Medical Investigation (2004) s01e09 Episode Script
Little Girl
Geez, Randy.
Come up for air.
Yes, it is.
My dad's gonna kill me being out so late.
Look, just tell your old man you were studying anatomy.
Before or after he crushes your throat with his workboot? Besides I don't feel so good all of a sudden.
Really? I never felt better.
You know? I can buy more sympathy on e-bay.
Take me home.
Come on No, I mean it.
Drive.
Whatever.
- Damn thing needs a tune-up.
- It needs a junk yard.
Randy.
- What? - There's a car coming.
- Just relax.
- No, there's a car coming fast.
- Come on.
- Randy? Come on, oh, my god.
- Randy? - Come on.
- Randy! - It won't start! Are you okay? Oh, man, he's really hurt.
He's more than hurt, Randy.
He looks sick.
Look, just sit tight, okay.
We're gonna get you help.
Don't worry about me.
Take care of her.
Oh, my god.
She's sick, too.
My daughter.
Please, save my little girl.
Four deaths, one town.
What we're dealing with is aplastic anemia.
An idiopathic disease that kills by destroying its victim's bone marrow.
No bone marrow, no blood cells.
No blood cells, no oxygen, no immunity to disease, no blood clotting.
It's not a pretty way to go, and so far it's hitting at a disturbing rate of one in 25,000 in this area.
That's gotta be an off-the-chart cluster in anyone's book.
Look, we can all sit around here and say aplastic anemia is rare or it's random, but it doesn't change the fact that we're staring down the barrel to one hell of a deadly disease.
All right, here are the things aplastic can be triggered by.
Toxic exposure, drugs or other medications, radiation exposure, viral infection.
And our four victims are a banker, a teacher, a plumber and a cab driver.
All found dead, none of whom had any ties to one another or exposure to any of the above.
No commonalties between any of them? There's nothing I can find.
Unfortunately, by the time the victims' bodies got to us, blood and tissue degradation made them virtually useless.
Which in summation tells us? We're up against a non-contagious disease that's spreading and we have no idea how or why.
What are you thinking? How much I hate myself for wishing we had a living victim.
I think we've got one.
Her name's Carla Beyer, she's ten years old.
Night before last she and her father were in a car accident and she was transported to a hospital near Willemet, Maryland, which is about 45 minutes from here.
Two teenagers saw the whole thing, called 911.
She presented with dizziness, nose bleeds, bleeding gums, skin pallor, oral thrush.
That's consistent with aplastic anemia.
Any more details from the attending doctor? Yeah, that something like this was way beyond the sheepskin her tuition bought.
Willimet Hosptal Maryland Her CBC reveals a decrease in all blood cells and they've been dropping steadily.
Look, I know I don't have the resources that you do, but when I read your surveillance alert I knew that Carla was positive for aplastic anemia.
If Carla is aplastic, her last chance for survival would be to get a bone marrow transplant.
Miles, I want you to biopsy her marrow and then see if her father's a match.
I don't think that's gonna be possible.
Her father died from injuries sustained in the crash, but he had the same symptoms, same disease.
Two people from one family with aplastic anemia is unheard of.
What about the mother? The police haven'teen able to find her as yet.
So, this little girl's been in the hospital for two days without any family around her? Her parents are divorced, father got custody.
Carla and her dad are new in the area.
Her mom never even moved here.
Apparently, the police aren't even sure of the mother's name.
On it.
She has a slight concussion from the accident.
She's been unconscious since we stabilized her.
Her temperature's normal, but her breathing is labored.
She appears to have pinpoint hemorrhaging on the skin.
Petechia? Yeah, that's my guess.
Her platelets must still be dropping.
Look at her fingertips.
Very callused.
She must play the piano.
Mine were like rocks when I was a kid.
All right, let's see how we're doing here.
Daddy? Miles, I don't want her left alone.
If she so much as stirs or flutters an eye, I want to know.
We're not gonna lose her.
How'd it go with the cop? Forget about it.
Got a little testy when I offered to help find Carla's mom.
Claims they have it under control.
All right, I need you both to go to the father's house.
Test it for any potential causes of this breakout.
Eva, search it for any clues that will help us find the mother.
Without a bone marrow transplant, this little girl is never gonna make it.
I'll find her.
Damn, this place is spotless.
I could learn a thing or two.
It's not exactly what you'd expect from a single dad.
No wonder dad was so organized.
Looks like he was a CPA.
Ran his business out of the house.
Carla was lucky to have a dad who wanted to be so involved.
Looks like he had the lion's share of the custody, too.
Although it would appear she spent all of last week at her mom's.
There's pictures of Carla and her dad all over the room, but not one of her mother.
It's weird.
Her mother doesn't have much of a presence here, doesn't seem to have much of a presence in her life.
But she's definitely attached to her dad.
That's how we find mom.
I don't follow.
Dad's a CPA, right? Part of his job is to keep and file receipts for others.
If Carla was so attached to her dad, I bet he'd make sure he was available 24/7 for her.
Especially if she was with her mom.
And he could only be that available by cell phone.
Check for calls dad received on the days and nights that corresponds with the days Carla was with her mother.
We reverse directory that number and I bet we find mom.
Tell me you found the mother.
Her name is Angela Beyer.
She lives at 1258 tenth street in Willemet.
Wait a minute.
That's right there in the middle of the original cluster of four.
We've called, but there's no answer.
We're two hours away, but from your locale you're only about ten minutes from there.
We're on our way.
Mount Ranier, Maryland We're not in Kansas anymore.
Yeah.
Hell of a place for a little girl to spend her weekends.
Angela Beyer? Angela Beyer? It's an emergency.
Hello? Ms.
Beyer? Looks like she's been dead for several days.
She may've just given her daughter a death sentence.
How is she? / Still unconscious and her vitals are dropping.
Blood count? Falling.
Hematocrit down to 27%, hemoglobin at nine, her white blood cell count is 2,500 and her platelets are down to 30,000.
I can't keep her stable.
Put her in a sterile bubble, transfer her to the NIH and then get her in a reverse isolation unit now.
