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34

Inborn Error of Justice

24 March

Patricia Stallings
Gas chromatograms showing the difference in retention times of ethylene glycol and propionic acid.

Patricia Stallings was wrongfully convicted of poisoning her son Ryan with antifreeze. He was later proven to have died of a rare hereditary disease. Joe explains Gas Chromatography, and Sandra talks about her acid reflux.

Sandra got her information from:

Joe got his information from:

  • Unsolved Mysteries
  • The National Registry of Exonerations, by Michael S. Perry
  • Methylmalonic acidemia, on Genetic and Rare Diseases Information Center
  • Annual scientific meeting lecture, on American College of Medical Toxicology
  • Misidentification of propionic acid as ethylene glycol in a patient with methylmalonic acidemia. James D. Shoemaker, MD, PhD, Robert E. Lynch, MD, PhD, Joseph W. Hoffmann, PhD, and William S. Sly, MD. Article in The Journal of Pediatrics, March 1992.
  • Ethylene glycol, glycolic acid, and metabolic acidosis of unknown origin. Article in Clinical Chemistry · September 1993. DOI: 10.1093/clinchem/39.8.1753a · Source: PubMed.

Audio transcript

Midweek Murders contains graphic and explicit content, listener discretion is advised.

Guess who's vaccinated?! This bitch! Catch me outside. Oh yeah, you can't, because you're not vaccinated! I'm just kidding, I wouldn't go outside. That would require having a life.

My dad got his vaccine today.

Oh! Congratulations to your dad.

Cause he's an old man.

Should we start maybe? Smack this out of the park.

You're the one in a rush.

A bit, a little bit. And not only because I'm on the beers, so there might be a pee happening.

Multiple toilet breaks.

Yeah. I did go to the toilet beforehand, but you know. Just runs right through me. Are you hungover today? Or are you drinking?

I'm a drinky smurf.

Nice. I have a Hop House, wonderful.

Me too.

Oh! Wonderful, wonderful. Oh, it's almost like we're matching today! Sisters!

But only four left, because I got a bit carried away yesterday.

Whoops. What did you do yesterday? Watched footy?

Oh god, don't call it footy. [Laughter]

No, I realized. I realized I couldn't. I was like: "no, that doesn't... it doesn't work for you. Retract!"

[Music]

ah there it goes yeah we're ready we're

ready and at it

it's wednesday which means that it's

time to talk about crime you're

listening to midweek murders

and i'm your host sandra

I'm your host Joe.

