Document ZBvdr5nJkyE10bKLk6XJ22O3L

X feotiotib tufsam.1 mweikSTo tmva&sas cartsAes LiTioAtio* 3EELER-WANSKE CLINIC : h bccu* o , * COChanC u 3 4 *iS st 2 ' V M A U *' 0 - v*n.*c- v 0 ; V0 * C Vi'J*-:,5\i 'S *0P4'#O 3 ; - < 'At*ntr 9'* *.r,8 s jt 5*h S*ft s/VtasCrv 'em/AfeiC.:;*?'. 2 5-3 35 2 Jct ; Septemoer 28, 1970 R. Emmet Kelly, M. D. Monsanto Compony 800 N, linabergn Boulevard St. Louis, Missouri 63166 Dear Or, Kelly; Re: Corryl Vosburg We ore ltill seeing the workmen wno were injjred In the Cyanide derivative soiil, After receiving the literature that you sent and all other sources I could find, I believe most of our cases have been from the Cyanide derivatives. It is interesting that all seem to have cerebral signs and symptoms. They, of course, were cyanotic, but depression of his respirations and he would be almost in tetany with noted strong muscle contractions but not a convulsive type reaction. Then while attempting to keep him in oxygen he had such wild thrashing purposeless movements that it was impossible to keep him in oxygen. If his respiratory rate hod continued to drop, I was considering intubating nim even though we would have hod to use Anectine or a similar arug for muscle paralysis, then push oxygen with a Bird Machine or Anesthetic Machine. I I have hod occasion to us# oxygen by intubation on two cases this year -- one hod a stroke involving the basilar arteries ang_fhe respiratory center went out. We were aole to get oxygen going before his heart irreversible damage. If is interesting now soon such cases pick up a galloo rythym ana how auickly the heart muscle can regain its sfrengtn ana begin normal contracfibility wnen a normal oxygen concentration is reacned. The otner was in a six year old white female whose mother thought she hod the measles when In fact sne hod thrombocytopenia purpura and must have had many petechial hemorrhage into the orain and spinal cord. She finally must have had enaugh edema to knock out fh# respiratory center. The pediatrician and I initially thougnf the hod meningococcal meningitis (sne nod the positive Kernig's and nuchal rigidity) so you can imagine our surprise wnen sne naa a negative sninal tap. She also aevelooed a gallop rythym quickly and the gailop aisoopeared on tubing and forced oxygen. The girl expired ana we couidn't aef a post for religious reasons. Her piatelef count got down to less than 10,QQO/nsm^ What this is leading up to is that none of these oeooie with cyanide ooisoning deveiooed a gaiiop nor a significant drop in blood pressure. However, ail hoa received amyinifrife oeorn MCQ 9462375 T H IS N O TIC E . IT IS DUE TO THE O UALITY OF THE O R IG IN A L DOCUMENT. X oo ro WATER_PCB-SD0000063121 o Fmofie?n nfnxaxi MesgArw rxsomaet comui Litzaasiea I F THF. F I I X IMAGE I S LESS CLEAR THAN T H IS NO TICE. IT IS DUE TO THE OUALITY OF THE O R IG IN A L DOCUMENT. -2- Re: Oorryi Vosburg and cut of five only (wo required Sodium Nitrite and Sodium Thiosulfate infrovenously, The Kelocyanor from the literature oopeari to be perhaps better than the Nitrite - Thiosulfate method; or at least it leaves one more addition to the old method. One would hesitate to give Anectine to one wno aireaay nod cyanide poisoning and odd another toxin to the proolem but I feei if one waited until the spasm - tetany type reaction was gone and respirations stopped, ana one could intubate witnout this, that it would be too late. Tine cereorol cortex seeming to oe Dy tar me most sensitive to cyanide poisoning. I wish some of those Frenchmen would nave tried this. They tried almost everything else. Have you considered the amount of Kelocyanor we might need in stock? The instructions are in French out Miss Siraweil at fne Technical Library can fix this for us. Is this an experimental drug or has the Federal &ug Administration accepted its use? I realize it should be stored in a acrk place but how long is it stable? I brought uo the question of Federal Drug Administration because the instructions <re far too simple to suit their taste. Respectfully submitted, OOS:as Otto O. Smith, M. D, 'PYp o o to & ii MCO 9462376 WATER_PCB-SD0000063122 TRANSCRIPT OF PROCEEDINGS IN THE SUPERIOR COURT OF THE STATE OF DELAWARE IN AND FOR NEW CASTLE COUNTY MONSANTO COMPANY, Plaintiff, AETNA CASUALTY & SURETY COMPANY, - al. , Defendants Civil Action Number 88C-JA-118-1-CV NON-ARBITRATION CASE KELLY DEPOSITION EXHIBITS PROTECTED MATERIAL: MONSANTO INSURANCE COVERAGE LITIGATION Washington, D. C. Thursday, February 4, 1993 ACE - FEDERAL REPORTERS, INC. Stenotype Reporters 1120 G Street, NW Washington, D.C. 20005 (202) 347-3700 NATIONWIDE COVERAGE 800-336-6346 WATER PCB-SD0000063123