Monday, October 26, 2015

Alternative fatality

The Florida Medical Board has reprimanded and fined a physician whose patient — a toddler — died soon after being given a dose of amygdalin (also known as laetrile) to treat her advanced eye cancer.  Amygdalin — whose active component is believed to be cyanide — is not approved by the US Food and Drug Administration (FDA) and is controversial, given its unproven effectiveness and potential for deadly side effects.

Martha Grout, MD, agreed to give up her Florida license and pay a $2,500 fine. The Florida board took action against Dr Grout more than a year after the Arizona Medical Board reprimanded her for her role in the March 2013 death of the 18-month-old girl.

Dr Grout, medical director of the Scottsdale-based Arizona Center for Advanced Medicine, is still licensed in Arizona and Hawaii.

The Florida reprimand was not surprising, given the censure in Arizona, said Stephen Myers, a Phoenix, Arizona, attorney who represented Dr Grout in her proceedings with the Arizona Medical Board and the Arizona State Board of Homeopathic and Integrated Medicine Examiners.

Dr Grout was required under Florida law to report, within 30 days, the disciplinary action in Arizona, but did not. As a result, the Florida state health department instituted proceedings against her in February 2015...

Dr Grout was licensed in Arizona by both the Arizona Medical Board and the Arizona State Board of Homeopathic and Integrated Medicine Examiners. Only the allopathic board reprimanded her; the homeopathic board cleared Dr Grout in what Myers called a thorough investigation.

According to the August 2014 reprimand from the Arizona Medical Board, the child, Mercy Maynard, had retinoblastoma. She had an eye removed by oncologists in her home state of Maine in February 2013. The biopsy confirmed spread to surrounding orbital tissue. The oncologist urged the Maynards to follow up with a spinal tap for tumor staging, but they instead sought Dr Grout's care in Arizona.

The father signed a consent form with Dr Grout's clinic "that indicated that the safety and efficacy of many homeopathic medicines have not been established in controlled studies to the satisfaction of the FDA and many conventional physicians," according to the state medical board.

Dr Grout gave the child 3.4 milliliters of amygdalin on March 13, 2013. Amygdalin, found in fruit pits, raw nuts, and some plants, is used primarily in Mexico. According to the National Cancer Institute (NCI), amygdalin has not been shown to be effective in any controlled studies. The drug was popular in the US in the 1970s, but it also had the potential to be extremely toxic — mimicking cyanide poisoning — especially in the pill form, said NCI.

Twenty-four hours after Mercy received the amygdalin dose, Mr Maynard told Dr Grout that the child was having shortness of breath and bloating. He was told to come back to the clinic. Mercy almost immediately went into cardiorespiratory arrest and could not be revived, even by paramedics called to the scene by Dr Grout. Mercy died less than 3 hours after her symptoms began.

The hospital contacted the police, who began a child abuse investigation.

The Maricopa County Office of the Medical Examiner concluded that Mercy died from cyanide poisoning, as a result of the amygdalin dose. "This case represents toxicity occurring in the setting of an alternative medical regimen," according to the autopsy report.

The medical examiner concluded that there was "no apparent or stated intent to cause injury or death."

The Arizona Medical Board ruled that Dr Grout deviated from the standard of care by not making sure that the patient had tried all forms of accepted allopathic treatment and not ensuring that the amygdalin would pose no harm.

Dr Grout agreed to accept a reprimand for "unprofessional conduct."

Separately, the Arizona State Board of Homeopathic and Integrated Medicine Examiners conducted "an exhaustive investigation," executive director Chris Springer told Medscape Medical News. The board concluded that Dr Grout had acted within the scope of the laws that govern the practice of homeopathic medicine.

1 comment:

  1. Chelsea Ake-Salvacion was hoping to soothe her aching body at the end of the day by taking a quick dip in one of the cryotherapy tanks at the spa in Nevada where she worked. But the session ended tragically when the 24-year-old was found dead the next day, her body "rock-hard solid," according to a family member.

    Although the details of Ake-Salvacion's death last week are not clear yet, advocates of cryotherapy — which involves short exposure to very cold temperatures — say the treatment is safe when used correctly. For example, cryotherapy centers generally do not allow people, even employees such as Ake-Salvacion, to go into the machines without supervision.

    Ake-Salvacion's death may highlight the real risks of cryotherapy and also raise questions about whether it has real benefits. In a statement released by Ake-Salvacion's employer, Rejuvenice, the company said, "We firmly believe in whole-body cryotherapy treatments for pain management, athletic recovery, detoxification and a variety of other ailments. Millions of treatments have been given safely all over the world for more than 20 years."...

    Although there is no doubt that an ice bath can be a "potent analgesic," or pain killer, there have not been any studies directly comparing cryotherapy with ice water, said Joseph Costello, senior research associate in the department of sport and exercise science at University of Portsmouth in the United Kingdom.

    "There is not enough evidence to say whether cryotherapy is effective or is not effective for athletic recovery and muscle soreness," said Costello, who recently co-wrote a review article on the topic. He basically concluded that more research needs to be done.

    There are inklings that cryotherapy could offer benefits. Studies have found lower levels of inflammatory molecules, indicators of muscle soreness, in people after cryotherapy, and lower levels of creatine kinase, which is linked to muscle injury...

    Although ice bath therapy has been practiced for millennia — ancient Greeks used cold dips to ease muscle pain — the practice of cryotherapy has only come about in the last few decades, Costello said. It was first a treatment for rheumatoid arthritis and cancers and precancerous skin lesions. In the last decade it has taken off among both professional and recreational athletes around the world, and has become part of the health and wellness "salon culture," especially in the United States, Costello said.

    Indeed, people seek out cryotherapy at centers around the United States for a number of reasons, including relief for muscle and joint pain, recovery from illness and fatigue, and to boost beauty. Cryotherapy is purported to reduce wrinkles...

    Customers "walk out with a smile on their face," Fryben said, adding that they feel invigorated and very happy.
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