Thursday, Aug. 14, 2003

It was a case that had doctors and law enforcement in the small town of Perry, Okla. puzzled. What killed 53 year-old Carol Hellar?

From June 1994 until her death a year later, Hellar made 31 trips to various hospitals and clinics. She was seen by 23 doctors and hospitalized over a dozen times, always with the same symptoms – dehydration, mental confusion, kidney dysfunction and chronic metabolic acidosis (an abnormal decrease in blood acidity), yet no definitive diagnosis was made. Following her death, the medical examiner had a hunch, but still listed her death as undetermined.

What doctors did know about Hellar was that she was a manic-depressive with a bi-polar disorder. They assumed her medications – which included lithium – and their subsequent side effects were the cause of her symptoms.

It was during the latter stages of the two-and-a-half-year investigation into Hellar’s death and through a mutual friend that Alphonse Poklis, Ph.D., a forensic toxicologist in the Department of Pathology at Virginia Commonwealth University, received a phone call. “The principal investigator wanted me to review all of the information they had gathered in the case.”

According to the thousands of pages of information, Hellar’s only symptom that was inconsistent with a reaction to her medication was kidney failure. The records showed throughout her illness that Hellar had a steady decline in kidney function. At autopsy, significant levels of calcium oxalate crystals were found in her kidneys and brain, which could only be present as a result of a genetic disorder or ingestion of ethylene glycol, commonly known as antifreeze.

“The interesting thing about ethylene glycol poisoning is that the symptoms can easily mirror those of an overdose of lithium and other prescribed psychoactive medications – which is what kept her doctors off balance,” Poklis said. “Poisoning from ethylene glycol is usually accidental, or the result of an attempted suicide.”

Because of its physical properties, testing for ethylene glycol requires special equipment and can only be performed at a handful of hospitals and laboratories. As a result, Hellar’s blood was not tested for the presence of ethylene glycol until just weeks before her death, but at that point, it was too late. Hellar died in June 1995.

“Ethylene glycol by itself is not that toxic…it’s the metabolites that are created as the body breaks down ethylene glycol that make it lethal,” said Poklis. “The end result is kidney failure, among other things.”

For authorities, the ethylene glycol evidence boiled the case down to a question of suicide or, perhaps, homicide. They hoped Poklis could move the case in one direction.

The investigation had also revealed patterns in Hellar’s illnesses. She began getting sick shortly after marrying Dennis Hellar in June 1994. Over the next year, whenever Dennis was away on business, her health improved, but subsequently declined shortly after he would return. Interviews with family and friends largely discounted any tendencies Carol Hellar may have had toward suicide.

Poklis reviewed the reams of medical transcripts for six weeks and determined Carol Hellar had indeed been slowly poisoned with ethylene glycol.

With Poklis’ assessment of the facts in hand and his agreement to testify in court as a toxicology expert, investigators returned to Oklahoma to continue questioning Dennis Hellar. In the weeks that followed, Hellar was charged with murder and the medical examiner changed the cause of death to homicide by poisoning. Poklis never had to appear in court – shortly before the trial was to begin, Dennis Hellar confessed to poisoning his wife.

“Her case is a tragic confluence of her pre-existing illness, the medications she used, and the fact that all these things together looked like an overdose of her medication.”

According to his confession, Hellar dropped small amounts of antifreeze in his wife’s drinks and soups. He told police he did not want to divorce his wife because he would lose their apartment and all of her possessions.

“To me the real hero of all of this is the investigative team. I’ve worked a lot of cases where no indictments are handed down,” said Poklis. “The [investigators] dogged determination to get to the bottom of this case brought about justice.”

Poklis recently shared his involvement in the Hellar case with a video crew from Crime TV’s Forensic Files show. The show is slated to air this fall.

“I enjoyed sifting through the evidence,” said Poklis who is currently working on another poisoning case. “This is how forensic toxicology started out – as a way to help law enforcement solve cases. I do it because it’s our highest calling.”