so this week we're going to talk about

patricia stallings

who was sentenced to life in prison for

the murder of her son

ryan i got my information from the

national registry for accelerations

article in science mag by michelle

hoffman

wikipedia a book called genetic twists

of fate

by stanley fields and mark johnston and

an article on justice denad d

nad i got mine from unsolved.com

an educational law website which i

assume is some

university national institute of health

website

acmt.net no idea what that stands for

exciting but it was an annual scientific

meeting that doesn't sound very exciting

and then two journal articles one called

ethylene glycol glycolic acid and

metabolic acidosis of unknown origin

and another one called misidentification

of propionic acid

as ethylene glycol in a patient with

methyl melonic acidemia

and that is a mouthful so

patricia stallings had led a difficult

life and she had been homeless for a

while and at one point had to give up

her son for adoption

as she had been accused of child abuse

because of neglect

but how many children does she have at

that point

only one but not ryan yeah that wasn't

ryan it was another one

okay yeah but in the mid 1980s

she had managed to get her life back on

track and had secured a job as a store

clerk in saint louis

patricia had met her husband david at

her place of work

as he was a regular customer at the

store

they got married in 1988 moved into a

nice house

close to lake wawanoka we'll go with

that

i'm sorry and we'll move past it

and in 1989 the couple had a son

who they named ryan in a quote from the

book

genetic twists of fit patricia stated

that

that truly was the happiest time of my

life everything was perfect

everything a new house a new baby i mean

what could go wrong ever since he was

born

ryan seemed to suffer from gastric

distress

here i have my first question in sweden

we have this thing called colic which is

when babies

cry all the time they say that it's when

the baby have an upset stomach

constantly

is that gastric distress no oh

what is that in english ah it's uh

colic is it

i was expecting this story to be

something that wouldn't translate

and i'd have no idea what you were

talking about and you were like it's

called colleek

oh yeah colic

that makes so much sense

oh well all right yeah so colic is like

you said when a baby is distressed and

crying

and there's no known reason behind it

gastric distress would be things like

vomiting and diarrhoea

so only things that are involved with

digestion

and the gastric tract okay okay

so it's like what i have but but a

recognized medical condition

not this hissy my bowels don't work kind

of nonsense

that you've got well it's kind of the

same thing as colleek as a child

because they're like there's something

wrong with your digestive tract

we can't really do anything about it

good luck

yeah so ibs would coincide with the

bottom half of

gastric distress and gastric distress is

kind of an umbrella term

so ibs is probably included in that

somewhere and also we do vomit

not all of us but i do not that often

but you know although

that's because you've got a drinking

problem no

no it's because when i get stressed my

acid

reflux kicks into high gear it's got

nothing to do with anything other than

your alcohol consumption

sure okay i did not study seven years in

medical school for you to tell me you've

got

acid reflux and the best punchline of

that

joke was that you opened the beer right

after you said it

[Laughter]