Are you sure moving her is wise? NIH has the latest therapies.
Using those and finding a match on the national marrow donor program registry may be the only way to save her.
We'll move her to NIH, but what about Carla's mom? There is no mom.
The success rate to find Carla a bone marrow match on the donor registry is at best 50/50.
I thought you said aplastic anemia wasn't contagious.
It isn't.
So, how'd she die? They may have all been exposed to the same thing.
The source could be here.
We just don't know yet.
Having a mother like this is like having no mother at all.
I don't know for sure yet, but she doesn't appear to be aplastic.
Well, maybe she wasn't.
Hypodermic needle.
And it's damn far from sterile.
Her mother was on interferons.
If you ask me, that wasn't the only thing she was sticking in her veins.
Not the kind of needle we would associate with prescription drugs.
Maybe her drug use is what ruined her marriage.
Interferons are used to suppress chronic hepatitis.
Certain forms of hepatitis are known viral triggers for aplastic anemia.
You mean, Carla's aplastic anemia could have been triggered by catching a disease that her mother had because she's a junkie? Carla and her father.
Here's a pay stub from a local bar.
Which could make Carla's mother's hepatitis the causative agent and common link between the other four victims.
People come in for a drink and leave exposed to something that could kill them.
We could have been looking in the wrong direction the whole time.
Well, there's only one way to find out.
Get her and the father to NIH and autopsy them.
I want to know exactly what killed them.
I'll call you when I get the results.
Eva, dig into the backgrounds of both Carla's parents.
There's got to be a relative there somewhere.
Powell, get to the bar.
See if anyone remembers seeing any of the original four aplastic victims there.
Carla's a sweet kid.
She didn't talk much.
Sure liked the pretzels, though.
Tell me about her mother.
Real piece of work.
Can't imagine she was much of a mom.
Angie had, uh, a couple of go-arounds with rehab.
No matter how hard she tried, she just, she never could slay that dragon.
Not even for Clayton.
She wanted to get back together with her ex, huh? And Carla.
She was trying to work things out, but Clayton made it clear it wasn't gonna happen unless she kicked her drug habit.
So, you think she was the one getting people sick? That's what I'm trying to find out.
These are pictures of people who've gotten sick and died.
Recognize any of them? I know almost everyone who comes in here by name, face or how much head they have on their draw.
I'm sorry, none of them ring the memory bell.
Preliminary blood results for the little girl, her mother and her father.
Thanks.
Son of a bitch.
Carla Beyer has no aunts, no uncles, no grandparents on either side, no family at all.
Everybody has somebody.
Not her.
As far as I can tell, she's as alone as alone gets.
Then we sure as hell better get lucky with the bone marrow registry.
Yeah, I pushed them.
They're gonna rush her tests.
Can't someone just hold her hand or something? Most isolation units are to prevent what's in there from getting out.
But this is a reverse unit.
It's designed to keep things from out here from getting in.
Her immune system has degraded to such a point where anything she comes in contact with could be lethal.
Her oxygen levels are continuing to go down, her temperature's on the rise.
How do her lungs sound? Well, there's no clear signs of developing pneumonia, but with her white cell count dropping, it's only a matter of time before infection sets in.
I think we should give her a transfusion.
No, I don't want to go there yet.
Well, can't you do something? Try a round of G-CSF and then epogen first.
I'm coming up empty on any connection between the previous aplastic anemia victims and Carla's mom.
No one in their families ever knew of them going into the bar where she worked, and no one at the bar recognized any of them as customers.
The only victim connection to Angie Beyer is to Carla and her father.
If there's a commonality between them and her hepatitis, I can't find it.
And that doesn't matter.
What are you saying? but not because of the mom.
The mom died of liver failure caused by hepatitis C, which is a strain of the virus that does not trigger aplastic anemia.
- All right, so we're screwed.
- No, not totally.
I ran a standard blood test on Carla, the mother and father.
Type-wise, they don't match.
- What does that mean? - Did you do a DNA comparison? I tested 25 genetic markers on the mother, father and Carla's DNA.
But these results don't match.
Well, how can that be? They weren't her biological parents.
She must have been adopted.
Which means that somewhere out there, Carla has a birth mother and father.
And they could be the bone marrow donors she needs to save her life.
- Exactly.
- All right, so how do we find them? We need to find out where Carla was born, who handled the adoption, whether it was a public or private agency, whether it was an open or closed adoption.
I'll start with Carla's adoptive father.
He was the responsible one.
If anybody would have records, he would.
Yeah, he was meticulous, all right? - Filed everything.
- You guys keep her alive.
I'll find her birth mother.
All right.
Here we go.
Check registers for the last ten, 15 years.
Great.
Carla's about ten, so start there and look backwards.
Look for any large checks made out to a hospital, a woman's name, a lawyer You think they bought this baby? People desperate to have a baby will do almost anything.
Unfortunately, the same goes for people desperate enough to get rid of one.
Yeah.
Carla's adoption went through a little over ten years ago.
Her adoptive father's name was Clayton Beyer, and her adoptive mother's name was Angela.
What do you mean "was"? - They're both dead.
- Dead? And their adoptive daughter will be, too, if we don't find her birth parents.
I don't understand.
The little girl is ill.
She needs a bone marrow transplant, or she won't make it.
And she needs it now.
There's a chance if we can find her birth parents that their bone marrow will be a match and we can save this little girl's life.
Look, I'm sympathetic to your plight, but those records are sealed.
Well, then unseal them.
I can't do that.
This is a medical necessity.
Medical necessity or not, the law says I can't give you those records without a court order.
This little girl doesn't have time for a court order! Eva Look I understand that you're doing your job, but you have to understand that we're doing ours.
And right now, that means finding Carla's birth mother.
Maybe so, but for me, weighing that little girl's life against the confidentiality of her birth mother is not a decision I am empowered to make.
That's up to a judge.
Judge Markum? It's Eva Rossi.
Actually, it's been about 12 years, sir.
I wouldn't have called, but I need your help.
No, it's not about me.
