The death toll from cyanide-tainted "Extra-Strength Tylenol" capsules continued to mount here today as the sixth and seventh victims were identified and the Food and Drug Administration warned consumers across the country not to take the over-the-counter medication.
The most recent victim was identified by Chicago Mayor Jane Byrne and police as Paula Prince, a 35-year-old flight attendant found dead in her apartment late today. She was listed as the seventh victim in the rash of poisonings. A 24-capsule bottle of "Extra-Strength Tylenol" found in her bathroom carried lot number 1809MA, one not identified with the other six victims. In addition to today's two cyanide deaths, the FDA found more poisoned capsules.
The manufacturer, McNeil Consumer Products Division of Johnson & Johnson, has recalled two batches of Tylenol capsules -- lots numbered MC2880 and 1910MD -- more than a quarter-million 50-capsule bottles, nationwide.
The FDA also has ordered all bottles of "Extra-Strength Tylenol" capsules off store shelves in the Chicago area. The FDA national advisory against taking Tylenol applies only to the red and white "Extra-Strength" capsules, not tablets.
In the Washington, D.C., area, drugstores removed "Extra-Strength Tylenol" capsules from their shelves, although no signs of contaminated products have shown up. Details on Page A18.
Investigators here and FDA officials in Washington say they believe the contamination of "Extra-Strength Tylenol" capsules is limited to the Chicago area, and possibly to the batches received by one food and drug chain, Jewel-Osco. As the two batches were being recalled, FDA scientists analyzing Tylenol taken from hundreds of stores here found seven poisoned capsules in unsold bottles. FDA spokesman Bill Grigg said in Washington seven other capsules were suspicious. "The capsules apparently had a slightly tampered look to them," he said, and all 14 came from lot MC2880.
Contamination at the manufacturing level has been virtually ruled out by investigators, who are now seeking to discover whether boxes of the pain reliever could have been tampered with at the distribution warehouses or at the drugstores, or whether the killer injected cyanide into the capsules and placed them on store shelves.
"We have a madman out there," Illinois Gov. James R. Thompson said. "Anybody who would stuff cyanide into capsules that would kill anybody at random -- from a child to a grandmother -- is a madman."
The FBI, the Illinois State Department of Law Enforcement, the FDA, the U.S. attorney's office, four local police departments and two county coroner's offices are part of a task force investigating the poisonings that began Wednesday when three persons in the Chicago suburbs died after taking "Extra-Strength Tylenol" capsules tainted with cyanide.
Illinois Attorney General Tyrone Fahner said today that the task force is "investigating stereotypes of disgruntled employes . . . all along the production chain. From everything we know so far, the tampering occurred once the drug arrived in Illinois."
The investigation centers on Chicago warehouses and stores, since testing at the plants in Texas and Pennsylvania that shipped the suspect batches of Tylenol to the Chicago area in late August has proved negative.
During shipping, the containers of capsules are sealed in plastic and enclosed in cardboard. FDA officials are searching Illinois warehouses for opened or damaged packages, but have not found any.
One spokesman for the Illinois Department of Law Enforcement said that now that Tylenol capsules are being taken off the shelves the fear is that the killer may switch to another over-the-counter medicine.
The Tylenol deaths began Wednesday morning in Elk Grove Village, a middle-class suburb just northwest of O'Hare International Airport. Mary Kellerman, 12, who had stayed home from school the day before with a cold, was given "Extra-Strength Tylenol" capsules by her father for the lingering symptoms. Minutes later, he heard her fall. When he reached her, she had gone into a coma, and was dead before paramedics could get her to the hospital.
Some hours later, 27-year-old Adam Janus collapsed and was taken to Northwest Memorial Hospital in Arlington Heights, the town just north of Elk Grove Village. He had taken "Extra-Strength Tylenol" capsules for aching muscles.
Doctors attempted to resuscitate him at the hospital, but after hours of emergency treatment, he died. Stanley and Theresa Janus, his brother and sister-in-law, were at the hospital when Adam Janus died. Distraught, they went to his nearby house to grieve. Both took Tylenol capsules from the same bottle, according to Dr. Thomas S. Kim, chief of critical care at the hospital. Both collapsed and were quickly returned to the hospital where Stanley, 25, died despite hospital efforts to revive him. Theresa, 19, remained in critical condition through the night and the next day, but was declared brain dead and removed from life support equipment today, becoming the sixth fatality.
Two other victims were struck Thursday.
Mary Reiner, 27, of Winfield, Ill., had just returned home from the hospital with her new baby. She took "Extra-Strength Tylenol" early Thursday morning. In her purse, investigators found six capsules of the medication. Four proved to contain cyanide. All the pills were from batch MC2880.
Mary McFarland, 31, of Elmhurst, Ill., complained of a headache when she arrived at work Thursday. She took "Extra-Strength Tylenol" from a pill case in her purse and soon collapsed. Five of the 10 Tylenol capsules in her purse proved to contain cyanide, but the capsules were from a different batch than those afflicting the previous victims.
The two bottles of Tylenol she kept at home had batch numbers 1910MD and MB2738, but it is believed that McFarland took the capsules from the 1910MD batch, according to a spokesman in the DuPage County coroner's office.
The two suspect batches of "Extra-Strength Tylenol" were delivered by the company to two different regions, the MC2880 to the states east of the Mississippi and the 1910MD to the states west of the Mississippi. Both overlap in the Chicago market, a McNeil spokesman said.
Investigators say it is possible that all the poisoned "Extra-Strength Tylenol" bottles of capsules originated in shipments to the Jewel-Osco drugstore chain in the area.
Johnson & Johnson offered a $100,000 reward today for information leading to the arrest and conviction of the person or persons responsible for the deaths in Chicago.
Dr. Edmund R. Donoghue, Cook County deputy medical examiner, said that the killer apparently emptied out most of the Tylenol powder in the tampered capsules and replaced it with cyanide and possibly some other substance.
The "Extra-Strength" capsules normally contain 500 milligrams of Tylenol, but the fatal ones contained from 100 to more than 500 milligrams of cyanide, said Michael I. Schaffer, chief toxicologist in the office of the Cook County medical examiner. Between 50 and 100 milligrams of cyanide is considered a fatal dose, he said.
Dr. Thomas Kim, who is chief of critical services at Northwest Memorial Hospital, said from the time the first victim came into his hospital he was puzzled about the cause of the illness.
Here, he said, he had a victim in Adam Janus who was young and healthy, with no diseases, and after hours of work, doctors could not revive him.
It was then that Kim began to think of poison. By the time the second and third victims from the same family came in, he decided to run a blood test for cyanide poisoning.
He said the poison could have been anything, but cyanide kills very quickly without symptoms, and so he thought he would try the test. He also found that all three of the victims had taken Tylenol. Earlier he had police take all possible drugs and other poison agents from the Janus home.
Early Thursday morning the cyanide tests came back positive.