yeah so when ryan was three months old

patricia took him to the emergency room

at cardinal glennon

children's hospital in saint louis on

the 7th

of july 1989 as ryan had fallen acutely

ill

he couldn't seem to keep his food down

and patricia noticed that he seemed

lethargic

and that he had trouble breathing at

first

she had arranged to go to another

hospital but patricia claimed that she

got lost

on the way there which i'm guessing

people found suspicious

because it was noted in a lot of the

articles and stuff that i read

anywho ryan was placed in the

pediatric intensive care unit oh my god

i just

why did you pick a case that's all about

hospitals you know there are going to be

words in there that neither of us can

say

and with neither of us you mean me yeah

i was being nice

and patricia and david checked into the

hospital

hotel which i'm not sure it was a hotel

but they rented a room at the hospital

and i was like i'm gonna

put this in my own words so we'll just

call the hospital hotel there might not

be one

disclaimer over the hospital did some

tests

and when the results came back they

showed that high levels of

ethylene glycol was found

in ryan's blood an ingredient found in

antifreeze and acetone for us

non-americans antifreeze is

an engine coolant question mark

no one antifreeze is not an american

thing

oh okay cool

i don't know

and two you're kind of in the right

ballpark

with it being engine coolant it's part

of what's used in the fluids of engine

coolant

to stop it from freezing in low

temperatures

okay it's also widely used in the

aeronautics industry and is one of the

biggest pollutants minus you know jet

fuel

from the air industry because they pour

it all over their planes and then it

rains and it all gets washed into the

water system

oh i didn't know that so

now i'm going to ask you what ethylene

glycol

is it's like a manufactured thing

yeah it's synthetic particularly in the

u.s

it's ingested a lot in suicide attempts

so a lot of the hospitals will get

ethylene glycol

poisoning cases it also presents

a very similar set of symptoms

to inherited metabolic diseases yeah

we'll get to it

so we don't spoil anything go give you

the symptoms of

ethanol eff

wow the tables have turned

oh i found that way too satisfying

yeah here you did

ah okay sorry i'm finished

the symptoms of ethylene glycol

poisoning and vomiting

abdominal pain renal failure coma

and quite interestingly like with

alcohol poisoning the medical treatment

for ethylene glycol ingestion is to

administer

ethanol oh which is

an alcohol yeah ethylene glycol has no

natural role in the body it's poison

it's toxic it is manufactured for its

low freezing point to be used in

anti-freeze products

oh cool yeah so dr robert lynch

who was the person treating ryan got

understandably worried

and notified the relevant authorities

about his suspicions

that ryan had been poisoned and with

understandably worried i'm not sure if

that's

accurate to be fair to the doctor you

send

the blood tests off and you get a result

from the lab

and you assume that what comes back from

the lab is correct

so from his point of view understandably

he would be concerned because this

sample has come back with

poison in it yeah yeah so ryan was then

placed in a foster home

and was not in patricia and david's care

for three

months although patricia was allowed to

visit him

with a social worker present on one such

visit

on the 1st of september 1989

patricia was left alone with ryan for a

couple of minutes

as she fed him from a bottle and four

days later

patricia was apprehended outside of her

home

at the police station she was informed

that ryan was in the hospital

but she was not allowed to visit him

patricia stated about the

arrest that i kept thinking this would

all get straightened out

i thought somebody would figure this out

they'd

say oops and we'd all go home

the police had arrested patricia because

they thought that she had poisoned ryan

with the baby food

drink in the bottle at her last visit

with him he had been hospitalized only

three days later

and had passed away on the seventh they

also claimed that there were traces of

ethylene glycol on this bottle

antifreeze was found in the basement of

the stalin's home

although i don't think they ever deny

that they

owned antifreeze and patricia was

charged with first degree murder

and although she didn't know it at the

time she was pregnant

in february 1990 patricia gave birth to

another son

david junior he was put into foster care

and both

patricia and david were refused visits

with him

only weeks later david jr was taken to

the hospital

as he had fallen ill with the same

symptoms as ryan had suffered from

and the hospital he was taken to was the

same one patricia had first arranged to

take ryan to

before getting lost on the way and

settling on

cardinal glennon children's hospital

at the hospital david junior was

diagnosed with methylmelonic aciduria

mma for short a rare hereditary disease

so what is mma and not the

mixed martial arts that's when people

kick and

punch the [ __ ] out of each other inside

a ring before malonic aciduria is

an inherited metabolic disorder

so in this case it's from a recessive

gene

which means that you need to inherit one

gene from

both of your parents who will be

carriers

so in the words of the hunger games the

odds are

ever in your favor right i thought you'd

enjoy that