It's about a little girl named Carla.
You gotta be kidding me? Are you positive? No, thanks.
- Connor.
- Thanks, Joe.
I know that look, and it's not good.
That was the bone marrow registry.
Carla came up negative for a possible donor match.
The growth factor leveled Carla's blood count for a while, but she's already showing signs of slipping.
So, she's dying from a disease, and we still can't find the source.
She's not the last victim.
I just got a call from the Maryland state health department.
They found two more cases of aplastic anemia, that resulted in death.
They happened in a town 30 miles north of Willemet called Riverdale, and they happened prior to the original four victims.
So not only are we fighting a non-contagious disease, that's been spreading, but we've been searching for its source in its wrong place.
Frank, get to Riverdale.
Find anything that ties the victims there to the victims in Willemet.
All right.
I found Carla's birth mom.
Her name is Cyndi Weaver.
According to her records, she was an unwed teenager who gave the child up at birth a little over ten years ago.
There's no mention of a father.
She's married now.
She lives at Covington estates.
I'm sure this is one knock on the door she wasn't expecting so soon.
Try one she was never expecting.
On her surrender form terminating her parenthood, she checked the box that said she never wanted to be contacted regarding the child, ever.
You guys are early for pickup, but just in time for cake.
No, we, we're not here to pick up any children.
We're here to talk to Cyndi Weaver.
Oh, it's Cyndi Harmon now.
- Just a sec.
- Thank you.
Honey, door's for you.
Hi.
Can I help you? I'm Dr.
Stephen Connor.
This is Eva Rossi.
We're from the national institutes of health.
What's going on? We're here to talk to you about one of your children.
Is there something wrong with one of my boys? It's not your boys.
It's a girl.
Your daughter.
Daughter? No, I don't have a daughter.
I have two sons.
We're talking about the daughter you gave up for adoption a little over ten years ago.
Adoption? This is some kind of mistake.
She's very sick.
She needs a bone marrow transplant to survive.
- Well, you have the wrong person.
- Your maiden name is Weaver? Right? From Lexington? Yeah, but I never had a daughter.
Honey? Come on, we've got a pinta to bash.
Oh, they were just leaving.
Good luck to you.
She's lying.
And this is gonna prove it.
Hey.
How's she doing? Miles says she's a fighter.
She's not gonna give up.
Sounds like someone I know.
If she does make it, without family, it's not gonna be pretty.
You don't get adopted at ten.
You bounce around from foster home to foster home.
It's just not fair.
- It's her, isn't it? - Cyndi Weaver is Carla's mother.
DNA doesn't lie.
How could a mother not want to help their child? I have my theories, but don't get me started.
We need to get this woman in here, type her marrow.
- Carla needs her.
- I'll get her here.
All right, including Carla and her father, we have six cases in Willemet.
We now know there were two other cases before this 30 miles north in Riverdale.
One retired contractor, one college coed.
Add that to the background diversity of these victims in this local cluster, and we have nearly every walk of life covered.
The only thing we don't have is someone alive to talk to, to see how these people all fit together.
We have one.
A transfusion could give Carla enough strength to wake up.
A transfusion could also reduce her ability to accept a bone marrow transplant.
Connor, she's not creating any red blood cells as it is.
It's only a matter of time before her marrow shuts down completely.
At least if we try this transfusion now, she may be able to wake up and tell us something that will help us stop this thing.
Hey, C? I don't like the risk either, but the kid has a point.
Even if we can't save her, maybe she can help us save others from the same fate.
Do it.
Eva, whatever you do, make the sale.
- I need to get to work.
- And I need to talk to you.
I knew you'd be back.
Summa cum laude at Yale, recruited by the cream of the fortune 500 crop.
An out-of-wedlock baby hardly fits into the plans of a high school sophomore going places like that.
I'll be the first to admit, I was young and stupid getting pregnant in the first place.
The truth is, I was drunk at a party.
I don't even know who the father was.
So giving her up for adoption was the best thing for the girl and, yes, for me.
The girl's name is Carla.
Don't make it sound like I, I threw her in the trash or tried to sell her to the highest bidder.
No, it wasn't like that.
She shares your gift for music, by the way.
I never saw her when she was born.
I forced myself not to look at her.
I was afraid she'd look at me.
I knew if our eyes met, I'd never let her go.
They told me she was adopted by good people.
She was one of the lucky ones, but her luck has run out.
Both of her parents have died in the last few days.
Her mother of a long-term illness, and her father of the same disease that's killing her.
You said something yesterday about, uh, bone marrow? She has aplastic anemia.
It means that her bone marrow doesn't work.
And she's not responding to medicine.
If she doesn't get a transplant soon, she'll die.
Okay, you can't just walk in here and drop that on me.
Your husband and sons, they don't know, do they? No.
No one in this life does.
That's why I waited for them to leave.
And, and how do you expect me to explain this to my husband and to my boys with no warning? That I created all of this based on a lie? You don't have to tell your family.
You don't have to look at Carla, but only you can save her life.
Any word from Eva? Nothing yet.
I've got a bone marrow specialist standing by if when Carla's donor comes in.
- She's waking up.
- Get Powell.
Carla? Carla, can you hear me? Can you open your eyes? There you go.
Where am I? You're in a hospital.
My name's Dr.
Connor.
Where's my dad? He and your mom aren't here right now.
But they'd want me to take care of you.
Am I sick? Yes, Carla, just like your daddy.
I need to ask you about places that you and your dad may have gone to lately.
Or things you may have done that you normally wouldn't have.
I'm really tired.
Just stay with me just for a few more questions, okay? And then I'll let you rest.
Has your dad taken you anyplace where there may have been a lot of chemicals? Like a factory.
My dad works at home and except for school, piano and soccer, we're usually there.
All right.
What about soccer? Have you seen anyone spreading fertilizer on the field you know, to help the grass grow? If they did, it didn't work.
The field's mostly dirt.
Carla? My dad got that for me, my birthday.
He brought it when mama took me to the river.
You went to a river? I invited my dad for a picnic.
She wanted us to be a family again.
