Elixir Sulfanilamide: Deaths in Georgia

The FDA’s Atlanta Station Chief, John J. McManus, learned on October 20th that more than 21 gallons of Massengill’s product had been distributed among 83 drug vendors or physicians in 60 different communities within Georgia. Most were small towns scattered about the northwest part of the state or along the South Carolina border (for a map of the distribution of elixir in Georgia, go here). Unfortunately McManus received little help from Georgia officials in the urgent effort to confiscate Elixir Sulfanilamide. The state’s Chief Drug Inspector, Jackson Evans Bush, said he could spare only two of his men (who were able to visit about 15 of the 83 druggists). Consequently McManus mustered two of the FDA’s chemical analysts, in addition to two junior inspectors, to cover the rest of the state.

In their “race against death,” as it was declared by the Atlanta Constitution, the FDA men learned that at least two dozen prescriptions for Elixir Sulfanilamide had been written in Georgia. In addition, several individuals had obtained the elixir over the counter from local druggists. The FDA’s investigation in Georgia extended well into November and uncovered 13 elixir-related deaths.

Elixir-related deaths in Georgia (11 confirmed, 2 possible):

Ewell Daughtrey (or Daughtry), 32, an unmarried railroad foreman from Dillard, Alabama, died at 1:30 pm on September 26th at the Atlantic Coast Line Railroad Hospital in Waycross, Georgia. A month later, the Atlanta Constitution reported the suspect death at Waycross. But the hospital’s chief of staff publicly denied the report, because the patient—who was, nevertheless, believed to have died of poisoning—had not received sulfanilamide “in any form” while at the hospital.

An ensuing FDA investigation ultimately revealed that Daughtrey had indeed received two ounces of Elixir Sulfanilamide on September 16th in Alabama, as treatment for gonorrhea. (Daughtrey, like John Holloway and Anderson Crews, was therefore one of the first known recipients of Elixir Sulfanilamide.) The elixir was prescribed by a physician in Clio. Thereafter Daughtrey experienced the typical signs and symptoms of diethylene-glycol poisoning, including anuria. A series of physician referrals in Alabama ultimately led to the 200-mile transfer, by rail, to the company hospital in Georgia on September 23rd.

On admission at Waycross, Daughtrey was noted to be comatose. Hospital physicians, who were unaware of the elixir treatment, detected uremia (the NPN level was 100 mg/dL) and a troubling creatinine level (5 mg/dL). Poisoning with mercury bichloride was entertained, despite the fact that there was no recent history of its use. Inpatient treatment consisted of “hot packs in an effort to rid blood of poison thru skin pores.” Heroic, but futile, efforts were also made by one physician, who “ran tubes all the way to kidney and with syringes could not obtain any urine.” The medical staff found Daughtrey’s case “very odd” and one in which they “gave their interest and professional skill.” Daughtrey died three days after admission. An autopsy showed that the kidneys were “perhaps an unusual deep red in color.”

When interviewed by the FDA, one of Daughtrey’s treating physicians in Alabama claimed that Daughtrey’s kidney dysfunction could have been caused by gonorrhea, but he also conceded that it was probably aggravated by Elixir Sulfanilamide. The FDA let the chronology of events speak for itself.

Daughtrey’s Georgia death certificate recorded his causes of death as uremia and acute nephritis. Daughtrey was buried in Baptist Cemetery in Brundidge, Alabama on September 28th.

Jewell Fitts, a 36-year-old unmarried post office clerk from Dahlonega, died on the evening of October 5th at Downey Hospital in Gainesville. Assigned to investigate the territory of northern Georgia, Chemical Analyst Arthur Henry was, at first, stonewalled by Dahlonega’s “extremely irascible” physician, Dr. Samuel A. West, who had received one pint of Massengill’s elixir. Henry’s interviews with West on October 22nd and 26th produced only sketchy information about any elixir prescriptions. Undeterred, the FDA agent continued his investigation by “gossiping with natives.” These interviews revealed that Jewell Fitts had, in fact, obtained Elixir Sulfanilamide from Dr. West.

