Police and emergency personnel found four unconscious people inside a home in Mountainair, New Mexico on May 19. Two were pronounced dead at the scene; a third died later at University of New Mexico Hospital. A fourth occupant survived and was hospitalized [1, 2].

The two deceased were identified as Micah (or Mika) Rascon, 51, and Georgia Rascon, 49. The third victim's identity has not been released [1, 3].

Eighteen to 25 first responders were exposed to a toxic powdered opioid mixture at the scene, causing symptoms such as nausea and dizziness. Of those exposed, two remain hospitalized in serious condition. Many who were sickened were treated and released after decontamination [1, 4, 2, 3].

The substance was confirmed by DEA lab analysis to be a mix of fentanyl, para-fluorofentanyl, and methamphetamine in powdered form [1, 3]. Authorities believe the drug transmits through contact rather than airborne exposure [4, 2].

New Mexico State Police Chief Matt Broom called the substance "a more illicit form or version of fentanyl," and praised responders who became sick as they worked to protect the community [3]. University of New Mexico hospital CMO Steve McLaughlin said, "Fentanyl is particularly dangerous because it requires only a tiny amount to cause an overdose. The tiniest possible dose can cause serious symptoms in an exposed individual" [1].

First responders initially wore protective gear but not full hazmat suits. Mountainair volunteer firefighter Antonette Alguire said, "I guess we're just going to have to start wearing hazmat suits into these calls and wearing oxygen. It’s getting to that point where we just have to live in fear, even saving lives" [4]. Torrance County Fire Chief Gary Smith said multiple debriefings are planned to evaluate their response and improve safety measures [3].

Authorities do not believe drug manufacturing was occurring in the home, which contained only powdered drugs [1, 3].

The incident has spurred reviews of first responder protocols and PPE use for hazardous drug calls. Two first responders remain hospitalized as of May 23 while others recover after exposure [4, 2, 3].