CNN.com – Woman killed by viper among her exotic pets – Sep 13, 2004
Police believe an urutu pit viper bit the woman Monday, and neighbors said she drove herself to a hospital. She was transferred to University Hospital, where she remained in critical condition until her death Saturday evening.
“We have no idea how she made it to the hospital in the first place,” said North College Hill police Sgt. Robert Kidd.
Well, it’s because these toxins kill by causing a coagulopathy, and the victim then bleeds to death (usually internally, with intracranial hemorrhages and that sort of thing), but in a human-sized victim it takes a bit of time for all that to start. Unfortunately, once it starts it’s very very hard to turn off even with a good antivenom, which brings us to the next point.
Driving to the hospital made sense (it’s what I would have done), but the antivenin is where this falls apart. A while spent googling says this particular snake is very common in South America (pic 1/2 way down), and there’s an antivenin that works. Unfortunately, this bite happened in North America (Cincinnati) where this particular …polyspecific Bothrops antivenom… is not widely available. The Cincinnati and Columbus Zoos might have had it, and I’m sure they were called. There’s the Miami-Dade Fire Rescue Antivenin bank as a resource, too.
I couldn’t find a US source for this antivenin by googling (I’m sure it hasn’t been FDA approved, since there’s no market for it here), though I’d bet some herpetologists have it on either a compassionate or investigational basis. Finding it, if it exists, might be a trick.
Often, I see this sort of medical oddity and say “what would I do?”, and the answer I came up with is, I’d pour all the CroFab in I could find while looking for a specific antivenin, and get the patient to the ICU, while replacing all those clotting factors that are getting chewed up. I’m sure they did just that, and it’s too bad she died.
Pit bulls and pit vipers don’t make good pets.
I wonder if the snake was killed to try to make anti-venom from it directly?
Sorry.
Or even a milking attempt tried…
Did she even know what she had? I cannot fathom the thought process that she must have gone through.
“Hmm, Let’s see, an extremely poisonous snake, rare in North America that will kill me if I let it bite me, Gee, I’ve got to have one!”
Actually, this incident is a backhanded compliment to Emergency Departments everywhere.
People have a lot of faith in the ER doc’s abilities to fix anything, especially a animal bite.
When I lived in the High Desert in Sou. Ca. the ?misnamed ?Mojave Green? (actually the Mojave Rattlesnake) had a reputation for being aggressive and highly venomous. I used to see them on walks in the desert with my dogs (my wife refused to go with me, she was convinced I, or the dogs, were doomed) And never saw what I would consider ?aggressive? behavior, certainly not as aggressive as the Southern ?cotton mouth?
As for the lethality of the venom, it?s reputation appears justified according to this website.
http://www.emedicine.com/emerg/topic541.htm
I do know that all the ERs in the High Desert had pretty aggressive treatment programs for the snake. We had one G.I. get bit while I was stationed at George AFB, near Victorville, CA and even though he survived he was medically discharged for lingering after effects (I have no idea what!)
Bottom-line, venomous creatures are best left in nature
The best source for information about antivenin in the US is the ARIZONA POISON & DRUG INFORMATION CENTER
Arizona Health Sciences Center, Room 1156
1501 North Campbell Avenue
Tucson, AZ 85724
They can help locate exotic snake antivenin sources.
We recently had a death from either a black mamba or african twig snake. Both were in the box, guy who owned the snakes got bit and died. He left the box of 4 poisonous snakes on an empty lot in Downtown Little Rock. Thankfully the guy who found it did not open it.
Snake antivenin manufacture takes a while. Step one, get venom. Step two, inject a small does of the venom into an animal that makes antibodies that work in people (horses are the classic, though sheep are being used as well). Step three, remove blood from the animal and extract the antibody to the venom (while leaving behind all the other antibodies normally found in the host animal, which is a skill). Setp four, refine, then purify the antivenin. Step five, make sure the antivenin is of a known dose, then it can be given.
So, it’s not a quick procedure, and any actions with the snake wouldn’t have helped this patient.
I seem to recall that most snake bite deaths (like most freshwater drownings-from-boats) happen to persons with a positive and non-trivial blood alcohol level.
True or false?