The 10-year-old girl in the Linden, NJ carbon monoxide poisoning tragedy, Emike Asekomhe, is still in “extremely critical condition” at Newark Beth Israel Hospital. Her 9-year-old brother died after both were found unconscious by their mother at 7:30 a.m. on Tuesday, May 3rd.

The mother has stayed by the girl’s side in the hospital. The town is hosting a candlelight vigil Saturday, May 7th in Dorothy Ford Park. It is not known whether or not the girl received hyperbaric-oxygen treatment.

The hyperbaric-oxygen treatment reduces the degree of problems in secondary conditions resulting from the poisoning. The normal oxygen treatment will see more secondary problems. These delayed symptoms are sometimes called Delayed Neurological Sequelae and can range from memory problems to seizures to visual problems.

The important aspect to remember about treating carbon monoxide poisoning is the follow-up. Scheduling follow-up visits with specialists and neurologists is essential to take care of the delayed symptoms from the poisoning. Otherwise these symptoms will go untreated.

Giuseppe Pepe and colleagues at Careggi University General Hospital in Florence, Italy published a 2011 study called “Delayed neuropsychological sequelae after carbon monoxide poisoning: predictive risk factors in the Emergency Department. A retrospective study.” The study stated that DNS usually occurs after recovery from acute carbon monoxide poisoning. Early recognition of patients at risk for DNS in the emergency department may help with the quality of care provided. The researchers looked at past emergency department visits to research predictive risk factors for DNS development.

The researchers studied all patients admitted to the emergency department for CO poisoning at Careggi University General Hospital from 1992 to 2007. Patients were asked to come to three follow-up appointments at one, six, and twelve months. They then analyzed the data to study the risk factors for DNS.

Of the 347 patients admitted to the emergency department for CO poisoning from 1992 to 2007, 141 took part in a follow-up visit after one month. Twenty-four percent of those were diagnosed with DNS.

No significant correlation was found with sex, headache, transient loss of consciousness (blackouts), Glasgow Coma Scale between 14 and 9, and arterial lactate. The study developed risk factors for DNS and also emphasized that adequate patient follow-up is necessary and more research should be done in this area.

DNS can occur in the weeks or months following the actual carbon monoxide poisoning. Initial symptoms of acute carbon monoxide poisoning may include headaches, nausea, malaise, and fatigue. The symptoms following the poisoning must also be tended to. These delayed neurological symptoms may include difficulty with higher intellectual functions, short-term memory loss, dementia, amnesia, psychosis, irritability, a strange gait, speech disturbances, Parkinson’s disease-like syndromes, cortical blindness, and a depressed mood.

It is important to schedule follow-up visits to check up on the possible delayed neurological sequelae. Early identification of risk factors may also improve care. This is going to be true in the Linden, NJ carbon monoxide poisoning tragedy. For those with DNS, the symptoms can be treated, and a full recovery is possible.

Linden, New Jersey Carbon Monoxide Poisoning Leaves One Child Dead

Attorney Gordon Johnson


A young boy is dead and his sister is in critical condition after the Linden, New Jersey carbon monoxide poisoning tragedy. While a carbon monoxide detector was installed in the home, it didn’t warn the family. The 9-year-old boy was pronounced dead shortly after the event, and his 10-year-old sister was taken to the hospital and transferred to a different hospital for specialized treatment.

When I read the article about this boy and his sister online at NBC New York, my first area of concern was the condition of the sister. Treating carbon monoxide poisoning with hyperbaric oxygen significantly reduces the cognitive sequelae (conditions resulting from an injury). In Dr. Lindell K. Weaver’s study published in The New England Journal of Medicine, “Hyperbaric Oxygen for Acute Carbon Monoxide Poisoning,” published in 2002, the group treated with hyperbaric oxygen saw much less frequent cognitive sequelae (25 percent) than in the normobaric oxygen group (46.1 percent.) Hyperbaric oxygen is pressurized to 2 or 3 atmospheres absolute. Normobaric oxygen is pressurized to 1 atmosphere absolute. In other words, those who just get oxygen through a mask will have more trouble than those who get treated in the hyperbaric chamber.

