***!!!***!!! 2021 "blood pressure was 181/57 mm Hg, heart rate of 70 beats per minute, respiratory rate of 20 breaths per minute, and an oxygen saturation of 77% on room air. She appeared cyanotic and reported a burning sensation in her throat. She had no apparent burns to the oropharynx and was not in respiratory distress. Laboratory evaluation revealed a methemoglobin level of 41%. The patient received a single dose of methylene blue 1 mg/kg within one hour of emergency department arrival with rapid improvement in the methemoglobin level." "Over the course of several hours, the patient developed hypoxemic respiratory failure, acute renal failure, and severe intravascular hemolysis. She underwent multiple sessions of intermittent hemodialysis to manage the metabolic acidosis and to potentially remove unbound chlorite. The hemoglobin nadired at 9.6 gm/dL (baseline 13.6 gm/dL). Peripheral blood smear showed ghost cells and schistocytes. Despite aggressive resuscitation and blood transfusions, she developed disseminated intravascular coagulopathy (INR 6.46, undetectable fibrinogen) and died two days following the ingestion."