But they fought.
They always fight.
That must not have been a very fun picnic.
Except for me and my dad went swimming.
You and your dad swam in the river? For a little while.
The water didn't smell very good.
Why don't you get some rest now? If you need anything, there'll be someone right out here for you, okay? Thank you, Carla.
There's a river near Willemet.
20 minutes upstream on its banks in Riverdale, the town where the second cluster developed.
Check it out, Frank.
Was that really fair? What are you talking about? Lying to Carla about her mom and dad, suggesting they're still alive.
Aren't you just setting her up for an even bigger fall? That little girl just lost both of her parents and you want to talk to me about being fair? The only thing I'm concerned about right now is saving that little girl's life, and when I do, then I'll tell her the truth.
Riverdale, Maryland Truth is, my husband loved being out on that river more than being home.
I'm sorry for your loss.
Fred was a good man.
You take these from the river? Yes, ma'am.
Your husband must've loved to fish.
Every day.
He worked his whole life so he could spend his last years putting a line in that dirty water.
- Dirty? - Gower chemicals, two miles up.
Turned every fisherman on the river into catch and release.
Their insecticides must work.
I haven't seen a cricket around here in three years.
The plant's right on the river.
Saw it myself.
The EPA confirmed to me they were cited a year ago for excessive benzene waste output into the river.
All right, the dead fisherman I get, but what about the coed? I talked to her parents again.
Turns out she spent the last few months of her life working as a water-ski instructor.
On the river.
You got it.
Nice work, Frank.
Duran.
/ Nat, we're looking for benzene.
Double-check Carla and her father's blood and pray like hell it's there.
Dr.
Connor! What happened? / Out of nowhere, her blood pressure plummeted! She could be septic.
Push I.
V antibiotics.
Mask her.
Her resps are too high.
She's in V-fib.
Defibrillator! Stay with us.
Stay with us.
Clear! No change! / Again! Clear! Normal sinus rhythm.
Push the bicarb and dopamine.
If her heart rate drops, give her atropine.
Miles, keep pushing the antibiics.
We got to stop this infection long enough to buy us some time.
Unfortunately, time is something we're still gonna need.
I'm sorry, Stephen.
She wouldn't come.
She's showing early signs of heart failure.
Shortness of breath, fluid in the lungs.
Her immune system is practically nonexistent.
Another bacteria invades her body, she won't make it.
Connor.
I found something.
Hey.
/ Hey.
I did a GC-mass spec analysis of blood samples from both Carla and her father.
Were they positive for benzene? The blood tested negative for benzene, but I found a nitrobenzene compound.
What do you think, chloramphenicol? It was under the rock the whole time, we just never knew where to look.
What the hell is chloramphenicol? It's a powerful antibiotic, and it's been known to cause aplastic anemia.
So how did it get into the little girl and her father? Other countries use it in livestock to keep their animals healthy.
Imports containing traces aren't supposed to be allowed in the country.
You can't inspect everything that comes in.
It's in a variety of products, chicken, crayfish, shrimp.
It's even found in milk and honey.
You don't need a high dose of it to cause aplastic anemia.
Wait a minute.
Wait a minute, wait a minute.
The retired contractor from Riverdale, the guy who fished all the time according to his autopsy, he had undigested shrimp in his stomach.
Can I talk to you? My family thinks I'm visiting a friend for the weekend.
So you have me until Monday morning.
But I need to know that you're sure about this.
Because once the procedure starts, there's no backing out.
I'm not backing out.
I'll do whatever you want.
But as I told Ms.
Rossi, it's all on one condition.
I don't want to see the little girl, and I don't want her to see me.
Okay.
You really think that's what got my husband sick? That's what I'm gonna find out.
Did you eat any of these? I'm allergic to crustaceans.
But Fred couldn't get enough of them, he ate them like peanuts.
He had them damn near every day for lunch.
There's no markings on this bag.
Do you have any idea where he got them? I think he picked them up down in Willemet, but I have no idea where.
Vitals? B.
P.
, heartbeat, respiration as stable as we can hope for.
- How's the mother's marrow? - Clean.
We should be ready to transplant in a few minutes.
- Connor.
- Yeah, look, it has to be the shrimp.
Any idea how it ties into Carla and the dad? No, I'm not for sure, but I know there weren't any shrimp in dad's house.
Are you positive? Absolutely.
If we're sure it's chloramphenicol in the shrimp, where did they ingest it? Hell if I know.
What about Carla's mom? There was no food in that house, except for toaster pastries and sugar cereal.
Wait a second, what about take-out? Take-out? For the picnic at the river.
We know Carla and her dad ate there together.
I'll call you back.
Picnic, what do I know about a picnic? You were her friend.
Carla said her mom had her dad meet them at the river.
Yeah, I remember that.
She brought food.
Do you have any idea where she got it? I gave her all the leftovers from the happy hour from the day before.
Which was shrimp.
Yeah, peel and eat.
Who's your supplier? - Why? - Who's your supplier? Ming distribution.
It's about a mile from here.
The guy imports from Southeast asia, it's really cheap.
Yeah, but it's also deadly.
If you have any left, I suggest you dump it.
Most of the marrow's infused.
One more unit and we're done.
Stephen, her breathing.
Get a mask on her.
Hives.
She's having an allergic reaction to the marrow.
We need to stop the procedure now.
- No, she needs the marrow.
- Her B.
P.
's dropping.
She's going into anaphylactic shock.
We need to take care of this now.
She will die without the marrow.
Nurse, push epinephrine, benadryl and steroids.
Right away.
Let's hope for the best.
I found the source of the shrimp.
A seafood importer from Vietnam.
He's been shut down, shrimps been recalled, the word's out.
Good work, man.
How's the kid? Touch and go.
Well, that has to be a good sign.
Hey.
How are you feeling? Hungry.
Miles, get this young lady something to eat.
Happy to.
Where's my mom and dad? Did she Did Carla is she okay? Why don't you look for yourself? Hey.
- You okay? - I'm fine.
You sure? I'm fine, Stephen.