Henry then found the attending physician of the Gainesville hospital, Dr. John K. Burns, who described how Fitts had been admitted on September 29th for “kidney lock.” Dr. Burns said that, during six days of hospitalization, Fitts had passed less than one ounce of urine. Burns also relayed that, after learning of the toxicity of Massengill’s product, he urged West to inform the victim’s family of the poisonous medicine. But West allegedly “refused to do so, saying it would ruin his practice.”

Burns recorded the cause of Fitts’s death as acute hemorrhage nephritis. Fitts was buried in Mount Hope Cemetery in Dahlonega on October 7th.

Betty Louis Satterfield, the 34-month-old daughter of Jonnie and Rosa Mae from Greensboro, died on October 6th.* FDA inspectors Rayfield and Olson, along with a state inspector, probably learned of this death on or about October 20th, while investigating the whereabouts of a one-pint shipment of Elixir Sulfanilamide to the City Pharmacy of Greensboro. According to the FDA report, the child was first seen on October 1st by Dr. Goodwin Gheesling, 68, who diagnosed erysipelas of the right leg. Local therapy—consisting of ichthyol ointment, lanolin, and Vaseline—was recommended, along with four ounces of Elixir Sulfanilamide (one teaspoon “in a little water” every three hours). To address the girl’s “chest involvement” and low-grade fever, the physician offered Phenacetin (Bayer’s brand-name antipyretic drug), aspirin, and cocoa-flavored quinine—the latter as treatment for possible malaria.

On October 4th, the child was brought back to the physician, who “found the chest involvement seriously complicated.” The respiratory rate was “much accelerated,” and her temperature exceeded 102 ⁰F. Prescriptions dispensed at this time were Calcidine (a branded calcium-iodine preparation for laryngitis), syrup of ipecac, and Cocillana (a narcotic cough syrup).

Gheesling made a house call the following day and found that the erysipelas had improved, but that “all the other conditions” were “aggravated.” Prescribed treatments at this time reflected the direness of the child’s condition: atropine sulfate, presumably to stimulate the heart rate; elixir lactated pepsin for gastrointestinal disturbance; morphine sulfate for pain; and soothing peppermint water. On October 6th, the girl was observed to be cyanotic and in a semicomatose condition. The next day, cyanosis was “completely developed,” and she was “fully” comatose. The child died on the afternoon of October 7th, presumably at home.

The official causes of death were listed as pneumonia and septicemia. Although the FDA apparently did not question the contribution of Massengill’s elixir to the girl’s death, the treating physician was “quite sure that there was no kidney involvement nor suppression of urine.”

The recorded cause of death on Betty’s death certificate was streptococcal sepsis. The child  was buried on October 7th in the Shiloh Cemetery at Penfield.

* There is disagreement between the Georgia death certificate and the FDA records regarding the date of death. The state record indicates that the child died on October 6th; FDA records provide the date of October 7th.

Luther Norman Gillham, a 29-year-old married man from Porterdale, died on October 8th at a Covington hospital. During his first visit to Cannon’s Drug Store in Porterdale on October 21st, FDA Inspector Wiley Simms learned that a four-ounce prescription had been dispensed from a one-pint bottle of Massengill’s antibiotic elixir (the remainder of which had already been returned to company headquarters in Bristol). Simms directed the druggist to contact the prescribing doctor to ensure that the medication was discontinued.

For unclear reasons, the agency’s follow-up of this prescription was not performed until November 2nd, when FDA Inspector Lewis Smith visited the drug store. To what must have been his surprise, Smith found no record of the reported elixir prescription at Cannon’s; however, he noticed that a prescription was missing from the chronological records for the date of October 1st. After “some denials,” the druggist finally admitted to Smith that Dr. Jackson C. Loveless, 46, whose office was at the rear of the drug store, had written a four-ounce elixir prescription for Gillham on October 1st.

