The oxygen from the mask provided by paramedics during her transport to the hospital likely converted the DMSO into dimethyl sulfate (DMS), a highly toxic and carcinogenic alkylating agent.
Although dimethyl sulfate has a very low vapor pressure at body temperature, it is believed to have transitioned to a gaseous state due to the vacuum inside the vacutainer.
Respiratory therapist, Maureen Welch, noted that Ramirez's age, even with her diagnosis of cervical cancer, was odd since most patients exhibiting her symptoms were elderly.
[3] Hospital staff administered diazepam (Valium), midazolam (Versed) and lorazepam (Ativan) to sedate Ramirez; and followed up with lidocaine and Bretylium agents to address her abnormal heartrate.
[4][2][self-published source][3] Kane passed the tube to Julie Gorchynski, a medical resident, who noticed manila-colored (yellow-brown) crystalized particles floating in the blood.
Using a standardized questionnaire, Osorio and Waller found that the people who had developed severe symptoms, such as loss of consciousness, shortness of breath and muscle spasms, tended to have certain things in common.
But other factors that correlated with severe symptoms did not appear to match a scenario in which fumes had been released: the survey found that those afflicted tended to be women rather than men, and they all had normal blood tests after the exposure.
[6] Livermore scientists postulated on The New Detectives that the change in temperature of the blood drawn, from the 98.6 °F (37 °C) of Ramirez's body to the 64 °F (18 °C) of the emergency room, may have also contributed to a conversion from DMSO2 into DMSO4.
However, many organic chemists turn their noses at this theory, citing the length of time required for a reaction like this to occur and the uncooperative variables within Ramirez's body in making the conversion.
[2][self-published source] The family pathologist, Dr. Richard Fukomoto, was unable to examine her body upon its release, due to a large set of strange circumstances.
Some of the organs in Ramirez's body were cross-contaminated with fecal matter, her remains had become heavily decomposed by the time Dr. Fukumoto could examine them, and her heart had gone missing.
These findings led to further doubts from her family about the standard of care maintained at the hospital and by the county coroner, as along with her heart the vial of blood taken prior to Ramirez's death could not be located.
The Murdoch Mysteries episode "A Most Surprising Bond" is loosely based on the Ramirez case, using the DMSO hypothesis to explain how a hospital patient's blood is causing those around her to fall ill. Gloria Ramirez's story also played a part in inspiring the 1995 episode "Stink Bomb" of the three-part film anthology Memories by Katsuhiro Otomo, where a lab technician ingests an experimental drug and becomes a walking biohazard.