Those with brain damage after carbon monoxide poisoning make up the majority of our practice today, and we have found remarkable differences in the outcomes of those who get hyperbaric oxygen treatment and those who don’t. The biggest difference is in the degree of problems with secondary issues that occur after the effect of hypoxia (lack of oxygen to the brain) has worn off. The condition is called Delayed Neurological Sequelae and the problems worsen from day 1 to day 60 after the carbon monoxide poisoning occurs.

Tomorrow we will talk about the nature of those complications in our followup blog for concerns that may linger with the survivor of this Linden, New Jersey carbon monoxide poisoning incident.

Four people nearly died of carbon monoxide poisoning Sunday in Nebraska after a car was left running in a home’s attached garage.

Authorities were investigating the near-fatal incident that took place on Mulberry Court in La Vista, Neb. Police called to the scene found Terah Yager, 31, who was barely conscious and then actually collapsed.

Police rescued Yager, 27-year-old Nicole Meyer and two girls, both 12, from the home. In the house police encountered the overpowering smell of natural or petroleum-based gas, as well as smoke.

Meyer had left a car running in the garage on Saturday at 11 p.m., according to police. She and the girls were treated and released from Nebraska Medical Center, while Yager received treatment at the house.

Sunday morning the carbon monoxide level in the house was more than 500,000 parts per million, and constant exposure to Co levels above 150 to 200 parts per million can be deadly. Don’t run engines indoors. Any time someone is found unconscious with carbon monoxide poisoning, it is important that they continue to follow with a doctor in the days after the exposure, even if they have been discharged from the hospital. Carbon monoxide poisoning can get worse in the period of 2 to 40 days after the exposure. This is called delayed neurological sequalae or DNS. See For more on carbon monoxide poisoning and prevention, go to

More than 250 students were evacuated and two restaurants were temporarily closed when high levels of carbon monoxide set of alarms at a Center Center building in Philadelphia early Monday morning, according to the Philadelphia Inquirer.

The 17-story building, located at the corner of Broad and Chestnut Streets, houses a Capital Grille and an Olive Garden. Officials shut those eateries down when they measured carbon monoxide levels of as high as 3,800 parts per million in one of them, the Inquirer reported.

The historic building, 1346 Chestnut St., is also the residence for 552 students at the Art Institute of Philadelphia. They were sent to nearby hotels at the institute’s expense.

At concentrations of more than 150 to 200 parts per million, carbon monoxide causes disorientation, unconsciousness and even death, the Inquirer said, citing information from the U.S. Consumer Product Safety Commission.

Authorities Monday hadn’t determine the source of the carbon monoxide.

For a better understanding the full consequences of carbon monoxide exposure go to

New York’s law mandating the installation of carbon monoxide detectors in dwellings goes into effect Feb. 22.

The law requires that carbon monoxide alarms be installed in all new and existing one- and two-family homes, multi-family residences and rentals that have a fuel-burning appliance, system or attached garage, as reported this week by The Journal-Register of Medina, N.Y.

The paper recommends that to prevent carbon monoxide poisoning, consumers should put in at least one carbon monoxide detector with an audible warning signal near sleeping areas and outside bedrooms. That alarm should have the approval of a nationally recognized lab, such as Underwriters Laboratories.

It is remarkable that laws mandating the installation of carbon monoxide detectors has lagged so far behind smoke detector requirements. Kudos to the NY State legislature. For more on the effects of carbon monoxide poisoning see:

Dear Attorney Johnson:

I thought I’d share with you some of what happened yesterday when I spent Christmas with my dad, sister and nephew.

While driving to Kentucky, my dad was telling me that my nephew Jim was doing very well in the 6th grade making all A on his report card, but had missed 18 days of school. Jim’s doctor did some blood work and discovered that he had a carbon monoxide level of 3.1. He slept in a back room where the furnace was located. “So there was something wrong with the furnace?” My dad, who seems to be in eternal denial, responded, “Well, you know there are the fumes from the school buses. He did get sick when he went on a field trip.” I said, “If the cause of the problem were bus fumes, there would be a lot of kids having problems.” Then my dad says, “Well, there are a lot of other kids missing school as well.”

Fortunately, they did have Jim start sleeping in the front room. And my dad did replace the furnace even though he said that he had someone come out and check it and found “nothing wrong with it.” Jim’s carbon monoxide level did drop down to .6 once he started sleeping in the front room. He now has his own room that he sleeps in.

Well, that was my Christmas. We did have a pleasant time.