When interviewed by Smith, Dr. Loveless admitted that Gillham had visited his office on September 23rd with “a very evident pronounced case of gonorrhea.” The doctor prescribed a water-based concoction of zinc sulphate, lead acetate, colorless hydrastis (goldenseal), and bismouth subnitrate, which was to be injected (presumably by way of a penis syringe). About a week later, however, on October 1st, Gillham again presented to the doctor, who then prescribed Elixir Sulfanilamide—which had just been received by Cannon’s Drug Store from Massengill’s headquarters in Bristol.

Dr. Loveless also admitted that he had taken the prescription record for the elixir from the drug store files. Evidently frightened of being associated with Elixir Sulfanilamide (given the national publicity) but apparently even more frightened of a government inspector, Loveless offered to return the prescription record. He furthermore admitted that Gillham had died, and that his patient had received subsequent treatment from Dr. W. W. Baxley, also of Porterdale.

Accompanied by Loveless, Inspector Smith proceeded to interview Dr. Baxley, who revealed that he had been first called to Gillham’s home on October 4th, when he “found the patient suffering considerable pains about the kidneys.” He attributed the symptoms to progressive gonorrhea. Unaware that Dr. Loveless had prescribed Elixir Sulfanilamide, Baxley recommended sulfanilamide tablets as treatment, along with capsules containing caffeine, citrate, acetophenetidin (Phenacetin), and acetylsalicylic acid (aspirin). Baxley also administered a “hypodermic of morphine” to “ease the severe pain.”

Baxley revisited Gillham on October 5th, at which time the patient complained of nausea and vomiting. Gillham also claimed that he had not passed any urine. Baxley then prescribed sodium bromide, elixir phenobarbital, and liquid taka-diastase (a digestive aid). The next day, Baxley found Gillham to be delirious and febrile, and the patient remained anuric; 24 hours later, Gillham was comatose. On the morning of October 7th, Baxley admitted Gillham to the Huson (or Hudson) Memorial Hospital in Covington, where the patient received a liter of glucose and a half liter of saline intravenously. Gillham died the following day; the cause was attributed to nephritis.

When Inspector Smith interviewed Baxley, the physician was surprised to learn that his patient had been given Elixir Sulfanilamide. “It was the first he had heard of it,” the FDA agent reported. Baxley then suspected that the product had killed his patient: “I might say that this man’s symptoms were strikingly similar to cases reported who had died taking [Elixir Sulfanilamide],” he told the agent. After the FDA interview, Baxley proceeded to Gillham’s house in an attempt to locate the remaining elixir, but he was informed that all of Gillham’s medicine bottles had been “broken and buried.”

Dr. Baxley recorded Gillham’s causes of death as acute nephritis and suppression of urine, with a contributory cause of “G. C. urethritis.” Gillham was buried in Alcova Baptist Church Cemetery in Lawrenceville on October 10th.

Herman Bolton, a 35-year-old* divorced taxi driver from Millen, died on October 16th in a local hospital. On October 22nd, FDA Inspectors Allan Rayfield and Ollie Olson visited Bell’s Drug Store in Millen, where one gallon of Massengill’s elixir had been shipped. The store manager, Mr. Seaborn Crawford Bell (son of the owner, Henry Quinn Bell), assured the inspectors that no sales of the product had been made from the store, and that the gallon had been returned intact to the manufacturer on October 18th “via express.” Examination of the store’s prescription files supported the claim.

However, FDA Inspector Ford, stationed in Bristol, later found that only seven pints and 10 ounces had been returned from Bell’s Drug Store, leaving six ounces unaccounted for. Inspector Rayfield returned to the Millen drug store on October 28th, when Mr. Bell again reassured the agent, by way of an affidavit no less, that no elixir had been dispensed. Bell did admit, however, that he had given 36 sulfanilamide tablets to Bolton on or about October 6th and a mixture of tincture of benzoin compound and “Goinchon” on October 14th. Bell also acknowledged that he had filled a prescription for Bolton, written by Dr. Henry G. Lee, for Atabrine, an antimalarial drug.

