Published: Thursday, February 10, 2011, 7:15 AM
Updated: Thursday, February 10, 2011, 8:40 AM
Star-Ledger Staff By Star-Ledger Staff
Tianle "Heidi" Li of Monroe enters the courtroom in New Brunswick on Wednesday to be arrai
Tianle "Heidi" Li of Monroe enters the courtroom in New Brunswick on Wednesday to be arraigned on murder charges. She is accused of murdering her estranged husband, Xiaoye Wang, by poisoning him with thallium.
MONROE — Dressed in green jail garb and with her hands cuffed in front of her, 40-year-old chemist Tianle Li stood before a judge in New Brunswick on Wednesday and listened with quiet composure as she was charged with murdering her husband by dosing him with a rare lethal drug.
Li’s lawyer, Steven Altman, entered a plea of not guilty, and a few minutes later, the hearing was over.
But while the legal part of this story was sorting itself out, startling details were emerging about a frantic, heroic attempt by doctors, scientists, and federal and state agencies to save the dying husband as he lay in a hospital, slipping away from thallium poisoning.
The scramble to save 39-year-old Xiaoye Wang began around 9 p.m. on Jan. 25, when Steven Marcus, the medical and executive director of New Jersey Poison Control, received a call from University Medical Center in Princeton. A doctor was on the other end of the line telling him about Wang and that thallium had been discovered in his system.
Marcus couldn’t believe what he was hearing. This was only the second time in his 43-year medical career that he’d come across a case of thallium poisoning. The physician at the Princeton hospital knew little about the deadly chemical and even less about how to treat it.
"It’s either attempted suicide," Marcus told the doctor, "or homicide."
There was silence on the other end of the phone, Marcus said.
Then he told the physician there was only one way to save Wang’s life — an antidote called Prussian Blue — and only one company in the United States manufactured it.
Thallium is tasteless and odorless and was used in rat poisoning and insecticides until it was banned in the United States in the 1980s because of its toxicity. It is still used in small doses in glass-making, mirror circuits and certain medical tests.
Marcus, who says his nickname is "House," a reference to the television character because he’s often called about perplexing medical cases, said his first thought was to contact everyone he could think of who might be able to help.
One of the first he reached out to was a former colleague at the U.S. Department of Energy’s Oak Ridge National Laboratory in Tennessee. Marcus had taken a course there 10 or 15 years earlier and remembered asking at the time if the lab kept antidotes on hand for thallium.
A year or so prior to that he had been contacted by doctors treating a New Jersey schoolteacher for thallium poisoning. The woman eventually recovered and no one was ever arrested, but the unusual case had stayed with him.
At 5 a.m. on Jan. 26, as scientists at Oak Ridge tried to figure out how to get Prussian Blue to New Jersey in the middle of a snowstorm, Marcus shoveled his driveway in North Jersey, then headed to Princeton, continuing to make calls the entire way — to the state Health Department, to New York City poison control, to anyone who might have Prussian Blue in stock and was closer than Tennessee.
No one did, but Christopher Rinn, the assistant commissioner of New Jersey’s Department of Health and Senior Services, told Marcus the agency was at his disposal.
"He said, ‘Whatever you need. Let’s cut through this bureaucracy,’" Marcus recalled.
By this time, however, Wang was unconscious. He had come to the hospital in Princeton on his own on Jan. 14, the same day he and Li were due in court to finalize their divorce, said Middlesex County Assistant Prosecutor Nicholas Sewitch, who confirmed after Li’s arraignment Wednesday that Wang was administered a "lethal, massive" dose of thallium.
A neighbor living near the couple’s home in Monroe Township, who identified herself only by her last name, Patel, said the two were "not friendly. We didn’t talk ... We knew they were having problems. We saw the cops there all the time."
Sewitch was unable to say how the thallium was administered or whether it was given in several small doses over time, or in one dose. All he would confirm is that the drug was ingested in December or January. He also would not comment on where Li allegedly obtained the thallium, but did say it would have been available to her at Bristol-Myers Squibb in Lawrenceville, where she’s worked since 2001 as a research chemist.
When Wang first arrived at the hospital on Jan. 14, Wang was experiencing "flu-like" symptoms, Sewitch said.
Thallium poisoning typically includes loss of hair, thickened skin, severe gastrointestinal pain and loss of feeling in the extremities. Wang didn’t present many of those symptoms until a few days after his arrival, Marcus said.
At that point a nurse recalled cases of thallium poisoning in China in the 1990s and suggested Wang’s urine be tested, Sewitch said. No lab in New Jersey was capable of performing the test, so Wang’s urine sample was sent out of state.
Twenty-four hours later, the diagnosis of thallium poisoning was confirmed and Marcus was notified.
