The Cryonics Institute’s 117th Patient
Cryonics Institute Case Report for Patient Number 117
CI patient number 117 is Sylvia Ann Sinclair. Permission to make public the name of this patient was granted by the patient’s husband, Alan Sinclair. Sylvia Sinclair was received at CI on May 21st, 2013. She was 66 years old when she died. When Mrs. Sinclair was received by CI, she had already been perfused with CI’s vitrification solution and cooled in dry ice by Cryonics-UK team members and their cooperating funeral directors. Upon arrival at CI she was further cooled in the computer controlled cooling chamber to liquid nitrogen temperature over a period of five and a half days and then placed in a cryostat for long-term cryonic storage. Below is a case report that was written by Cryonics-UK team member Mike Carter and is being shared with his permission.
SUMMARY OF STANDBY, PERFUSION AND COOL-DOWN WITH DRY ICE CARRIED OUT BY CRYONICS-UK IN MAY 2013
Last May, Cryonics-UK (CUK) was called out to attend the death of a very special member, Sylvia Sinclair. She was special to CUK not only because she was a founder member but because without the huge effort put in over many years by her and her husband Alan, it is unlikely that CUK would exist. She was also known to members for the way she looked after us all during meetings held at her and Alan’s house, keeping us well supplied with teas and coffees and feeding us with lovely home-cooked meals.
Silvia had always seemed to be fit and active, so it was something of a shock to learn that she had an aggressive cancer, and would not be expected to live more than a few weeks. CUK had been pre-warned that her health had become critical by mid-April 2013, and on 13 May we were warned that death was expected within days. A team of CUK volunteers was called out that evening and most team members arrived at her house on the south coast of England in the early hours of the following morning, along with the CUK ambulance, loaded with the call-out equipment, perfusate (VM1) and medications.
She died at about 4:00am on 15 May and was immediately placed in an ice bath and taken to the CUK ambulance, which was parked outside the house. Ice was added to the ice bath at about 4:10am and chest compressions given by means of a CPR machine. Medications were administered via a FAST intra-osseous infuser in the sternum, plus Maalox (an antacid), administered via a CombiTube inserted in the throat. Once the medications had been administered, shortly after 5:00am, the ambulance was driven to the premises of a local embalmer, who was waiting for us.
The patient was placed on the embalmer’s table, still in the fabric ice bath liner, surrounded by ice, and the embalmer inserted cannulas into the carotid arteries and jugular veins. While this was being done, the perfusion kit was set up, filled with sterilising solution and de-aired. The sterilising solution was then replaced with 10% perfusate, and perfusion was begun. This continued with 30% perfusate, followed by 70% (VM1). The full quantities of 10% and 30% perfusate were given but flow rates gradually reduced during administration of the 70% solution, and flow finally ceased with about a third of the solution remaining in the reservoir. Perfusion was therefore terminated at about 8:20am and the patient transferred to the ambulance, in the ice bath. The reason for the cessation of flow was not clear, but the embalmer thought that it was due to dehydration (which was evident as perfusion proceeded), leading to a closing of the blood vessels.
The perfusate had been kept in a domestic freezer prior to perfusion, and a temperature probe placed in the patient’s ear indicated temperatures fluctuating around 1°C to 4°C during the perfusion procedure.
The ambulance was driven to the premises, in London, of the funeral director handling transport procedures and documentation, arriving there shortly after 11:00am. The body was immediately transferred to CUK’s transport container, which had been pre-cooled with dry ice. After this transfer, readings of the temperature probe indicated a fairly rapid initial cooling, with the temperature falling to -22°C by 4:30pm, but after that the rate of cooling slowed, reaching -30°C the following morning, and -33°C that afternoon. After two days, only 5kg of the original dry ice remained, with the temperature at -34°C, and it was topped up with a further 120kg. The rate of cooling then increased but again slowed after about 20 hours, eventually levelling off at about -63°C even though more than 90kg of dry ice remained. A further top-up of 110kg on the fifth day again increased the rate of cooling, bringing the temperature to below our target shipping temperature of -70°C twelve hours after the top-up. It seemed that simply disturbing the dry ice, or perhaps the air within the container, significantly increased the rate of cooling.
On the evening of the fifth day, the container was packed with insulation, some of the dry ice removed to leave the maximum-allowable 45kg, and the container sealed, with the final recorded temperature of -73.6°C. The target temperature of -70°C for shipping the container was to ensure that the dry ice in the container would last as long as possible.
The container was received by the Cryonics Institute the following day, with the temperature within the transport box recorded as -61.8°C, and with 27kg of the original 45kg of dry ice remaining, implying that there would have been sufficient dry ice to last around three days.