When interviewed by Rayfield, Dr. Lee reported that he had examined Bolton “a few days” before his death and recorded “complete stoppage of the kidneys, enlarged spleen and liver, the inability to retain food or liquids in the stomatch, and considerable albumin in what little urine the doctor could obtain.” The physician also noted severe flank pain and failing eyesight. Lee said that it was difficult to diagnose and treat Bolton, because the patient was “mentally deranged as a result of a head injury received in an automobile accident about a year ago.” Without further knowledge, Lee diagnosed “semi-comatose malaria” and sent Bolton to the hospital on October 14th.

Rayfield then learned that, in the hospital, Dr. R. E. Jones diagnosed Bolton with gonorrheal infection, “slight temperature,” and acute nephritis with complete anuria. It was noted that Bolton had also suffered with vomiting and diarrhea, which suggested to the doctor the possibility of chemical poisoning. Dr. Lee recorded the cause of death as lobar pneumonia, with the contributory cause of “comatose malaria.” In hindsight, however, Jones and Dr. Lee admitted to the FDA agent that Bolton’s death was consistent with elixir poisoning; although they had no knowledge as to whether the patient had actually consumed the product.

It then became the FDA’s job to establish that Bolton had indeed obtained Elixir Sulfanilamide—most probably from Bell’s Drug Store—despite repeated denials from the store’s manager. On November 3rd, Inspector Rayfield interviewed Bolton’s half-brother, who reported that he had cleaned out the decedent’s car and found a “half-filled 6 fluidounce bottle containing a clear red liquid with Bell’s Drug Store label.” There was evidently no number or doctor’s name on the bottle, and Bolton’s brother reported that he had thrown the bottle in a rubbish pile next to his store. Then, according to Rayfield’s report,

[The half-brother], 3 negro laborers, 2 white boys and myself spent half of the morning and the entire afternoon thoroughly searching this rubbish pile and surrounding area in an attempt to find this bottle. It has not yet been found. All the children in the immediate vicinity have been questioned by [the half-brother] and myself and none have apparently seen it.

Bolton’s mother confirmed to Rayfield that her son had received two different medicines from Bell’s Drug Store, one of which was a “red, clear liquid which he took in doses of 2 teaspoonfuls in water every four hours.” When Bolton became seriously ill, his mother questioned the “advisability of continuing […] the red medicine.” An interview with Bolton’s coworker and a return to Millen Hospital failed to produce further leads.

Finally on November 4th, Mr. Bell admitted to Rayfield that he had, in fact, dispensed six ounces of Elixir Sulfanilamide to Bolton. The reason for Bell’s turnaround remains undisclosed in FDA records; however, it is possible that the manager had difficulty refuting Rayfield’s unmistakable descriptions of the elixir from Bolton’s half-brother and mother. Rayfield discovered that Bell and Bolton were “quite good pals” before the victim’s disabling car accident and concluded that the elixir had been sold over the counter, without a prescription. It seems likely that Bolton had presented to his friend in confidence, complaining of gonorrheal symptoms, and that the store manager had casually supplied the six ounces of Elixir Sulfanilamide in a moment of misguided compassion.

The recorded causes of death on Bolton’s death certificate are lobar pneumonia and comatose malaria. These were based on clinical assessments. Bolton was buried two days after his death.

* The chief source for Bolton’s age is his death certificate (birthdate, October 23, 1901). The FDA reported that Bolton was 25 years of age at the time of his death. Bolton can also be found in census records under the name of Herman McMillan.

Robert Lee Fields, a 66-year-old widowed farmer from Garfield, died on October 17th.

