The mysterious fumes that killed one person and sickened nine others inside a McDonald's restroom this week may have brought the most unwanted publicity to the city of Pooler, Ga., since Gen. William Tecumseh Sherman set up Union headquarters there before negotiating the peaceful surrender of Savannah in December 1864.
Local fire officials remained stumped Friday about what toxic chemical or chemical mixture knocked two women unconscious Wednesday at the fast-food restaurant in their east Georgia city of about 19,000. One of the women, Anne Felton, 80, of Ponte Vedra, Fla., died after going into cardiac arrest. Firefighters administered oxygen to Carol Barry, 56, of Jacksonville, Fla., before she was admitted to a Savannah hospital, Pooler Fire Chief G. Wade Simmons said.
"Every one of the 10 people that had some sort of symptoms ... had been or were in that restroom," Simmons said.
No one anywhere else in the restaurant was affected.
He was hoping that results of an autopsy conducted at Georgia's state crime lab in Savannah "will lead us in some direction."
Among other confounding aspects of the case, he said, was how quickly the gas disappeared. "It was there, and then it was gone in the next hour to hour and a half we were doing things at the scene," he said.
By the time a Savannah hazardous materials analyzed air samples from the restroom, they found nothing detectable.
That left law enforcement officials and toxicologists to speculate about what the victims might have inhaled, and how it ended up in the women's room. "We've heard everything from terrorist attacks to carbon monoxide to sewer gas to God knows else," Simmons said.
Much of the speculation centered on the possibility that the women were sickened by a noxious combination of cleaning chemicals. Labels on toilet bowl cleaners, drain openers, window and glass sprays and scouring powders usually caution against using more than one product at a time.
Simmons said that based on employees' routines at the Pooler McDonald's, workers would have cleaned the women's room early in the day, before serving up Egg McMuffins to the morning breakfast crowd. But the initial report of someone choking didn't get called in until just before noon Wednesday, further deepening the mystery of why people suddenly became ill so much later. None of the products on the cleaning cart had spilled, he said, and the cart wasn't even near the bathroom when patrons began developing symptoms.
"Cleaning chemicals are common culprits in bathrooms," said Dr. Kelly Johnson-Arbor, a medical toxicology specialist at Hartford Hospital in Connecticut. "Perhaps the people in the bathroom mixed together bleach and ammonia," which would produce chloramine gas, an irritant. "It doesn't usually cause people to die, but if it's in a high enough concentration and/or the person had underlying cardiopulmonary disease (such as asthma), it could certainly be potentially fatal."
Dr. Marcel J. Casavant, chief of pharmacology/toxicology at Nationwide Children's Hospital in Columbus, said he thought the most likely culprit was hydrogen sulfide, or "sewer gas," which blocks the body's ability to use oxygen. It's called a "rapid-knockdown" gas, he said.
"If the concentration is high enough, just a few breaths could be lethal," he said. "If the restroom has a floor drain connecting to the sewer, and the floor drain has a U-shaped pipe which generally stays full of water, thus keeping the sewer gas out of the restroom, but the water in the U dried up, then gas could freely enter the restroom. "