What was it like for you? You know when you knocked on your birth mother's door? She didn't answer.
Come up for air.
Yes, it is.
My dad's gonna kill me being out so late.
Look, just tell your old man you were studying anatomy.
Before or after he crushes your throat with his workboot? Besides I don't feel so good all of a sudden.
Really? I never felt better.
You know? I can buy more sympathy on e-bay.
Take me home.
Come on No, I mean it.
Drive.
Whatever.
- Damn thing needs a tune-up.
- It needs a junk yard.
Randy.
- What? - There's a car coming.
- Just relax.
- No, there's a car coming fast.
- Come on.
- Randy? Come on, oh, my god.
- Randy? - Come on.
- Randy! - It won't start! Are you okay? Oh, man, he's really hurt.
He's more than hurt, Randy.
He looks sick.
Look, just sit tight, okay.
We're gonna get you help.
Don't worry about me.
Take care of her.
Oh, my god.
She's sick, too.
My daughter.
Please, save my little girl.
Four deaths, one town.
What we're dealing with is aplastic anemia.
An idiopathic disease that kills by destroying its victim's bone marrow.
No bone marrow, no blood cells.
No blood cells, no oxygen, no immunity to disease, no blood clotting.
It's not a pretty way to go, and so far it's hitting at a disturbing rate of one in 25,000 in this area.
That's gotta be an off-the-chart cluster in anyone's book.
Look, we can all sit around here and say aplastic anemia is rare or it's random, but it doesn't change the fact that we're staring down the barrel to one hell of a deadly disease.
All right, here are the things aplastic can be triggered by.
Toxic exposure, drugs or other medications, radiation exposure, viral infection.
And our four victims are a banker, a teacher, a plumber and a cab driver.
All found dead, none of whom had any ties to one another or exposure to any of the above.
No commonalties between any of them? There's nothing I can find.
Unfortunately, by the time the victims' bodies got to us, blood and tissue degradation made them virtually useless.
Which in summation tells us? We're up against a non-contagious disease that's spreading and we have no idea how or why.
What are you thinking? How much I hate myself for wishing we had a living victim.
I think we've got one.
Her name's Carla Beyer, she's ten years old.
Night before last she and her father were in a car accident and she was transported to a hospital near Willemet, Maryland, which is about 45 minutes from here.
Two teenagers saw the whole thing, called 911.
She presented with dizziness, nose bleeds, bleeding gums, skin pallor, oral thrush.
That's consistent with aplastic anemia.
Any more details from the attending doctor? Yeah, that something like this was way beyond the sheepskin her tuition bought.
Willimet Hosptal Maryland Her CBC reveals a decrease in all blood cells and they've been dropping steadily.
Look, I know I don't have the resources that you do, but when I read your surveillance alert I knew that Carla was positive for aplastic anemia.
If Carla is aplastic, her last chance for survival would be to get a bone marrow transplant.
Miles, I want you to biopsy her marrow and then see if her father's a match.
I don't think that's gonna be possible.
Her father died from injuries sustained in the crash, but he had the same symptoms, same disease.
Two people from one family with aplastic anemia is unheard of.
What about the mother? The police haven'teen able to find her as yet.
So, this little girl's been in the hospital for two days without any family around her? Her parents are divorced, father got custody.
Carla and her dad are new in the area.
Her mom never even moved here.
Apparently, the police aren't even sure of the mother's name.
On it.
She has a slight concussion from the accident.
She's been unconscious since we stabilized her.
Her temperature's normal, but her breathing is labored.
She appears to have pinpoint hemorrhaging on the skin.
Petechia? Yeah, that's my guess.
Her platelets must still be dropping.
Look at her fingertips.
Very callused.
She must play the piano.
Mine were like rocks when I was a kid.
All right, let's see how we're doing here.
Daddy? Miles, I don't want her left alone.
If she so much as stirs or flutters an eye, I want to know.
We're not gonna lose her.
How'd it go with the cop? Forget about it.
Got a little testy when I offered to help find Carla's mom.
Claims they have it under control.
All right, I need you both to go to the father's house.
Test it for any potential causes of this breakout.
Eva, search it for any clues that will help us find the mother.
Without a bone marrow transplant, this little girl is never gonna make it.
I'll find her.
Damn, this place is spotless.
I could learn a thing or two.
It's not exactly what you'd expect from a single dad.
No wonder dad was so organized.
Looks like he was a CPA.
Ran his business out of the house.
Carla was lucky to have a dad who wanted to be so involved.
Looks like he had the lion's share of the custody, too.
Although it would appear she spent all of last week at her mom's.
There's pictures of Carla and her dad all over the room, but not one of her mother.
It's weird.
Her mother doesn't have much of a presence here, doesn't seem to have much of a presence in her life.
But she's definitely attached to her dad.
That's how we find mom.
I don't follow.
Dad's a CPA, right? Part of his job is to keep and file receipts for others.
If Carla was so attached to her dad, I bet he'd make sure he was available 24/7 for her.
Especially if she was with her mom.
And he could only be that available by cell phone.
Check for calls dad received on the days and nights that corresponds with the days Carla was with her mother.
We reverse directory that number and I bet we find mom.
Tell me you found the mother.
Her name is Angela Beyer.
She lives at 1258 tenth street in Willemet.
Wait a minute.
That's right there in the middle of the original cluster of four.
We've called, but there's no answer.
We're two hours away, but from your locale you're only about ten minutes from there.
We're on our way.
Mount Ranier, Maryland We're not in Kansas anymore.
Yeah.
Hell of a place for a little girl to spend her weekends.
Angela Beyer? Angela Beyer? It's an emergency.
Hello? Ms.
Beyer? Looks like she's been dead for several days.
She may've just given her daughter a death sentence.
How is she? / Still unconscious and her vitals are dropping.
Blood count? Falling.
Hematocrit down to 27%, hemoglobin at nine, her white blood cell count is 2,500 and her platelets are down to 30,000.
I can't keep her stable.
Put her in a sterile bubble, transfer her to the NIH and then get her in a reverse isolation unit now.