On October 21st, Inspector Rayfield visited Metter‘s Chandler Pharmacy, which had received one gallon of elixir. Rayfield was informed that a six-ounce prescription had been dispensed by Dr. Robert L. Kennedy, 39, to a woman from Stillmore and that the remainder of Massengill’s product had been returned to the company. Promising to check up on the woman, Dr. Kennedy conveyed to Rayfield that his patient had consumed almost all of the medication and “suffered no ill effects, excepting some pain in the region of the kidneys when first taking the Elixir.”

On November 10th, Inspector Ford, stationed at Massengill’s headquarters in Bristol, reported that no package from Chandler Pharmacy had been received. This news immediately prompted Rayfield to revisit the pharmacy, where he learned that another elixir prescription had been dispensed, also by Dr. Kennedy, to a 45-year-old widow, Lillie Lyons. Further investigation revealed that Fields, who was living with Lyons, had secured the medication for her. In his continued investigation, Rayfield learned from Fields’s adult son that both patients had suffered with gonorrhea and that both had taken the medicine.

The cause of death on Fields’s death certificate, which was signed by Dr. H. A. Alderman of Portal, was acute nephritis.

Leonard Jackson Dees, a 22-year-old single “colored” farmer from Griffin, died on October 18th in adjacent Lamar County. The FDA learned of this fatality on the morning of October 20th, after lawyers had contacted state laboratory officials, asking where they “could get some medicine analyzed in connection with a damage suit.”

In the FDA’s immediate follow-up, it was learned that Dees had visited Dr. Arty E. Huckaby, 54, of Griffin on October 11th for treatment of a gonorrheal infection. Dr. Huckaby reported that he had been prescribing sulfanilamide tablets for Dees, “but on this particular day when in Cole’s Drug Store he noticed the new shipment of the Elixir and decided to use it instead of the tablets.” The official report continued,

Dr. Huckaby did not see Dees again until Oct. 18, when he was called to Dees’ home. He found him in a very low state and near collapse. He found that he had not urinated between Oct. 11 and the 18th and had taken about 2/3rds of the original 6 oz. prescription according to directions, namely 2 teaspoonsful in water every 4 to 5 hours. After patients death he was autopsied by Dr. Fry, Griffin, Ga., on Oct. 21st. Autopsy revealed a redened [sic] condition of the kidneys and liver which indicated paralysis of the kidneys.

At the time of death, which was attributed to acute Bright’s disease, neither Dr. Huckaby nor Dr. Fry was aware of the emerging nationwide fatalities due to Elixir Sulfanilamide. In retrospect, however, both believed that the product had killed Dees.

The outcome of the damage suit, in which unnamed plaintiffs were presented by attorneys Chester A. Byars and Claude Christopher, is unknown by this writer.

Dees was buried in Spring Hill Cemetery near Milner on October 20th.

Lillie Lyons (née Nealey), a 45-year-old widow and farm laborer from Aaron or Garfield, died on October 19th in a Statesboro hospital. Through its continued investigation of the Chandler Pharmacy in Metter, the FDA learned on November 10th that an eight-ounce elixir prescription, written by Dr. Robert L. Kennedy, had been dispensed to Lyons, and that she had shared the medicine with her live-in mate, Robert Lee Fields. The widow’s hospital physician, Dr. Benjamin “Ben” Arastus Deal, 53, cited the official cause of death as “locked bowels” or intestinal obstruction.

Lyons was buried in Popular [sic] Springs Cemetery in Emanuel County on October 20th.

Robert L. Parks, a 19-year-old man from Dahlonega, died on October 19th at Downey Hospital in Gainesville. From interviews with the “extremely irascible”Dr. Samuel A. West on October 22nd and 26th, FDA Analyst Arthur Henry learned that Parks had received a few (either two or four) ounces of elixir from the physician. It was further revealed that, when Parks “began to show bad effects from the medicine,” West sent his patient to the hospital, about 20 miles southeast of Dahlonega.

