To the Editor:
In their article, “Pediatric fatality secondary to EDTA chelation,” Arla Baxter and Edward Krenzelok repeat an error originally made by Dr. Mary Jean Brown, chief of the Lead Poisoning Prevention Branch of the Centers for Disease Control and Prevention: that the death of the 5-year-old boy in Pennsylvania was “linked to the use of look-alike and sound-alike medications with similar indications and pharmacology which resulted in the wrong medication being administered.”Citation1
As we explained shortly after the fact, the choice of edetate disodium (Na2EDTA) was no accident.Citation2,Citation3 It was based on the “Protocol for the Safe and Effective Administration of EDTA and Other Chelating Agents for Vascular Disease, Degenerative Disease, and Metal Toxicity,” promulgated by the American College for Advancement in Medicine (ACAM), the most conspicuous advocacy organization for implausible uses of Na2EDTA.Citation4 As such, it would have been surprising only if the practitioner in question, an ACAM member, had not chosen the disodium salt.Citation3
Nor do the two EDTA salts have “similar indications and pharmacology.” At the time of the boy's death, Na2EDTA was approved for two conditions: hypercalcemia and digitalis toxicity. Edetate calcium disodium (CaNa2EDTA) was approved for one: lead poisoning. We suspect that Drs. Baxter and Krenzelok would agree that there is a crucial pharmacologic difference between the two drugs. Fortunately, most health care facilities in the United States will probably no longer stock Na2EDTA, because the FDA has recently withdrawn its approval.Citation5 Toxicologists and others, however, should beware of fringe practitioners obtaining it from compounding pharmacies.
We completely agree with Drs. Baxter and Krenzelok's conclusion but reiterate that this case was not a simple matter of the “wrong medication being administered.” As we argued at the time, the practitioner
“didn't give the ‘wrong type’ of chelating agent. He gave the more dangerous of two very wrong agents, and he gave it in the most dangerous possible way. No form of EDTA should have been used because there was no indication for it…
It is probable that if [he] had used CaNa2EDTA instead of Na2EDTA, or even if he had given Na2EDTA as directed by its package insert (slowly over 3 hours), the child would not have died suddenly. But this should not distract the Board, the medical profession, or parents from the real point of the case: quackery killed the boy.”Citation3
References
- Kane K. Drug error, not chelation therapy, killed boy, expert says. Pittsburgh Post-Gaz (online), 18 January 2006.. http://www.post-gazette. com/pg/06018/639721.stm. Accessed 10 August 2006.
- Atwood K. Death by chelation, revisited. Health Care Renewal weblog, 2006. http://www.hcrenewal.blogspot.com/2006/01/death-by-chelation-revisited.html. Accessed 26 January 2006.
- Atwood K. Death of an autistic child: chelation without indication. Health Care Renewal weblog, 2006. http://www.hcrenewal.blogspot.com/2006/11/death-of-autistic-child-chelation.html. Accessed 20 November 2006.
- Rozema TC. The protocol for the safe and effective administration of EDTA and other chelating agents for vascular disease, degenerative disease, and metal toxicity. J Ad Med 1997; 10(1):5–100.
- Department of Health and Human Services. Food and Drug Administration. [Docket No. FDA–2008–0321.] Hospira, Inc., et al. Withdrawal of approval of one new drug application and two abbreviated new drug applications. Fed Regist 2008; 73(114), Thursday, 12 June 2008/Notices. http://www.edocket.access.gpo.gov/2008/pdf/E8-13273.pdf. Accessed 10 August 2008.