It seemed like just another quiet week at Binghamton General Hospital in March of 1962. But in the nursery, something strange was happening. Nearly half of the 29 babies were having trouble feeding. Some gagged on their bottles, while others vomited after swallowing. Nurses couldn’t figure out what was wrong, but the symptoms weren’t serious enough to raise alarms, at least not yet.

The Shocking Discovery

By Friday, tragedy struck. Three babies had died. At first, the hospital staff thought it might be an infection, but tests showed no such thing. The next day, three more babies passed away. As worry grew, no one thought to check the formula. After all, some babies were still eating just fine.

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It wasn’t until Sunday that Practical Nurse May Pier, while making a cup of coffee, noticed something strange. She thought she was using sugar to sweeten her drink, but it tasted like seawater. She tasted it again and realized it wasn’t sugar, it was salt. And it had been added to the bottles of 14 babies.

A Life-or-Death Situation

The hospital’s medical director, Dr. Jason Moyer, called in all ten pediatricians to figure out what was going on. They quickly realized they were dealing with something they had never seen before: salt poisoning. They reached out to Dr. Laurence Finberg, an expert from Johns Hopkins University, for help. With no time to waste, the doctors started treating the affected babies, hoping to save their lives.

Desperate Measures to Save the Babies

Some of the babies had already been sent home with the tainted formula. One of them, Lisa Marie Bealo, had been given a day’s supply of the salty formula, but her father said she would gag and make strange noises while trying to drink it. They managed to get only an ounce into her before rushing her back to the hospital.

Sadly, Lisa died a day and a half later. For the most critical cases, Dr. John Kiley from Albany Medical College performed a procedure called peritoneal dialysis, draining and replenishing fluids in the babies' bodies to flush out the dangerous salt.

How a Simple Mistake Led to Death

As the doctors worked to save the babies, autopsies revealed the shocking cause of death: too much salt in their systems. It turns out that a nurse had accidentally used the wrong canister when filling the formula.

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What was supposed to be sugar was actually salt, and it had been mixed into the babies’ bottles. A nurse had filled the canister from two identical containers in the kitchen, one marked “sugar” and the other “salt.” The salt container’s label had been torn, and it seemed the lids were switched, leading to the deadly mistake.

Chaos and Long-Term Consequences

After the tragedy, the hospital faced more turmoil. Bomb threats came in, and a mysterious fire broke out, only adding to the chaos. Even after the salt was flushed out of the babies' systems, doctors weren’t sure what long-term effects the poisoning would have. The amount of salt they ingested was equivalent to four pounds of salt for an adult, far more than the human body could handle.

A Wake-Up Call for Hospitals

In the aftermath, Binghamton General Hospital took action. They put stricter rules in place to prevent this kind of mistake from ever happening again. Salt and sugar would no longer be stored in the same place.

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Other hospitals followed suit, and New York State passed new regulations for hospital safety. This tragedy changed the way hospitals handled formula and ingredients to ensure no other families would face the same heartbreak.

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