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      CO Poisoning Diagnosis Prevents Potential Disaster for Hotel Guests 
      In the early evening on November 7, 2012, paramedics transported a guest suffering from an unknown illness to Mills-Peninsula Hospital in Burlingame, CA. Radiologist Gregory M. Lim, M.D., was called in on the case. The patient was not conscious and had a high fever; other than that, no history was provided except that he was a guest in a hotel. After ruling out several other factors, a CT scan was performed on the man’s brain. The results puzzled Dr. Lim. “Something did not look right about it; the harder I looked, the more I scratched my head,” Dr. Lim said.

      Dr. Lim thought the man might have had a stroke but the results of the scan were different. Dr. Lim finally decided it might be carbon monoxide poisoning, but was still not positive. “I’ve only seen it once or twice during my training,” Dr. Lim said. “And I said, ‘Oh my gosh, am I going to make this kind of call?” Dr. Lim told emergency room physician Karin Molander, M.D. She also couldn’t believe it. “My first thought was, ‘We’re in California,’” she said. “We haven’t seen carbon monoxide poisoning since I was a medical student in Chicago.”

      A blood test showed the carbon monoxide in the patient’s system was abnormally high, but just about the amount of a heavy smoker. Then the patient’s wife said her husband didn’t smoke. The doctors had their answer.

      Ironically, Dr. Molander believes the lower carbon monoxide readings were a result of the good work by the paramedics. “The fire department supplying oxygen to the patient so quickly and at such a high flow, I think that’s why the level was lower,” Dr. Molander said.

      After consulting with the paramedics, firefighters decided to go back to the hotel and test the grounds for carbon monoxide. They isolated the leak and some 500 hotel guests were evacuated. A potentially bigger disaster was prevented.

      “We’re kind of like detectives; this is kind of like a real life episode of ‘House’ or something,” Dr. Lim said. But neither doctor says they think of themselves as heroes. “I’m just a small piece in a big puzzle but I’m glad that the diagnosis I made led to the safety of many other people who could have potentially been injured,” Dr. Lim said. “We radiologists make critical diagnoses that affect the management of patients every day,” Dr. Lim concluded.