"If someone at the hospital had not guessed it might be thallium and tested for it, it might have gone undetected," Marcus said.
With time running out, Marcus suggested to a pharmacist at the Princeton hospital that she contact chemical supply companies in the area to try and obtain a less pure dose of Prussian Blue, which is also used to dye clothes as well as microscopic specimens in biological research.
A dose of the non-medical grade was found in a matter of hours and rushed to Princeton the medical center, but Marcus and the other doctors realized they had no idea how much of it to administer.
Still traveling through snow and ice, Marcus suggested diluting the bright blue powder in water and simply doubling the recommended dose.
Nearly two hours after leaving his home, Marcus arrived in Princeton. The non-medical grade Prussian Blue had been administered through a gastric tube, but Wang had showed no response.
In the meantime, Marcus had contacted a federal facility near Albany, N.Y., that had the purer form of the antidote, and an SUV was dispatched to Princeton. When it finally arrived five hours later, Wang was near death.
The antidote would be useless. Marcus, along with a number of doctors and nurses, stood beside Wang’s bed, unable to do anything more.
Sometime around 3 p.m. on Jan. 26, as several detectives stood nearby, Wang’s heart monitor flatlined.
"There was remarkable cooperation between the hospital, poison control, the police, the state health department, the Centers for Disease Control and the nuclear energy department in Tennessee — all to get this antidote to the hospital in snow in a matter of a few hours," Marcus said. "Unfortunately it was too late."
By Amy Ellis Nutt and Sue Epstein/The Star-Ledger
Staff writer Amy Brittain contributed to this report.
http://www.nj.com/news/index.ssf/2011/02/doctors_scientists_led_heroic.html李天乐涉嫌“铊杀”案华裔护士成关键证人 解药晚到了一步 据世界日报消息，在新泽西州的华裔妻子涉嫌毒杀丈夫案中，与华裔化学研究员李天乐(专题)正办离婚的王晓晔就医治疗无效后，是一名华裔护士提醒医师，王晓晔可能是铊中毒。一群医师，科学家，联邦政府及州府的调查人员，随即四处奔忙以拯救生命垂危的王晓晔，可惜取得解药时，为时已晚。这名华裔护士目前已被检方列为关键证人。
新泽西密德萨士郡检察官办公室发言人欧内尔（詹姆斯奥尼尔）表示，这名护士曾在中国参与治疗铊中毒的病例，察觉与王晓晔的症状有相似之处，因而提醒王晓晔就医的普林斯顿大学医院，应做此罕见毒物的化验。
据新泽西州明星纪事报报导，1月25日晚上9时，新州毒物控制处处长马可斯，接获普林斯顿大学医院打来的电话，该医院医生告诉他，调查人员在王晓晔体内发现金属铊。
马可斯无法相信他听到的讯息，因为在他43年职业生涯中，这只是他第二次碰到金属铊中毒案例。
这位普大医院医师对这种化学药物所知十分有限，更不知道应如何治疗马可斯告诉该名医生：。“这若非自杀案件，就是谋杀案件。”
之后，他告诉该名医生，治疗王晓晔的唯一方法，是使用普鲁士蓝（普鲁士蓝）这种解药。而目前全美只有一家公司制造普鲁士蓝。
金属铊是一种无味，无嗅的药物，它被用来制造杀老鼠的毒药及杀虫剂。由于它具有毒性，美国从1980年年代开始禁止使用。然而，迄今仍然有人使用少量的金属铊来制造玻璃，并用作某些医疗检测。
1月26日清晨5时，田纳西州橡树脊市的科学家，试图在暴风雪肆虐之际取得普鲁士蓝，以紧急送到新泽西州。马可斯勉力铲除了住家车道积雪，驾车前往普林斯顿市。一路上，他不断打电话给新州卫生厅，纽约市毒物控制处及可能持有普鲁士蓝的任何人。
当时，王晓晔已经昏迷。马可斯建议普林斯顿大学医院的一名药剂师，与附近地区的化学药物供应公司取得联系，以取得纯度较低的普鲁士蓝。结果虽然取得非医疗用的普鲁士蓝，但是马可斯及其他医师却都不知道应该使用多少剂量。
马可斯建议透过一根胃管，输入王晓晔体内双倍剂量的非医疗用普鲁士蓝，但是，王晓晔却没有任何反应。
在此同时，马可斯与纽约州奥本尼市一个联邦政府机构取得联系。该机构存有纯粹的普鲁土蓝解药。但是，当一辆多功能车奔驰五个小时，将解药送抵普林斯顿市时，王晓晔已经濒临死亡。1月26日下午3时左右，王晓晔停止心跳。解药送抵已迟，来不及救他一命。
[ 此帖被卡拉在02-11-2011 21:16重新编辑 ]
