Tragic Death of Former Yankee's Son Can Be Explained By Simple Chemistry

Last month, a family vacation turned into a preventable tragedy, especially for those associated with the New York Yankees organization.

Although the Arenas Del Mar Beachfront & Rainforest Resort in Costa Rica initially denied that carbon monoxide was the cause of the death of Miller Gardner, the 14-year-old son of longtime Yankee outfielder Brett Gardner, a simple blood test definitively proved otherwise.

Elevated levels  of carboxyhemoglobin (Figure 1) are conclusive evidence of carbon monoxide poisoning, not food poisoning, as was initially suggested.

Figure 1. The structures of hemoglobin (L) and carboxyhemoglobin (R) differ only by the molecule bound to the iron atom (orange). In normal hemoglobin, iron binds oxygen (O₂), enabling its transport throughout the bloodstream. In carboxyhemoglobin, the iron binds carbon monoxide (CO) instead, blocking oxygen transport and leading to asphyxiation. The green oval shows the oxygen molecule normally bound to hemoglobin. The blue oval highlights carbon monoxide

What Makes CO So Dangerous?

How can a gas cause death so quickly — even when plenty of oxygen is present? It comes down to simple chemistry.

Both carbon monoxide and nitrogen can cause death by asphyxiation, but through very different mechanisms.

• Nitrogen is inert and harmless in the presence of oxygen. It makes up 78% of the atmosphere and doesn’t interfere with oxygen transport.
• Carbon monoxide (CO), even at just 1% of air, can be lethal.

Why?

CO binds to hemoglobin 240 times more tightly than oxygen (Table 1). This isn’t just competition — it’s chemical "armed robbery." CO blocks oxygen from attaching to hemoglobin and displaces oxygen that’s already bound because of the differences in binding affinity.

Table 1. The relative binding constants (K_a) of oxygen and carbon monoxide to hemoglobin. With K_a values, the higher the number the tighter the binding.

Bad blood

The overall effect of the two gases on blood oxygen is shown in Figure 2. 

Figure 2. (Left) Carbon monoxide (CO) and oxygen (O₂) compete to enter the bloodstream, where CO can impair normal oxygenation (Health, Safety and Environment). (Right) CO binds tightly to hemoglobin, displacing oxygen (and also carbon dioxide)  preventing gas exchange in red blood cells (Alaska.gov).

So, while it takes an overwhelming amount of nitrogen to deprive your brain of oxygen, carbon monoxide not only competes with oxygen for free hemoglobin, but actually displaces oxygen that is bound to it. This is why it can kill a person in as little as three minutes, depending on the exposure. 

Where did the CO come from?

According to an April 5th New York Times article, the Gardner's room was adjacent to a room that contained machinery. Although no particular machine was singled out possibilities, include clothes dryers, water heaters, pool heaters, or even malfunctioning restaurant equipment. Whatever the cause, this tragic accident was entirely preventable. With proper maintenance of utilities and appliances and inexpensive CO detectors the Gardner family would be back from a great vacation and

 not in the news.

A full description of the health effects of CO can be found in the following CDC report.