so to put it into perspective if two

carrier parents

were to have four children two of them

would be completely unaffected one of

them

would be positive for and one of them

would be a carrier for mma methylmalonic

acid

will stop you from being able to break

down

certain proteins in your diet which

causes a toxic buildup

of methamlonic acid which is what then

causes

the toxic symptoms and side effects so

in your diet there are

four amino acids that you would break

down

in your body from proteins so you eat a

bit of chicken

that chicken's full of protein that

protein might include

isoleucine valine methionine and

threonine

those are the four amino acids that are

affected by

mla your body will break that down into

propional coenzyme a that will break

down

into methylmelonyl coenzyme a

and that will break down into methyl

melonic acid

when it gets to methylmalonyl coenzyme a

there are more steps in a normal

metabolism

to break it down further for you to then

be able to use that

as an energy source in patients that

suffer from

methyl melanic acid urea it stops

there so the methyl myelonyl coenzyme a

just all gets converted into

methylmalonic acid

and you can't get rid of it and it

builds up and builds up and builds up

until you start exhibiting symptoms now

the interesting part is that this is

an inherited metabolic disorder so

children have it from birth they've

always had this condition

but it only starts exhibiting itself

when the diet changes from breast milk

or placental absorption

onto artificial food because then the

protein ratio

changes or when they move on solid food

and start eating

normal proteins and carbohydrates and

that's when the build-up starts

happening

so that's why there's a delay between

how old did you say ryan was three

months

yeah so yeah he would have been

breastfed or

pumped and would be having his mother's

milk which would have already

broken down the proteins to being on

formula milk which will have

those proteins in them that they assume

the child can break down

and that's when it starts building up

and going wrong and that's why

david junior was taken into hospital

much

sooner right because his mother wasn't

in the picture

yeah so he would have been moved on to

artificial milk

pretty much straight away was he weeks

old when he was first admitted

i think so there's no cure for mma

and there's no cure for a lot of iems

but there is a treatment plan which

involves

a low protein diet and a lot of

supplements and certain drugs that can

aid the body

in the metabolism process apparently

1 in 90 000 babies

in the u.s are diagnosed with mma

but the good thing is that there are

nationwide protocols

that are looking at newborn screening to

give children

the best chance of survival that's mma

i'm done

done cool moving swiftly on

because of david junior's diagnosis

patricia's lawyer

realized that ryan must have died from

mma rather than having been poisoned

but he presented no evidence to prove

that theory

the judge decided that patricia's lawyer

wasn't allowed to present this theory to

the jury

but he did tell the jury that ryan could

have died of natural causes

george b mcelroy iii

that's the name and a half the

prosecutor responded

you might as well speculate that some

little man from mars

came down and shot him full of some

mysterious bacteria which

no that is not at all what he's saying

and also what i've got another quote

from our georgie boy

oh god here we go okay regarding

the decision to release to the jury the

information

that ryan could have had methyl

melanocateuria

begin quote we were concerned that if it

came

out that ryan had this methyl melonic

aciduria we believe that would not be

relevant

and might cause the jury to make a

decision

based on something that's really not

relevant end quote oh my

god so what you're doing there georgie

boy

is uh withholding evidence yeah

it's the exact same symptoms

both children had it patricia was not

allowed to see david junior at all

i don't understand how that could be

irrelevant

in any way it is the most

relevant i got so annoyed oh god

also during the trial there was a no

passed between the judge

and georgie boy and that note

had on it a confession from the treating

doctor

if we go back to this boy who i

previously defended

as seeing the lab results and just

trusting them

that note said that the treating doctor

considered

the possibility of methylmelonic

acetyria

but decided not to test for it oh what

because there's nothing

like putting the safety of your patients

first

i retract all of my face that i had

presumptuously put in him i feel like

this

is crazy but oh well i read a lot of

like

things about experts that testified

that he must have been poisoned and

stuff like that but i didn't include

that

but just so the listeners know the

prosecution put up a lot of experts that

said

that he must have been poisoned even

though

his symptoms from being poisoned with

ethylene glycol would have presented

itself

earlier than after through the days

of the exposure and would have responded

to treatment yeah he went through

hemodialysis

and was treated with ethanol if you

catch that early enough

those are the antidote to ethylene

glycol poisoning

so he would have recovered so i feel

like these experts

in quotation marks must have not been

that

knowledgeable after all or maybe they

just

chose to admit that i don't know so

while we're

