Cadmium poisioning death called extremely rare
Intentional poisoning by heavy metals — particularly cadmium — is so rare that the death of Russell Repine of Indiana County may be among only a handful of recorded cases in the United States, according to forensic pathologists.
"It's very uncommon and extremely rare to find (intentional) heavy metal poisoning," said Dr. Scott Denton, a deputy forensic pathologist with the Cook County, Ill., Medical Examiner's Office.
Out of 400 homicides he has investigated in seven years, Denton could recall only one in which a person was poisoned. That case involved a lethal overdose of illegal drugs.
"It is very, very, very rare," added Denton, who searched scientific literature on the subject.
Repine, 61, of Brush Valley, died last March of what his family and authorities at first believed was a heart attack. After questions were raised by Repine's family, Indiana County Coroner Thomas Streams obtained a court order to exhume his body.
Toxicology tests later revealed Repine had been administered a massive, lethal dose of cadmium, a metal found in nature and used in a number of industrial and commercial manufacturing processes. Because of the high amount of cadmium in Repine's body, Streams ruled the death a "criminal act" rather than from environmental or work-related causes.
State police also began investigating the case but have yet to name a suspect.
Meanwhile, questions from family members also led to the December arrest of a Florida man in a suspected cadmium poisoning case.
Authorities there have charged a Pinellas County man with first-degree murder, alleging that he slipped cadmium into his wife's drink. John Creamer is accused of killing Jayne Reel Creamer during a Valentine's weekend trip to an Orlando resort. An autopsy revealed the woman's death was caused by a combination of cadmium, Xanax and alcohol.
While arsenic and cyanide are more widely used in terms of deliberate poisoning, cadmium is used infrequently, according to Allegheny County Coroner Dr. Cyril Wecht, who has investigated thousands of deaths in his career.
"It's very rare. Many books don't even mention it," Wecht added.
Since Repine's death, Streams has exhumed a second body and is considering digging up three more in the ongoing investigation. The coroner said he is awaiting toxicology results on the remains of Anna Nagg, 58, of Saltsburg, whose body was exhumed late last year. If the results show that Nagg also died of a lethal dose of cadmium, he may exhume three additional bodies, all members of one family.
The U.S. Bureau of Justice Statistics, which tracks and analyzes crime trends, did not include a listing about poisons in its latest report on homicide trends in the United States. Poisons were not even listed as a manner of death except in cases involving carbon monoxide or illegal drugs. The Centers for Disease Control lists poison deaths only by pills, alcohol and chemicals; heavy metals are not included in its reports.
Denton said cadmium is rarely used to murder someone because it is so hard to obtain.
However, an investigation by the Tribune-Review revealed that cadmium — in various forms and of the highest purity — can be purchased over the Internet and through catalog sales for less than $100 from a number of companies that manufacture chemical compounds for scientific and industrial use.
Dr. Joshua Hamilton, director of the Dartmouth Toxic Metals Research Program at Dartmouth University in New Hampshire, said these metallic compounds usually are sold for research or manufacturing purposes. He said a customer could buy 50 grams of 98 percent pure cadmium chloride for $22 plus shipping. He added these metals are not regulated by law.
Pathologists say that cadmium remains in a person's body for years.
During an autopsy, Denton said, a pathologist would take samples of the victim's muscular tissue, brain, liver, lung, kidney and spleen so toxicologists could measure the amount of cadmium in the body. He also said the contents of the stomach and small intestine usually are examined for cadmium levels because traces of the metal remain embedded in body tissue for decades.
Denton said before a body is exhumed, investigators also need to check the soil surrounding the grave site to make sure it is not contaminated with cadmium, a substance found naturally in the environment and in the workplace.
"It's not uncommon for deaths like this to eventually come to the surface," Denton continued. "At first, they're attributed to natural causes, but you need someone with a high nose for suspicion."
In the Indiana County investigation, Repine's son, Kerry, at first didn't suspect foul play because his father was a heavy smoker and heart disease ran in the family.
Nagg's health also was precarious; she suffered from diabetes and was on the waiting list for a liver transplant. Her death certificate initially indicated she died as the result of cirrhosis, sepsis, heart failure and pneumonia.
