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Arthur E. DePalma, MD; Donald S. Kwalick, MD, MPH; Nathan Zukerberg, MD

JAMA. 1970;211(12):1979-1981.

Abstract
Two siblings were poisoned with parathion, chlordane, and dimpylate (Diazinon) when they ingested the contents of an unlabeled jar. One of the children died despite atropine sulfate and pralidoxime chloride therapy. The patients had the highest serum gastric contents and tissue levels of parathion, chlordane, and dimpylate ever recorded, to our knowledge. The onset of symptoms was rapid and progressed quickly to coma and convulsions. Cardiac arrest occurred in the fatal case. Blood cholinesterase levels were markedly decreased in both patients, and urine paranitrophenol levels remained elevated for more than a week in the survivor. The danger of removing a toxic substance from its original container and placing it elsewhere is obvious. Rapid, aggressive, and specific therapy for organophosphate poisoning must be instituted even before diagnosis is confirmed by laboratory procedures.

Author Affiliations
From the Department of Pediatrics, St. James Hospital, Newark, NJ (Dr. Zukerberg), and the New Jersey Community Study on Pesticides, New Jersey State Department of Health, Trenton (Drs. DePalma and Kwalick). Dr. DePalma is now with University of Oregon Hospitals, Portland.

Footnotes
Reprint requests to Director, Pesticide Project, New Jersey State Department of Health, PO Box 1540, Trenton 08625 (Dr. Kwalick).

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