Are you sure moving her is wise? NIH has the latest therapies.
Using those and finding a match on the national marrow donor program registry may be the only way to save her.
We'll move her to NIH, but what about Carla's mom? There is no mom.
The success rate to find Carla a bone marrow match on the donor registry is at best 50/50.
I thought you said aplastic anemia wasn't contagious.
It isn't.
So, how'd she die? They may have all been exposed to the same thing.
The source could be here.
We just don't know yet.
Having a mother like this is like having no mother at all.
I don't know for sure yet, but she doesn't appear to be aplastic.
Well, maybe she wasn't.
Hypodermic needle.
And it's damn far from sterile.
Her mother was on interferons.
If you ask me, that wasn't the only thing she was sticking in her veins.
Not the kind of needle we would associate with prescription drugs.
Maybe her drug use is what ruined her marriage.
Interferons are used to suppress chronic hepatitis.
Certain forms of hepatitis are known viral triggers for aplastic anemia.
You mean, Carla's aplastic anemia could have been triggered by catching a disease that her mother had because she's a junkie? Carla and her father.
Here's a pay stub from a local bar.
Which could make Carla's mother's hepatitis the causative agent and common link between the other four victims.
People come in for a drink and leave exposed to something that could kill them.
We could have been looking in the wrong direction the whole time.
Well, there's only one way to find out.
Get her and the father to NIH and autopsy them.
I want to know exactly what killed them.
I'll call you when I get the results.
Eva, dig into the backgrounds of both Carla's parents.
There's got to be a relative there somewhere.
Powell, get to the bar.
See if anyone remembers seeing any of the original four aplastic victims there.
Carla's a sweet kid.
She didn't talk much.
Sure liked the pretzels, though.
Tell me about her mother.
Real piece of work.
Can't imagine she was much of a mom.
Angie had, uh, a couple of go-arounds with rehab.
No matter how hard she tried, she just, she never could slay that dragon.
Not even for Clayton.
She wanted to get back together with her ex, huh? And Carla.
She was trying to work things out, but Clayton made it clear it wasn't gonna happen unless she kicked her drug habit.
So, you think she was the one getting people sick? That's what I'm trying to find out.
These are pictures of people who've gotten sick and died.
Recognize any of them? I know almost everyone who comes in here by name, face or how much head they have on their draw.
I'm sorry, none of them ring the memory bell.
Preliminary blood results for the little girl, her mother and her father.
Thanks.
Son of a bitch.
Carla Beyer has no aunts, no uncles, no grandparents on either side, no family at all.
Everybody has somebody.
Not her.
As far as I can tell, she's as alone as alone gets.
Then we sure as hell better get lucky with the bone marrow registry.
Yeah, I pushed them.
They're gonna rush her tests.
Can't someone just hold her hand or something? Most isolation units are to prevent what's in there from getting out.
But this is a reverse unit.
It's designed to keep things from out here from getting in.
Her immune system has degraded to such a point where anything she comes in contact with could be lethal.
Her oxygen levels are continuing to go down, her temperature's on the rise.
How do her lungs sound? Well, there's no clear signs of developing pneumonia, but with her white cell count dropping, it's only a matter of time before infection sets in.
I think we should give her a transfusion.
No, I don't want to go there yet.
Well, can't you do something? Try a round of G-CSF and then epogen first.
I'm coming up empty on any connection between the previous aplastic anemia victims and Carla's mom.
No one in their families ever knew of them going into the bar where she worked, and no one at the bar recognized any of them as customers.
The only victim connection to Angie Beyer is to Carla and her father.
If there's a commonality between them and her hepatitis, I can't find it.
And that doesn't matter.
What are you saying? but not because of the mom.
The mom died of liver failure caused by hepatitis C, which is a strain of the virus that does not trigger aplastic anemia.
- All right, so we're screwed.
- No, not totally.
I ran a standard blood test on Carla, the mother and father.
Type-wise, they don't match.
- What does that mean? - Did you do a DNA comparison? I tested 25 genetic markers on the mother, father and Carla's DNA.
But these results don't match.
Well, how can that be? They weren't her biological parents.
She must have been adopted.
Which means that somewhere out there, Carla has a birth mother and father.
And they could be the bone marrow donors she needs to save her life.
- Exactly.
- All right, so how do we find them? We need to find out where Carla was born, who handled the adoption, whether it was a public or private agency, whether it was an open or closed adoption.
I'll start with Carla's adoptive father.
He was the responsible one.
If anybody would have records, he would.
Yeah, he was meticulous, all right? - Filed everything.
- You guys keep her alive.
I'll find her birth mother.
All right.
Here we go.
Check registers for the last ten, 15 years.
Great.
Carla's about ten, so start there and look backwards.
Look for any large checks made out to a hospital, a woman's name, a lawyer You think they bought this baby? People desperate to have a baby will do almost anything.
Unfortunately, the same goes for people desperate enough to get rid of one.
Yeah.
Carla's adoption went through a little over ten years ago.
Her adoptive father's name was Clayton Beyer, and her adoptive mother's name was Angela.
What do you mean "was"? - They're both dead.
- Dead? And their adoptive daughter will be, too, if we don't find her birth parents.
I don't understand.
The little girl is ill.
She needs a bone marrow transplant, or she won't make it.
And she needs it now.
There's a chance if we can find her birth parents that their bone marrow will be a match and we can save this little girl's life.
Look, I'm sympathetic to your plight, but those records are sealed.
Well, then unseal them.
I can't do that.
This is a medical necessity.
Medical necessity or not, the law says I can't give you those records without a court order.
This little girl doesn't have time for a court order! Eva Look I understand that you're doing your job, but you have to understand that we're doing ours.
And right now, that means finding Carla's birth mother.
Maybe so, but for me, weighing that little girl's life against the confidentiality of her birth mother is not a decision I am empowered to make.
That's up to a judge.
Judge Markum? It's Eva Rossi.
Actually, it's been about 12 years, sir.
I wouldn't have called, but I need your help.
No, it's not about me.
It's about a little girl named Carla.
