By Bill Scanlon
Rocky Mountain News
AURORA, Colo. — Did Ernest Herrera die from the bite of a brown recluse spider?
His widow thinks so. And according to his death certificate, “spider bite” was a significant condition contributing to his death.
But a spider expert said it is virtually impossible for Herrera to have died the way he did from a spider bite.
The fact that it’s an intriguing medical mystery doesn’t soften the pain for Cindy Herrera, of Aurora, who said that her husband was “my love, my life, my friend.” And it doesn’t stop her from asking whether misdiagnosis and delays caused her husband to die unnecessarily.
Ernest Herrera, 52, an electrician, was moving boxes at a seldom-used Aurora Water Department warehouse on the last day of September when he felt a sharp pain in his forearm.
He thought something must have bitten him.
He came home an hour later, showed his wife the mark and said he was in some pain.
She said she told him, “It doesn’t look good, Ernie. You’d better keep an eye on that.”
By the next day, he was in severe pain, so he went with his foreman to a workers compensation medical clinic, Cindy Herrera said.
Aurora uses two different clinics, and Ernest Herrera chose to go to the one run by Health One, said Jeff Baker, spokesman for the Aurora Water Department.
Pain grew worse
Cindy Herrera said the doctor there gave her husband some intravenous antibiotics and spent several hours with him.
But when they returned to the doctor the next day, after the pain got worse, “He only gave us three minutes of his time,” she said.
“And he never took my husband’s vitals” even though Ernest Herrera said he was in excruciating pain and that it hurt all the way up his upper arm, she said.
When she suggested that the wound on her husband’s forearm looked like those shown in pictures of brown recluse spider bites she had found on the Internet, "(The doctor) laughed at me,” she said. “He thought I was a joke.”
When she told the doctor that her husband had been hallucinating for two days, he told her it was probably just the medication, she said.
On Friday, paramedics took Ernest Herrera to the University of Colorado Hospital in Aurora.
His liver, kidneys, lungs and heart failed, and he was pronounced dead Oct. 5.
Leslie Horna, spokeswoman for Health One, said, “We reviewed all the records and we believe we treated him as was appropriate.”
At her home last week, Cindy Herrera stood in the bedroom, where the IV tubes still were hanging.
“He was the most wonderful man you ever met,” she said. “He would take a bad day and turn it into something good. He was my salvation.”
Paula Cushing, curator of spiders and other invertebrates at the Denver Museum of Nature and Science, got a call from one of the Herreras’ relatives and later talked to the Rocky Mountain News.
“If I had to put money on it, this didn’t have anything to do with spiders,” she said.
Other possibilities
She said she has sympathy for the Herreras and doesn’t discount the possibility that there may have been a misdiagnosis.
But she said that rather than being too reluctant to attribute a lesion to a spider, many doctors are too eager to pin it on the eight-legged creatures. And when they do, they lose precious time in finding the real reason for the infection.
“The way it was described to me, it sounds like the guy had MRSA,” she said.
Methicillin-resistant staphylococcus aureus is an infection that is resistant to most antibiotics.
Cushing said she doubts the spider theory for several reason.
First, brown recluses aren’t indigenous to Colorado. Second, even if a brown recluse hitched a ride and made its way to Colorado, it wouldn’t survive the dry, cold air here, she said.
Third, a brown recluse spider would not leave the kind of mark that was described to her, Cushing said.
Most typically, a bite from a brown recluse would produce “absolutely nothing,” she said. If it breaks the skin, only in the very rare case would it spread enough to require a skin graft to cover the lesion, she said.
“A death result from the bite of a brown recluse spider is unbelievably rare, if it’s ever been recorded at all,” Cushing said.
The only other spider with enough venom to cause serious harm to humans is the black widow, she said.
“And that doesn’t cause a necrotic lesion like he suffered from,” she said. “It affects the nervous system.”
She said it is possible that Ernest Herrera could have even been poked by a staple or a nail or suffered a mosquito bite that was scratched - anything that would have allowed a hole in the skin in which bacteria could enter.
“MRSA is incredibly common,” she said. “It’s becoming an epidemic.”
Cindy Herrera said she is not convinced.
She said that when she looked at pictures of brown recluse bites, she saw “all the signs of what was happening with his arm - redness, a black hole, water pockets all over his arm. It was exactly what my husband was suffering.”
Awaiting autopsy
Cindy Herrera said she wanted to donate her husband’s organs after his death, but that doctors told her that except for his eyes, the other organs were too impregnated with poison to be useful to anyone else.
Jacque Montgomery, spokeswoman for the University of Colorado Hospital, said that “by the time we got involved in the case, we were treating it as a straight heart attack.”
Still, the fact that “spider bite” was listed on the death certificate is intriguing, as is Cindy Herrera’s contention that she was told the organs were too poisoned to be used, she acknowledged.
An autopsy isn’t complete. When it is, there may be more answers, she said.
Baker, of the Aurora Water Department, said that the typical precautions when moving boxes around at the Sand Creek Reuse Facility are to wear gloves and long-sleeve shirts.
“We regularly spray those areas,” he said.
Baker said Ernest Herrera had worked for Aurora for slightly more than six months and was “well thought of” by his co-workers.
Cindy Herrera said that spider bite or not, it was a big mistake not getting him to the hospital right away. If her husband had been there, nurses would have noticed when things went very wrong.
As it was, on Friday, she called the paramedics and waited a few minutes for them to arrive, while trying CPR herself. And then more minutes were lost on the drive to the hospital.
Information
Brown recluse spider
- Size: Adults have a leg span about the size of a quarter.
- Coloration: Brown to dull yellow
- Habitat: Crevices or corners in buildings, under furniture and inside boxes
- Distribution: Native to the southern Midwest, west into Texas and Oklahoma and south to the Gulf coast. The spider has turned up in other parts of the country, probably inadvertently transported by humans.
- Bite: Brown recluses generally bite only when accidentally pressed against the skin. While the spider can inject a powerful venom, many victims react slightly or not at all. Others report intense pain. In a small percentage of cases, the bite causes a slow-healing, ulcerous wound that causes heavy scarring. In very rare cases, death may occur.
- Identification: A number of spiders closely resemble the brown recluse, making positive identification impossible without having the actual spider. Other complications, such as staph infections, can cause the wound ulceration found in some brown recluse bites. There is no antivenin to brown recluse venom.