The Albert Stevens Case (CAL-1): A 64 Sv Cumulative Dose from a 1945 Plutonium Injection -A Case Study in Radiation Dosimetry and Medical Ethics

On May 14, 1945, Albert Stevens, a 58-year-old house painter, was injected with a mixture of Plutonium-238 and Plutonium-239 at the University of California Hospital in San Francisco. He was misdiagnosed with terminal stomach cancer and was not informed of the experiment's nature. Stevens survived for 21 years after the injection, accumulating an estimated effective dose of 64 Sv (6,400 rem) — the highest known accumulated radiation dose in any human. This paper reviews the historical context of the Manhattan Project's human injection experiments, analyzes the dosimetric calculations that led to the 64 Sv estimate, examines the biological effects observed over two decades, and discusses the profound ethical implications of this case. The CAL-1 case remains a critical reference point for understanding long-term internal radiation exposure and the necessity of informed consent in human subjects research.