NEWS PRESS (Fort Myers, Florida) 14 June 06 Snake bite thought fatal - Man dies, another bitten in encounter (Denes Husty Iii)
A medical examiner must answer a rare question: Did a coral snake bite deliver enough poison into a Bonita Springs man's body to kill him in a matter of minutes?
It may take up to two months for Dr. Robert Pfalzgraf, deputy chief medical examiner for District 21 in Fort Myers, to find out.
If the coral snake did kill Inocencio Hernandez-Hernandez, 29, his may be the first such death in more than four decades, authorities said.
"We just don't hear of a lot of fatalities from coral snake bites," said Carl Barden, director of Medtoxin Venom Laboratories in DeLand.
A toxicology test was ordered to rule out any other possible cause of death, Pfalzgraf said.
Pfalzgraf said that during the autopsy, he found a small puncture wound on one of the victim's fingers.
If a coral snake had not been identified in this case, Pfalzgraf said that he may have thought the wound was something other than a snake bite.
"A coral snake bite is pretty innocuous-looking, unlike a rattlesnake bite," the doctor said.
Coral snakes don't have large fangs like rattlesnakes, said JoAnn Chambers-Emerson, educator for the Florida Poison Information Center office in Tampa.
But coral snake venom is much deadlier, Barden said.
Whereas a lethal dose of rattlesnake venom is usually 100 to 150 milligrams, a lethal dose of coral snake venom is usually 5 milligrams for an adult, Barden said.
"It has a very, very powerful neurotoxin in it," he said.
The poison, Barden said, attacks the nervous system and, if untreated, causes a person to stop breathing.
He thinks the test results will confirm his suspicion.
"I expect this was a death caused by a coral snake," Pfalzgraf said.
The events leading to Hernandez-Hernandez's death began Saturday evening in the woods behind Buffalo Chips restaurant west of Old U.S. 41 near the railroad tracks in Bonita Springs, deputies said.
Hernandez-Hernandez and his friends were drinking beer and found a snake, a case report said.
Friend Daniel Gonzalez said he struck the snake several times with a tree branch.
Hernandez-Hernandez did likewise and was bitten when he tried to move the snake with his hands.
Hernandez-Hernandez then stomped the snake with his boots and cut it with a broken beer bottle.
Another friend, Jesus Moreida, was bitten while putting the snake into a plastic jug.
Moreida went to Bonita Springs Fire Station 1, where a firefighter identified the reptile as a coral snake. Moreida was taken to North Collier Hospital.
Hospital officials said they had no record of a person by that name being treated there or its affiliate, Naples Community Hospital, or at Lee Memorial Hospital.
Back at the camp, Hernandez-Hernandez collapsed a short time after he was bitten, Gonzalez said. Gonzalez went for help.
Medics pronounced Hernandez-Hernandez dead at the scene.
"The person who was with him told us he didn't last more than 15 minutes before he fell and started foaming at the mouth," said Noel Bautista, who lives in the woods.
Hernandez-Hernandez "was a hard worker and he liked his beer, but he was easygoing," Bautista said.
Friends identified the victim as Fernando Hernandez, but relatives Tuesday gave his real name to medical examiners.
Although a coral snake's poison is extremely lethal, deaths are rare because of anti-venom like that produced by his laboratory, Barden said.
The anti-venom was developed in 1967, said Dr. Robert Norris, chief of emergency medicine at Stanford University and a snake poison expert.
Since the anti-venom was developed, no deaths have been reported to the American Association of Poison Control Centers, he said.
The last mention of a coral snake bite death he could find in medical literature was in 1963 in Florida, Norris said.
"The reason this guy had a bad outcome is that he didn't seek treatment," Norris said.
• Coral snakes are 20 to 35 inches long and have red and yellow bands.
• There are an average of 8,000 poisonous snake bites in the United States annually, including six to eight fatal bites, mostly by rattlesnakes and none by coral snakes, according to Carl Barden, director of Medtoxin Venom Laboratories in DeLand.
• 56 coral snake bites, but no fatalities, have been reported to the Florida Poison Information Center since Jan. 1, 2005. There have been no deaths recorded since the agency began keeping computer records in 2000.
• 5 milligrams of coral snake venom may be enough to kill a person if the bite goes untreated.
• Coral snake anti-venom first developed in 1967.
• To avoid being bitten, the old saying holds true: "Red and yellow, kill a fellow."
• For more information, go to www.snakesandfrogs.com.
Snake bite thought fatal - Man dies, another bitten in encounter

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