uh on the topic of the

criminal proceedings it was posed in

court

that it could have possibly been

methylmelonic acid

urea

it could possibly have been mufa melanic

acetyria

the prosecutors argued that there was an

important and significant difference

between ethylene glycol and propionic

acid and so they believed that ryan had

still been poisoned

now to explain propionic acid is a

naturally occurring acid in the body but

it also

has a significant buildup with patients

who suffer from mna

okay the reason that they made

that distinction between ethylene glyco

and propionic acid

is that it was questioned that with them

being

similarly structured they could show

the same signs on analyzers

as each other so i did some digging the

chemical formula

of propionic acid is c3h6o2

the chemical formula for ethylene glycol

is c2h6o2

so these two compounds differ

by one carbon atom and in the eyes of

the prosecution that was enough

to be able to say nope the analyzers

would be able to pick that up

it's totally fine ignore it wait i have

a question

it might be a stupid question but i'm

gonna ask it anyways

what kind of results do the analyzers

show i'd look this up as well i'm a star

back in the days before triple

quadrupole gcm sns

i know that's a lot of things that you

will have no idea about

yeah me and the listeners we're in the

same boat here

i'm rowing you might as well go swim

ethylene glycol was detected by a method

called gcfid so it's gas chromatography

with a flame ionizing detector basically

what this is is that it will suck up

your sample

carry it along yep like a vacuum

not anything like a vacuum but for the

sake of layman um

okay

it will be carried along by a gas into a

column

that will separate everything in your

sample out depending on reactivity don't

need to go into that too much

and then it passes into the detector the

detector

ionizes it ionizing is basically just

breaking your compound up so where

the propanoic acid is c3h6o2

it will break it up into c2 and you'll

get a fragment there

so it just kills it basically on your

detector you will get

a peak where your sample has come off of

the column and entered into the detector

so they were looking at peaks so

in your graph at the end that you would

look at to determine the result

along the x-axis which is the one that

runs along the bottom

is time so that's just recorded in

minutes and then

up on the y-axis is intensity

so you'll get sort of a flat line from

time

zero it will carry on nice and flat and

then

your detector will pick up something in

this case propionic acid so it will

shoot up

and then your propionic acid has all

passed through so it will come straight

back down

and it will look like a nice tall peak

to be able to compare that you would run

a positive control

in one of those samples that you would

run would be

a known sample of ethylene glycol

so you put that in and you know the

concentration

and it comes out and gives you a

retention time

which is the time that the peak comes

out and a peak intensity

then you run your patient sample and

then you compare the two so what they

did

they compared the two and the reason

that it was mistaken was because the

person

interpreting the chromatogram or the

graph that comes out at the end

was a lazy [ __ ] [ __ ] there's no

nicer way to put it because i've seen

the graphs

were not the actual graphs that they

looked at but i've seen

someone run ethylene glycol on gcfid

and i've seen them overlay propionic

acid

yeah it's [ __ ] lazy is it because

i have this all in my head now i can see

it in front of me

and to me it does seem like it would be

similar they are similar yeah but

there are differences so when we go back

to the

chemical structure of the two yeah

propionic acid has that extra carbon

atom

now chromatographically speaking that

makes

[ __ ] all difference because carbon atoms

do not react

on an analytical column that just makes

it seem

even more similar it does but

the way that the compounds are

differentiated between that is that

ethylene

glycol has two oh groups

an oh group being commonly what you

would find in an alcohol

so the reason that you can identify an

alcohol

is because structurally they all have

an oh group so ethylene glycol has two

one on each end propionic acid only has

one and the other one is a double bonded

oxygen now i know we're getting into

quite deep chemistry here

but a double bonded oxygen is

not reactive so when propionic acid

passes through a column the only points

it's got one two three four five six six

points

of reaction ethylene glycol

has one two three four five six seven

eight

that is a difference it is a difference

it might seem like

only a small difference but the whole

point

of a chromatographic column

is to separate compounds of similar

nature

yeah and also you should be able to tell

the difference between six and eight

if this is your job well not necessarily

because the six and eight

isn't an obvious thing the only way that

that relates is the amount of time it

spends on the column

so between propionic acid which has got

six and ethylene glycol that's got eight

immediately looking at those two

structures you know

that ethylene glycol is gonna be on that

column for longer

so your ethylene glycol peak on your

chromatogram

is gonna come out later the time that it

comes out on the graph

will be later because it's stuck in the

column for longer

