My knowledge of 19th century medicine is not as extensive as my knowledge of early-mid 20th century American medicine and the reforms initiated by Flexner, the changes brought about by antibiotics, surgical advances, and the advances of pharmacology.

As for Dr. Blackwell.  Well, I grew up long enough ago that "women weren't doctors."  I found Elizabeth Blackwell reassuring:  If she could do it in the 1850's, surely I could do it a century later.  Not that it was easy, but if she could...

As far as Lucy goes.  Medicine is a passionate and demanding mistress.  Those of us who fall in love with her have little time, and less energy,  for much else.  But I admire Lucy greatly.  Without women like her on the political front lines for equality, my work on the medical front lines for equality would have been much more difficult if not impossible.  And I passionately believe that women can bring a dimension to medicine (and to politics) that is rare, much needed, and in today's corporatized medicine often lacking.

In addition, I'm a "Lucy Stoner."  Liked the name I was born with and kept it.  Caused a certain amount of hoo-ha at medical school at graduation.  For some reason they seemed to think that just because I had used my name all through school I would want another one on my diploma.  It's a good thing I was as exhausted  as I was - med school is not just intellectually rigorous - or I might have said things that would have prevented me from graduating at all.

As you probably know men attempt suicide less often, but succeed, as a percentage, more frequently than women.  This is due to the fact that they usually use much more immediately lethal means than pills: gunshot, single car accidents, hanging.  That's the one reason I might suspect foul play: it's an uncommon method for a man to use.  Still forcing someone to take a bunch of aspirin is sort of a silly murder method, too.

Working from very little info I'd say he was found in extremis at that lumbar yard and taken, unconscious, to a local hospital.  There he would have had a normal CT scan, so surely they would have done routine drug screens of urine.   The problem is that the routine screens do not include salicylate.  That's a separate blood test (as is acetaminophen).   The screens routinely done in ER are for "drugs of abuse."

The laboratory findings of salicylate poisoning change as the absorption and cellular effects increase.  I have always been impressed by the profound Kussmaul breathing.  These people sound like jet engines as the body blows off carbon dioxide to compensate for all that unbuffered acid.  

But if this man was near death his respiratory rate might actually have been depressed in which case someone would have had to think of salicylate poisoning and order a serum salicylate level to make the diagnosis - and as I mentioned this poisoning is rare these days.  I'd bet a lot of residents coming out of training have never even seen one.  Difficult to make a diagnosis one does not think of.  It's also possible that the original hospital was not able to do a salicylate level on site and sending one out always takes more time.

In addition I would not be surprised if alcohol was involved.  Quite a lot of it.  Both to wash down the pills and to help the suicide along with courage and/or unconsciousness.  The alcohol smell would have masked the acid smell of the ASA, and it's just possible that the serum bicarb, which should have been low, was not so low as to cause questions.

In any case, I suspect that the original hospital did  make the diagnosis and transferred him for hemodialysis, but since he died within 5 hours of transfer I am quite certain he was metabolically too far gone for it to make a difference.  In addition he was late into the poisoning and sometimes these very metabolically stressed/compromised patients just up and die.  Suddenly. For no immediately discernible reason.  It is also possible that his labs presented such a mixed picture that the original hospital did not really know just how acidotic he was at the cellular level and did not transfer him emergently - although even priority  transfers take more time than seems possible.

Sure would like to see his original labs, follow ups, and salicylate levels.

Should warn you that this is perilously close the the Bill Frist School of Medicine method of diagnosis  (although most doctors enjoy the puzzles of diagnosing from news reports) so take it with a shaker of salt.  It could be all wrong.