Cauley’s widow, Sylvia, filed a personal-injury suit against Massengill. Legal representatives were Caldwell, Brown, and O’Dell of Bristol, Tennessee, who also represented the widow of Fred L. Williams. At issue during the preliminary argument of the case was whether Florida’s or Tennessee’s statute of limitations applied: The former was one year from the time of the victim’s death; the latter, two years. On March 18, 1940, Judge George Taylor of the District Court of the Northeastern Division of the Eastern District of Tennessee dismissed the plaintiff’s action on the basis of Tennessee’s statute of limitations. Sylvia Cauley was ordered to “pay all the costs of the cause for which execution may issue.”

Possible

J. C. Donalson, the four-year-old “colored” son of A. B. Donalson and Elma Lee Gee, from Seaboard, died on October 16th at Quincy. This death was discovered on November 10th by FDA inspectors, who sought to determine the whereabouts of two ounces of elixir, which were missing from a pint bottle that had been returned to Bristol, Tennessee, by Dr. Robert Fain Godard, 61, of Quincy. On October 20th, Dr. Godard reported to Florida Inspector Taylor that he had returned his elixir supply intact to the manufacturer; however, FDA Inspector Ford, stationed at Bristol, found only 14 ounces in the returned bottle.

During the FDA’s follow-up investigation in November, it was learned that Dr. Godard had supplied another physician, Dr. James Lloyd Massey, 24, with the missing two ounces. Dr. Massey then prescribed the elixir for the Donalson boy, who may have been “suffering from ‘polio.'” There was evidently some disagreement between the physicians, in hindsight, about whether the child died of elixir poisoning. Massey believed that the drug killed his patient; Godard disagreed. Deferring to the ambiguity between the medical men (both of whom happened to be white), the FDA reported, “There is some question as to whether or not this patient died as a result of elixir poisoning.”

The Donalson boy was buried on October 16th in Seaboard, Florida.

Primary sources:

FDA historical records (AF1258), Rockville, MD: Letter from J. J. McManus to Chief, Eastern District. November 11, 1937.

Court records: Williams v Massengill (1939) [NARA, Atlanta, GA]; Cauley v S. E. Massengill, 35 F Supp 371 (ED Tenn 1940).