so one of the papers that i read

actually got the data from the lab that

tested it

so at naught point six

nine minutes ethylene glycol came out

at 0.63 minutes

propionic acid came out if you're

recording that and just looking at it

6369 they're quite similar the amount of

data that is being processed by the

computer

to be able to create this graph means

that the breakdown

is at no point no not one

minutes so it will scan the detector

every 0.1 minutes

and look for any signal oh so it is a

huge difference

yeah the difference between 6 3 and 6

9 is massive yeah the easiest way to

look at it is

when you are running these samples you

would have run your positive control

that positive control is just ethylene

glycol

so it goes through and you get a peak at

0.69 wonderful

you run your patient and suddenly your

ethylene glycol has shifted by almost a

minute

yeah that immediately in chromatography

is an issue because one your automated

software

won't even pick it up as the right peak

and two

it's coming out almost a minute earlier

you should

know that that peak coming out isn't

the same peak it would be a lot easier

if we did this

as a video podcast because it's so much

easier to explain with that chromatogram

in front of you

than it is just trying to do it verbally

yeah but you do

have the chromatograms no they're in one

of the sources

yes yeah so maybe we could put it up on

the website

midweekmergers.netify.app

so that people can look at it if you are

interested

listeners okay so patricia stallings

was then sentenced to life in prison in

january

1991 and i think the judge

wanted the death penalty as well i'm not

sure i read

one of the sources in may that same

year her case was featured on the

television program

unsolved mysteries and luckily

william s sly in his sip up zebra one

piece

cozied up on the couch with his cat

charles cheddar twiddlington v watching

that same program

this is what all of us biochemists do in

our spare time

and all of our animals are named as

extravagantly

well disclaimer none of that is true

except for him

[Laughter]

william s sly a professor

and the chairman of the department of

biochemistry and

molecular biology at st louis university

conducted tests of ryan's blood and

found that ryan had died of

mma just like to point out ran the

samples

immediately saw that ryan suffered from

mma

no second testing or referring elsewhere

like one batch done yeah which does

make me worried about the people who

work in these

labs but all right now you're all right

in the uk we're good at what we do

okay he and james shoemaker

head of a metabolic screening lab who

confirmed the absence of

ethylene glycol in ryan's blood

then contacted piero rinaldo

a metabolic disease expert from yale

university who persuaded the prosecutor

that patricia was

innocent and this is a summary of what

happened

from what i understand it they also sent

out these

blood samples maybe his or maybe someone

else's

to a lot of independent labs and found

that a lot of the labs returned a

positive

for ethylene glycol poisoning

even though it clearly wasn't

and by a lot it was half

which is disturbing yeah so the

prosecutor

mcelroy asked the trial court to order a

new trial because of

inadequate legal defense based on this

scientist's evidence i don't understand

what georgie boy is doing

because on the one hand he's prosecuting

like a bow of hell

and he's like let's just ignore counter

evidence this is all [ __ ]

and then more counter evidence of the

same ilk comes forward and he's like

actually your defense light was [ __ ]

we'll give you another trial yeah

i also felt like that was a ploy

to exonerate him from like having done

anything wrong

for being personally sued yeah he did do

stuff wrong so i don't really understand

but

all right patricia was released from

prison in july 1991 and

in september mcelroy dropped the charges

against her

and apologized salisbury yeah

and david junior was returned to his

parents thank god i read that

she sued the state or the prosecutor the

state

probably i think she sued the state and

the lab that ran the tests yeah that

makes sense

but she also donated money to the person

who ran against mcelroy

for the prosecution office which i

thought was

the best yeah ten thousand dollars

excellent excellent money well spent

so that's the case

so what are you gonna do now maybe quiz

i'm hoping

i was gonna say aren't we gonna quiz

yeah if you wanna

there's not a live one to play they're

not doing any in

march but i found one that we haven't

done yet for the listeners for context

we sometimes do a harry potter quiz on

reddit that they post on wednesdays

is that true tuesdays is the live game

the home games on wednesdays so for any

harry potter fans out there

there is a quiz on reddit which

subreddit is it on

dueling with one l okay is that the

american

version of that spelling no i think the

real spelling was taken up by someone

else

oh okay that makes sense i was like they

usually don't

remove else it's more about the zeds

more about the vowels color who needs a

u in there

to be fair

okay thank you so much for listening to

this week's episode of

midweek murders we'll see you next week

Bye-bye!

Bye.

[Music]

Topics
  • Patricia Stallings
  • Gas Chromatography
  • methylmalonic acidemia
  • people wrongfully convicted of murder
  • ethylene glycol poisoning
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