DAVIE, Fla. - Orioles pitcher Steve Bechler had a considerable amount of ephedrine in his blood when he collapsed and died of heatstroke, according to the toxicology report released yesterday by Broward County medical examiner Dr. Joshua Perper.
Perper said the concentration of ephedrine found in the blood sample taken before Bechler's death was consistent with reports that he had ingested three capsules of the weight-loss aid and stimulant Xenadrine. The results confirmed the preliminary report of the medical examiner, who concluded Feb. 19 that ephedrine had been a factor in the death.
"He had all the signs of catastrophic exertional heatstroke," Perper said at an afternoon news conference. "It was a culmination of multiple factors that include the ingestion of Xenadrine. It's my personal opinion that the toxicity of ephedrine played a significant role in the death of Mr. Bechler."
Though the results of the fluid and tissue studies were not surprising, the report figures to be of tremendous importance to the lawyer who is preparing to file a product-liability lawsuit against the manufacturer of Xenadrine (Cytodyne Technologies) on behalf of Bechler's widow, Kiley Bechler, and to the growing movement to restrict the over-the-counter sale of the herbal supplement, which has been linked to heart attacks, strokes and other deaths.
"It's unfortunate that it took an autopsy of a 23-year-old professional athlete to underscore the dangers of this poison," David Meiselman, Kiley Bechler's attorney, said in a statement released soon after the final autopsy report. "We appreciate Dr. Perper's thorough investigation and applaud his courage in sharing with the public the dangers of ephedrine. We look forward to holding those who profit at the expense of our health accountable for Steve Bechler's death."
Representatives of the ephedrine industry also were quick to put their own spin on the results. Cytodyne even sent a consultant to pose as a television reporter at the news conference and grill Perper on the scientific reliability of his conclusions.
"The company feels that it has not gotten fair and balanced coverage in the media," said Bryan Glazer, who made no secret of his affiliation after the news conference.
The Ephedra Education Council, an advocacy group funded by Cytodyne and several other ephedrine producers, held an afternoon conference call to restate their contention that ephedrine is safe when used as directed and to try to deflect blame toward the Orioles for not properly screening Bechler for possible health problems.
Even though some products advertise that they burn off fat by raising body temperature, industry advocates insist there is no clinical link between ephedrine and heatstroke. They'll have a tough time convincing Bechler's parents.
"He was healthy," Ernie Bechler, the pitcher's father, said yesterday from Medford, Ore. "We're in shock right now. Neither one of us knew he was taking this stuff. This is the first we've heard of it causing his death. People talk about closure. We will never have closure. Our son shouldn't have died."
The final autopsy report did not answer every question associated with Bechler's death. Perper confirmed that Bechler's body weight was 320 pounds when it was weighed for the autopsy on Feb. 19 - or 71 pounds heavier than he was listed after pitchers and catchers weighed in on the first day of spring workouts Feb. 14.
Though a significant amount of fluid retention and temporary weight gain is considered normal after dramatic attempts to counteract heatstroke, Perper indicated a weight increase of 70 pounds appeared to be well beyond what would be expected from the heavy infusion of fluids and plasma. He estimated the normal increase in weight to be about 20 pounds.
"The other possibility is that their weight at their time or perhaps our weight at our time, was maybe wrong," Perper said.
Orioles officials could not explain the discrepancy either. Bechler's weight was measured at 249 pounds on a relatively new, high-tech scale, the same scale that measured the weights of his teammates without anyone complaining of an inaccurate reading. Though Bechler came to camp 10 pounds heavier than he registered at his final weigh-in of last season, the change in his appearance was not dramatic.
"I saw Steve in the clubhouse, and I've seen him over the years," said Orioles physician Dr. William Goldiner. "He didn't look a whole lot different than usual ... 240 ... 250 ... He certainly didn't look 290. I didn't notice 20 or 30 pounds heavier."
Strength and conditioning coach Tim Bishop, who oversees the periodic weigh-ins, said Bechler refused to be weighed during offseason workouts but indicated there was no reason to believe his spring weight was inaccurate.
"It defies logic that one person's weight could be off that much," Bishop said.
The discrepancy might never be explained. Bechler's post-mortem weight figures to become an issue if Meiselman's lawsuit ever comes to trial, but experts in product liability law say the damaging toxicology report will force Cytodyne to pursue a quick out-of-court settlement.
The toxicology report also could fuel efforts by Major League Baseball to add ephedrine to the list of substances prohibited under baseball's collective bargaining agreement. The International Olympic Committee, NCAA and NFL already ban the substance.
Baseball's commissioner's office released a statement yesterday calling for more talks with the players union to add potentially harmful supplements to the sport's new drug policy.
"The report from the coroner on the death of Steve Bechler does not diminish Major League Baseball's concern over the safety of ephedra usage," the statement read, "particularly in the context of professional sports. The commissioner's office will continue to pursue all available avenues to secure the appropriate regulation of this substance and other nutritional supplements. We remain prepared to discuss the issues raised by Mr. Bechler's tragic death with the players association."
Major League Baseball Players Association director Donald Fehr made public a memo that will be distributed to union members today advising them for the second time in eight days to steer clear of ephedrine-based products.
"As we told you in our March 5 memo on this subject," Fehr said in the memo, "such dietary supplements are currently undergoing a more intensive scrutiny by the federal government, and we urge you to avoid supplements containing ephedra pending the results of that effort."