Probe focuses on arsenic in baby's death

The baby died yesterday at Children's Hospital after he and his sister became violently ill on Saturday shortly after they ingested the poison, which had been stored in a plastic jug next to similar jugs filled with spring water at a home on Little Nahant Road, a law enforcement official said.

The parents had needed water to mix the baby formula for the infant. They also gave some to the toddler, who was drinking water from a cup. No one else at the cookout became sick, the official said.

State Police in Massachusetts and Maine performed a high-speed relay Sunday, rushing to Children's Hospital with an experimental antidote from a Bangor hospital where several church parishioners were treated after they were poisoned with arsenic in April.

Nahant Police Chief William F. Waters declined to identify the victims or their parents, who live in Middleton, and said his officers are investigating with the State Police and the Essex District Attorney's office.

A Nahant town official and the law enforcement official identified the owner of the home as 75-year-old Constantine Pitsas, whose wife, Angeline, declined to comment yesterday, on the advice of an attorney.

"At this point in time, we are looking at this as a tragic accident," Waters said. "We have no reason to believe" that the owner of the home "was trying to do any harm to the children."

The law enforcement official said the victims' family is not related to Pitsas, a dentist, who the town official said is apparently a business acquaintance of the children's father.

The party Saturday at the secluded, seaside home was business-related. At some point, the children's parents needed water to mix baby formula, the law enforcement official said. Pitsas, who bottles his own water from a local spring, directed them to jugs filled with spring water next to at least one filled with arsenic, which is odorless and colorless.

Waters said investigators are trying to determine why Pitsas had the arsenic and why he kept it with water jugs.

Arsenic, typically sold as a liquid to be diluted with water, was used for years to kill rats, plant pests, and weeds. Starting a few decades ago, arsenic began to be replaced by other active ingredients, but remains in low concentrations in some weed killers, health officials said. Arsenic doesn't degrade, so old pesticides could still contain lethal concentrations.

Arsenic poisons its victims by interfering with the ability of cells to produce the energy that fuels all bodily functions. Waters said tests on the substance at the house showed a high concentration of arsenic mixed with water.

After drinking the poison, the children became sick a short time later, the law enforcement official said. They got progressively worse, and the parents left the cookout but apparently weren't too concerned because the toddler had a playmate who was sick earlier in the week.

But on the drive home to Middleton, the children became violently ill. The couple drove to Beverly Hospital, where a nurse asked what the children had had to eat or drink. The father drove back to Nahant, got the jug, and drove back to the hospital. When the nurse unfolded an old label turned inside out and stapled to the jug handle, they discovered it was arsenic, with a pricetag of 78 cents.

The children were immediately sent to Children's Hospital, where the poison control center for Massachusetts and Rhode Island is located. Doctors there consulted with colleagues in Maine who helped treat 15 adults sickened in April after they drank arsenic-laced coffee at a church event in New Sweden.

Officials at the Northern New England Poison Control Center in Portland, Maine, suggested that an experimental antidote helpful in the Maine cases could be used, in addition to readily available treatments.

They encouraged Eastern Maine Medical Center to send left-over dimercaptopropane sulfonate or DMPS to Children's, according to Dr. Anthony J. Tomassoni, medical director of the Portland poison center.

DMPS has been widely used abroad, where arsenic poisoning is more common, but has not been approved for sale by the US Food and Drug Administration. Doctors may obtain it through some pharmacies for emergency use.

At Children's, the drug was apparently used in combination with another antidote, British antilewisite or BAL. BAL works best to remove arsenic from the central nervous system (brain and spinal cord) but it is injected into muscle and can be very painful and can have toxic side effects.

DMPS can be given orally or through intravenous injection and helps remove arsenic elsewhere in the body, particularly in tissues and blood. Both chemicals work by binding to the arsenic and helping the body excrete it.

The 2-year-old girl was being treated at Children's Hospital yesterday, according to the Essex district attorney's office. An autopsy is scheduled to be performed on her brother today.

Officials at Children's Hospital and the poison control center declined to comment on the case, citing patient privacy regulations. "DMPS worked very well for us in Maine," said Tomassoni. "We thought it wise [for Children's] to shift to DMPS or use it simultaneously."

In New Sweden, one man died of the arsenic poisoning, but 15 others have recovered after aggressive treatment, Tomassoni said. No one, so far, has shown signs of the weakness and severe pain that are among the most debilitating long-term effects of arsenic poisoning, he said. One patient has shown signs of liver damage, but appears to be improving, he said. "These folks now all have low residues of arsenic in their urine, so low that it's indistinguishable from background levels," he said.

Yesterday, Denise Monteiro, a spokeswoman with the Department of Social Services, said that a complaint alleging that a child had been abused or neglected was filed with the agency yesterday. It is unclear who filed the report.

The filing of a report triggers a 10-day investigation that will include interviews and findings from both the Nahant police and the district attorney's office.

"The goal is to find out what really happened," said Monteiro. "We need to find out if the child was endangered, or if it was just a tragic accident that could not have prevented."

Alice Dembner of the Globe staff and Globe correspondents C. Kalimah Redd and Nick Zamiska contributed to this report.