02/18/2003 8:22 pm ET
Autopsy links ephedra to death
FORT LAUDERDALE, Fla. -- An autopsy performed on the body of Orioles pitcher Steve Bechler led the Broward County (Fla.) Medical Examiner to say that a weight-reducing drug containing ephedrine likely contributed to Bechler's death.
|By Becky Dubin Jenkins / MLB.com
Ephedra, from which ephedrine comes, is a substance that has been linked to heatstroke and heart attacks. It is contained in Xenadrine, the weight-reducing drug that was
found in Bechler's locker Sunday afternoon.
Dr. Joshua Perper also said that Bechler -- though physically healthy -- had a history of untreated, borderline hypertension; evidence of liver abnormalities; and had been on a diet. The combination of all the factors likely led to Bechler's death, though Perper can not confirm anything until toxicology reports are completed.
These are not expected for at least two and possibly three weeks.
Ephedrine is a stimulant that quells fatigue, aids weight loss and boosts performance. Ephedra is a legal, over-the-counter medication.
"The major concern here is that the FDA has banned the use of ephedrine in
weight-reduction medications, and it has warned about the danger of both
ephedrine and ephedra," Perper said. "However, the FDA [has not yet] taken
any kind of action against the use of ephedra in weight-reducing medications.
And, frankly, I don't see what the difference [is]."
Perper said the autopsy findings -- combined with the fact that Bechler was
participating in activities that increased his body temperature, something
Xenadrine also elevates -- converged and led to heatstroke. Bechler's death
was officially caused by multisystem organ failure, preceded by heatstroke.
He died at 10:10 a.m. Monday at North Ridge Medical Center. Bechler was 23.
The Commissioner's Office still has not officially commented on Bechler's death.
However, Commissioner Bud Selig told USA Today, "I'm deeply saddened by the death of Steve Bechler. My deepest sympathies go out to his wife and family. All of baseball shares this enormous grief."
"The manufacture label says very clearly that individuals who have heart
problems, hypertension or liver problems should not take this kind of
medication or should be very careful in taking it," Perper said of Xenadrine.
Xenadrine also makes an ephedra-free supplement.
Autopsy reports also showed that Bechler had very few traces of solid food in
his digestive tract. Perper said the digestive tract "doesn't clean itself in
a day or two," meaning Bechler's was so clean that it was obvious he had not
recently ingested much of anything solid. Perper also was told that Bechler
took three pills -- a full day's amount -- containing ephedra before Sunday's
After Bechler was pulled from conditioning drills for what manager Mike
Hargrove called "disciplinary reasons" on Saturday, he did not feel well,
Perper said. Perper was told that Bechler did not eat anything Saturday night
because he still felt ill.
"My feeling is that, probably, he was on some quite stringent diet," Perper
Orioles spokesman Bill Stetka said the actual bottle of supplements confiscated from Bechler's locker is at the medical examiner's office. There had initially been some confusion about where this bottle was.
The emergency medical technicians who tended to Bechler in the clubhouse Sunday were made aware of a bottle of nutritional supplements but did not take the bottle with them to the hospital, Perper said.
At the time of the news conference Tuesday, Perper said he was not sure if that particular bottle of supplements from Bechler's locker was the one he had with him at his office. Stetka confimred Tuesday evening that it was.
Perper said he not know why the EMTs did not take the bottle of supplements with them to the hospital on Sunday.
"This is a very good question, but unfortunately
I am not the one to answer the question," he said.
Ephedra is banned in minor league baseball, and players are subject to random
tests, Orioles team physician William Goldiner said Tuesday. Citing patient
confidentiality rules, Goldiner could not comment on whether Bechler had been
tested or, if so, when the last time he had been tested. Goldiner did,
however, say that random testing is conducted more frequently than once or twice a year.
Goldiner said the hard part of dealing with non-banned substances is trying to discourage players from using them.
"It's a terrible problem because what are we going to do then?" he said. "Investigate every can in everybody's locker on a routine basis? It gets to be a little [much]. ... And what happens to a player who says to you: 'Doctor, I know what the problem is. I want to use it because it helps me. It is a legal substance, and it is
not forbidden under Major League Baseball rules.' Then what am I supposed to say?"
Perper said that when weighed at his team-mandated physical Friday morning,
Bechler was 249 pounds. The Orioles' 2003 media guide lists Bechler as
weighing 239 pounds. All pitchers and catchers took physicals Friday, and
Goldiner said Monday that Bechler passed his physical, which routinely takes
about 20 minutes. If a player reports any physical problems to the doctor, he
is further examined.
But Bechler did not report any problems to the doctor who examined him and
was deemed "fit to go" and "fit to play." Bechler had a routine EKG in 1999,
and it, too, was normal.
Becky Dubin Jenkins is an editorial producer for MLB.com. This story was
not subject to the approval of Major League Baseball or its clubs.