Her family comforted her as she threw up in a bowl at her bedside and her condition worsened. In the evening, they called for an ambulance. The ER staff administered drug treatment and pumped air into Ramirez's lungs, and when her heartbeat suddenly began to falter, they tore open her shirt to use defibrillation paddles. At this point, nurse Sally Balderas recalls seeing an odd, greasy film on Ramirez's skin, like a puddle of oil on pavement.
Some witnesses recall a scent similar to ammonia suddenly being perceptible.
Registered nurse Susan Kane drew a blood sample from Ramirez, and she immediately noted a strong odor coming from the syringe. She handed the syringe to respiratory therapist Maureen Welch, who sniffed it and reported an ammonia smell. Within seconds of drawing the blood, Kane collapsed. Maintaining consciousness, she complained of burning pains on her face and was taken away on a gurney. Soon after, Gorchynski reported lightheadedness and then passed out.