In an interview with the hospital’s attending physician, Dr. John K. Burns, Henry learned that Parks had been admitted (like Dr. West’s other elixir-treated patient, Jewell Fitts) with “kidney lock.” During his five days of hospitalization, Parks passed only three ounces of urine. Dr. Burns reported that he was willing to attribute the patient’s death to Elixir Sulfanilamide.

Parks was buried in Mount Hope Cemetery in Dahlonega.

Seth L. (probably Lawton) Durden, a 26-year-old single “colored” truck driver from Wadley, died on October 21st in a Millen hospital.

FDA Inspector Allan Rayfield visited the Lewis Drug Company in Swainsboro on October 21st, at which time he learned that over-the-counter sales of the elixir had been made to two unidentified men. The inspector then contacted the county health officer, advising him to “be on the lookout” for any suspect deaths in the area. The death of Seth Durden and the hospitalization of Will Portwood (below) were discovered as a result.

Rayfield learned that Durden had seen Dr. R. C. Williams of Wadley on October 14th, at which time the patient complained of severe headaches, flank pain, and copious vomiting.* Dr. Williams diagnosed gonorrhea and acute nephritis and administered liquids both orally and subcutaneously “to get the kidneys to function”; however, these efforts failed to produce the desired effect.

On October 20th, Williams sent Durden to the hospital in Millen, where the patient was attended by Dr. R. E. Jones. In a note to Williams, Jones relayed his puzzling experience with Durden in colorful and comprehensive fashion:

You really handed me something when you sent me that patient. I went over him very carefully and could find nothing organically wrong with him other than his G. C. infection. As you said, he had almost a complete suppression of urine. I gave him about 4000 cc. of fluids during the time that he was here, but his kidneys never did open up. I catheterized him last night and got about 1-1/2 ounces of bloody purulent urine.

Jones then described his attempts to examine Durden’s renal system, by obtaining a “flat plate” or radiographic x-ray image of the abdomen and then by intravenously injecting a radiopaque dye (Hippuran, which is normally passed through the kidneys).

I took a flat plate of his abdomen yesterday afternoon which revealed no stones nor mechanical blocking of the ureters. I gave him an I. V. Hippuran, took a picture twenty minutes later and there was no dye collected in either kidney.

From the course that he ran and the general picture that he presented, he undoubtedly had an acute nephritis with almost complete anuria. Just what the cause of this condition I am not certain. Whether the anuria was due to his urethritis or not I do not know. He had diarrhea with nausea and vomiting, which suggested to me a possible chemical poison, probably bichloride of mercury.

I did everything I could for him but was unable to open up his kidneys. He died this morning at 12:45.

Dr. Jones’s impression, per the FDA report: kidney dysfunction due to “puss poison.”

While neither Jones nor Williams was aware at the time of treatment that Durden had taken Elixir Sulfanilamide, both agreed later that the product caused his death. On Durden’s death certificate, Jones recorded the cause of death as “Sulphanilamide Poison.”

Durden was buried on October 24th at Greens Cemetery in Emanuel County.

* Notably the doctor reported that Durden’s dog had died after eating the patient’s vomit.

Will (William Leon) Portwood, a 34-year-old farmer from Swainsboro, died on October 26th at Franklin Hospital. The county health officer, Dr. R. L. Smith recognized this case as being due to Elixir Sulfanilamide after being warned by Inspector Allan Rayfield on October 21st of over-the-counter sales from the Lewis Drug Company.

Portwood was admitted to the local hospital on October 22nd with acute nephritis and suspected appendicitis. When questioned by Dr. Smith, the patient admitted that he had purchased four ounces of Elixir Sulfanilamide from the Swainsboro drug store on October 16th, and that he had taken the medication for two days, until “severe nausea” prevented further consumption of the drug.

Soon after hospital admission, only one ounce of urine could be obtained by catheterization. Specific treatment for the poisoning was sought through an extended series of queries: first from Smith to the State Health Officer, then to the FDA’s Atlanta and Chicago Stations, and finally, to the American Medical Association. It was ultimately recommended that intravenous glucose and calcium gluconate be tried. Despite this last-ditch therapy, Portwood continued to produce only miniscule amounts of urine, and his clinical condition quickly deteriorated.