You gotta be kidding me? Are you positive? No, thanks.
- Connor.
- Thanks, Joe.
I know that look, and it's not good.
That was the bone marrow registry.
Carla came up negative for a possible donor match.
The growth factor leveled Carla's blood count for a while, but she's already showing signs of slipping.
So, she's dying from a disease, and we still can't find the source.
She's not the last victim.
I just got a call from the Maryland state health department.
They found two more cases of aplastic anemia, that resulted in death.
They happened in a town 30 miles north of Willemet called Riverdale, and they happened prior to the original four victims.
So not only are we fighting a non-contagious disease, that's been spreading, but we've been searching for its source in its wrong place.
Frank, get to Riverdale.
Find anything that ties the victims there to the victims in Willemet.
All right.
I found Carla's birth mom.
Her name is Cyndi Weaver.
According to her records, she was an unwed teenager who gave the child up at birth a little over ten years ago.
There's no mention of a father.
She's married now.
She lives at Covington estates.
I'm sure this is one knock on the door she wasn't expecting so soon.
Try one she was never expecting.
On her surrender form terminating her parenthood, she checked the box that said she never wanted to be contacted regarding the child, ever.
You guys are early for pickup, but just in time for cake.
No, we, we're not here to pick up any children.
We're here to talk to Cyndi Weaver.
Oh, it's Cyndi Harmon now.
- Just a sec.
- Thank you.
Honey, door's for you.
Hi.
Can I help you? I'm Dr.
Stephen Connor.
This is Eva Rossi.
We're from the national institutes of health.
What's going on? We're here to talk to you about one of your children.
Is there something wrong with one of my boys? It's not your boys.
It's a girl.
Your daughter.
Daughter? No, I don't have a daughter.
I have two sons.
We're talking about the daughter you gave up for adoption a little over ten years ago.
Adoption? This is some kind of mistake.
She's very sick.
She needs a bone marrow transplant to survive.
- Well, you have the wrong person.
- Your maiden name is Weaver? Right? From Lexington? Yeah, but I never had a daughter.
Honey? Come on, we've got a pinta to bash.
Oh, they were just leaving.
Good luck to you.
She's lying.
And this is gonna prove it.
Hey.
How's she doing? Miles says she's a fighter.
She's not gonna give up.
Sounds like someone I know.
If she does make it, without family, it's not gonna be pretty.
You don't get adopted at ten.
You bounce around from foster home to foster home.
It's just not fair.
- It's her, isn't it? - Cyndi Weaver is Carla's mother.
DNA doesn't lie.
How could a mother not want to help their child? I have my theories, but don't get me started.
We need to get this woman in here, type her marrow.
- Carla needs her.
- I'll get her here.
All right, including Carla and her father, we have six cases in Willemet.
We now know there were two other cases before this 30 miles north in Riverdale.
One retired contractor, one college coed.
Add that to the background diversity of these victims in this local cluster, and we have nearly every walk of life covered.
The only thing we don't have is someone alive to talk to, to see how these people all fit together.
We have one.
A transfusion could give Carla enough strength to wake up.
A transfusion could also reduce her ability to accept a bone marrow transplant.
Connor, she's not creating any red blood cells as it is.
It's only a matter of time before her marrow shuts down completely.
At least if we try this transfusion now, she may be able to wake up and tell us something that will help us stop this thing.
Hey, C? I don't like the risk either, but the kid has a point.
Even if we can't save her, maybe she can help us save others from the same fate.
Do it.
Eva, whatever you do, make the sale.
- I need to get to work.
- And I need to talk to you.
I knew you'd be back.
Summa cum laude at Yale, recruited by the cream of the fortune 500 crop.
An out-of-wedlock baby hardly fits into the plans of a high school sophomore going places like that.
I'll be the first to admit, I was young and stupid getting pregnant in the first place.
The truth is, I was drunk at a party.
I don't even know who the father was.
So giving her up for adoption was the best thing for the girl and, yes, for me.
The girl's name is Carla.
Don't make it sound like I, I threw her in the trash or tried to sell her to the highest bidder.
No, it wasn't like that.
She shares your gift for music, by the way.
I never saw her when she was born.
I forced myself not to look at her.
I was afraid she'd look at me.
I knew if our eyes met, I'd never let her go.
They told me she was adopted by good people.
She was one of the lucky ones, but her luck has run out.
Both of her parents have died in the last few days.
Her mother of a long-term illness, and her father of the same disease that's killing her.
You said something yesterday about, uh, bone marrow? She has aplastic anemia.
It means that her bone marrow doesn't work.
And she's not responding to medicine.
If she doesn't get a transplant soon, she'll die.
Okay, you can't just walk in here and drop that on me.
Your husband and sons, they don't know, do they? No.
No one in this life does.
That's why I waited for them to leave.
And, and how do you expect me to explain this to my husband and to my boys with no warning? That I created all of this based on a lie? You don't have to tell your family.
You don't have to look at Carla, but only you can save her life.
Any word from Eva? Nothing yet.
I've got a bone marrow specialist standing by if when Carla's donor comes in.
- She's waking up.
- Get Powell.
Carla? Carla, can you hear me? Can you open your eyes? There you go.
Where am I? You're in a hospital.
My name's Dr.
Connor.
Where's my dad? He and your mom aren't here right now.
But they'd want me to take care of you.
Am I sick? Yes, Carla, just like your daddy.
I need to ask you about places that you and your dad may have gone to lately.
Or things you may have done that you normally wouldn't have.
I'm really tired.
Just stay with me just for a few more questions, okay? And then I'll let you rest.
Has your dad taken you anyplace where there may have been a lot of chemicals? Like a factory.
My dad works at home and except for school, piano and soccer, we're usually there.
All right.
What about soccer? Have you seen anyone spreading fertilizer on the field you know, to help the grass grow? If they did, it didn't work.
The field's mostly dirt.
Carla? My dad got that for me, my birthday.
He brought it when mama took me to the river.
You went to a river? I invited my dad for a picnic.
She wanted us to be a family again.
But they fought.
They always fight.
That must not have been a very fun picnic.
