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The authors note that orthopedists and anesthesiologists with lengthy practice in North Carolina have observed that “members of the Lumbee Indian population have a significantly higher that normal familial incidence of congenital musculoskeletal anomalies, though this has not been documented” (p. 485). Since there is a link between malignant hyperthermia and inheritance, as well as between malignant hyperthermia nd musculoskeletal anomalies, the authors wished to report their experience with a case of malignant hyperthermia, the second documented Lumbee incident, so that North Carolina physicians will be aware that Lumbee patients may be at risk for malignant hyperthermia during or after anesthesia. The acute malignant hyperthermia occurred in the recovery room 2 1/2 hours after the patient had  received general anesthesia with isoflurane. Sixteen days later, the patient again needed anesthesia for a craniotomy. Precautions were taken against malignant hyperthermia, but some symptoms recurred four days after surgery.