On October 23rd, Portwood complained of “failing hearing and eyesight.” Three days later, “he was totally deaf and blind.” In addition, “[p]aralysis developed in the throat, arms and hands before death.” Dr. Smith officially ascribed Portwood’s demise to Elixir Sulfanilamide poisoning.

Portwood was buried in the cemetery of the Bethel Primitive Baptist Church in Twin City.

Possible

Arnette (or Anett) Lewis, a 16-month-old “colored” girl from McDonough died on October 6th at home. Word of this fatality came to FDA Inspector Lewis Smith by way of the local branch of a Baltimore-based drug company. One of the company’s customers, Dr. Robert V. Brandon, 26, of McDonough, had left a gallon bottle of Massengill’s product with the branch for analysis. The company then turned the bottle over to Smith, who discovered that two ounces were missing.

It was learned that the girl had first been brought to Dr. Brandon on October 4th for evaluation of a “bad sore throat” and “swollen neck and lips.” Brandon diagnosed a streptococcal infection and prescribed Elixir Sulfanilamide, which he had received directly from the Massengill company. The following day, during a house call, Dr. Brandon, along with Dr. W. P. Harris of Hampton, found the “throat situation pretty well cleared up.” Then suddenly at 1 am on October 6th, the girl “awoke from a sound sleep, gasped twice and…died.”

Although the child had consumed one-half of her elixir prescription during the two days, she had not shown the tell-tale signs of diethylene-glycol poisoning—namely kidney failure—during her brief illness. Brandon reported to Inspector Smith that the only possible indication of renal dysfunction was the child’s swollen face; however, he had noted this sign before he prescribed the elixir, he claimed. Dr. Harris believed that the child had suffered with either a “heart condition” or pneumonia.

Nevertheless, because of the girl’s death and recent news of elixir-related fatalities, Dr. Brandon wanted Massengill’s product chemically analyzed for clarification. Yet he remained skeptical about the elixir’s contribution to his patient’s death. The FDA report officially concluded, “There is considerable question that this patient died as a result of the administration of elixir sulfanilamide.”

In Dr. Brandon’s 1993 autobiography, Three Quarters: A Memoir, there is no mention of the Lewis case, his experience with Elixir Sulfanilamide, or any interactions with the FDA.

The child was buried in McDonough Cemetery in McDonough on October 7th.

Mrs. Mark (Morning Catherine) Reynolds (née Bracewell), a 77-year-old farmer’s wife from Dublin, died on October 12th. In its October 21st investigation of the E. L. Black Drug Store, which had received one pint of Massengill’s elixir, the FDA learned of five elixir prescriptions from this establishment. Follow-up investigation revealed the possible, elixir-related death of Mrs. Reynolds.

The FDA discovered that, on October 7th, Dr. Will C. Thompson had prescribed Elixir Sulfanilamide, one teaspoonful in water every four hours, as treatment for Reynolds’s pyelitis, or kidney inflammation. When interviewed by the FDA, Thompson described the woman, whom he saw only once, to be “in an extremely toxic condition” at the time of the prescribed treatment.

On November 4th, FDA Inspector Rayfield learned from the patient’s family that Reynolds had not complained of any stomach or back pains during the therapy, although she had vomited once. Specifically her “kidneys and bowels functioned normally and freely up until [she] died.” In fact, five minutes before she died, she rose from her bed and urinated. She then returned to bed, stated that the “felt funny,” and expired. Reynolds had consumed between one and two ounces of Massengill’s elixir. Her official cause of death, according to the county health officer, was “unknown.” The FDA concluded that Elixir Sulfanilamide was “not responsible” for this death.

Mrs. Reynolds was buried in Rock Springs Church Cemetery in Dublin on October 13th.

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