Except for me and my dad went swimming.
You and your dad swam in the river? For a little while.
The water didn't smell very good.
Why don't you get some rest now? If you need anything, there'll be someone right out here for you, okay? Thank you, Carla.
There's a river near Willemet.
20 minutes upstream on its banks in Riverdale, the town where the second cluster developed.
Check it out, Frank.
Was that really fair? What are you talking about? Lying to Carla about her mom and dad, suggesting they're still alive.
Aren't you just setting her up for an even bigger fall? That little girl just lost both of her parents and you want to talk to me about being fair? The only thing I'm concerned about right now is saving that little girl's life, and when I do, then I'll tell her the truth.
Riverdale, Maryland Truth is, my husband loved being out on that river more than being home.
I'm sorry for your loss.
Fred was a good man.
You take these from the river? Yes, ma'am.
Your husband must've loved to fish.
Every day.
He worked his whole life so he could spend his last years putting a line in that dirty water.
- Dirty? - Gower chemicals, two miles up.
Turned every fisherman on the river into catch and release.
Their insecticides must work.
I haven't seen a cricket around here in three years.
The plant's right on the river.
Saw it myself.
The EPA confirmed to me they were cited a year ago for excessive benzene waste output into the river.
All right, the dead fisherman I get, but what about the coed? I talked to her parents again.
Turns out she spent the last few months of her life working as a water-ski instructor.
On the river.
You got it.
Nice work, Frank.
Duran.
/ Nat, we're looking for benzene.
Double-check Carla and her father's blood and pray like hell it's there.
Dr.
Connor! What happened? / Out of nowhere, her blood pressure plummeted! She could be septic.
Push I.
V antibiotics.
Mask her.
Her resps are too high.
She's in V-fib.
Defibrillator! Stay with us.
Stay with us.
Clear! No change! / Again! Clear! Normal sinus rhythm.
Push the bicarb and dopamine.
If her heart rate drops, give her atropine.
Miles, keep pushing the antibiics.
We got to stop this infection long enough to buy us some time.
Unfortunately, time is something we're still gonna need.
I'm sorry, Stephen.
She wouldn't come.
She's showing early signs of heart failure.
Shortness of breath, fluid in the lungs.
Her immune system is practically nonexistent.
Another bacteria invades her body, she won't make it.
Connor.
I found something.
Hey.
/ Hey.
I did a GC-mass spec analysis of blood samples from both Carla and her father.
Were they positive for benzene? The blood tested negative for benzene, but I found a nitrobenzene compound.
What do you think, chloramphenicol? It was under the rock the whole time, we just never knew where to look.
What the hell is chloramphenicol? It's a powerful antibiotic, and it's been known to cause aplastic anemia.
So how did it get into the little girl and her father? Other countries use it in livestock to keep their animals healthy.
Imports containing traces aren't supposed to be allowed in the country.
You can't inspect everything that comes in.
It's in a variety of products, chicken, crayfish, shrimp.
It's even found in milk and honey.
You don't need a high dose of it to cause aplastic anemia.
Wait a minute.
Wait a minute, wait a minute.
The retired contractor from Riverdale, the guy who fished all the time according to his autopsy, he had undigested shrimp in his stomach.
Can I talk to you? My family thinks I'm visiting a friend for the weekend.
So you have me until Monday morning.
But I need to know that you're sure about this.
Because once the procedure starts, there's no backing out.
I'm not backing out.
I'll do whatever you want.
But as I told Ms.
Rossi, it's all on one condition.
I don't want to see the little girl, and I don't want her to see me.
Okay.
You really think that's what got my husband sick? That's what I'm gonna find out.
Did you eat any of these? I'm allergic to crustaceans.
But Fred couldn't get enough of them, he ate them like peanuts.
He had them damn near every day for lunch.
There's no markings on this bag.
Do you have any idea where he got them? I think he picked them up down in Willemet, but I have no idea where.
Vitals? B.
P.
, heartbeat, respiration as stable as we can hope for.
- How's the mother's marrow? - Clean.
We should be ready to transplant in a few minutes.
- Connor.
- Yeah, look, it has to be the shrimp.
Any idea how it ties into Carla and the dad? No, I'm not for sure, but I know there weren't any shrimp in dad's house.
Are you positive? Absolutely.
If we're sure it's chloramphenicol in the shrimp, where did they ingest it? Hell if I know.
What about Carla's mom? There was no food in that house, except for toaster pastries and sugar cereal.
Wait a second, what about take-out? Take-out? For the picnic at the river.
We know Carla and her dad ate there together.
I'll call you back.
Picnic, what do I know about a picnic? You were her friend.
Carla said her mom had her dad meet them at the river.
Yeah, I remember that.
She brought food.
Do you have any idea where she got it? I gave her all the leftovers from the happy hour from the day before.
Which was shrimp.
Yeah, peel and eat.
Who's your supplier? - Why? - Who's your supplier? Ming distribution.
It's about a mile from here.
The guy imports from Southeast asia, it's really cheap.
Yeah, but it's also deadly.
If you have any left, I suggest you dump it.
Most of the marrow's infused.
One more unit and we're done.
Stephen, her breathing.
Get a mask on her.
Hives.
She's having an allergic reaction to the marrow.
We need to stop the procedure now.
- No, she needs the marrow.
- Her B.
P.
's dropping.
She's going into anaphylactic shock.
We need to take care of this now.
She will die without the marrow.
Nurse, push epinephrine, benadryl and steroids.
Right away.
Let's hope for the best.
I found the source of the shrimp.
A seafood importer from Vietnam.
He's been shut down, shrimps been recalled, the word's out.
Good work, man.
How's the kid? Touch and go.
Well, that has to be a good sign.
Hey.
How are you feeling? Hungry.
Miles, get this young lady something to eat.
Happy to.
Where's my mom and dad? Did she Did Carla is she okay? Why don't you look for yourself? Hey.
- You okay? - I'm fine.
You sure? I'm fine, Stephen.
What was it like for you? You know when you knocked on your birth mother's door? She didn't answer.