FORT LAUDERDALE, Fla.--Steve Bechler, a 23-year-old prospective pitcher for the Baltimore Orioles, died of multiple-organ failure due to heatstroke Feb. 17, and ephedrine may have been a cause, according to several media sources. However, Bechler also had a host of medical problems, according to the Broward County medical examiner, Joshua Perper, M.D. In spite of this, most media outlets were quick to single out ephedrine as a relevant factor in the pitcher's death.
Before autopsy results were released, outlets such as the Associated Press (AP) and the Orioles' official Web site were quick to name ephedrine, a supplement "linked to heatstroke and heart attacks," as a possible factor in the death of Bechler, whose body temperature reached 108 degrees at one point. This despite the fact that toxicology reports would not be completed for two weeks.
According to a press release from Cytodyne Technologies (www.cytodyne.com), the medical examiner confirmed Bechler was taking Xenadrine RFA-1, an ephedrine-containing supplement manufactured by the Manasquan, N.J.-based company. While the medical examiner reported Bechler had been taking three capsules once daily, the company noted the recommended dosage is two capsules twice daily.
"Due to the lack of medical evidence available at this time, Cytodyne is unable to specifically comment on the circumstances surrounding the tragic death of Steve Bechler," according to a company statement. "Until the toxicology report becomes available, the cause of death remains unknown and may never be known. What is clear is that Xenadrine has been the subject of numerous clinical trials on people, which have conclusively demonstrated that the product is safe and effective when used as directed."
Ephedra's possible involvement in Bechler's death has again caused a stir regarding the regulation of the dietary supplement industry. "The heatstroke death of Baltimore Orioles pitcher Steve Bechler has . once again raised questions about baseball's lack of rules over dietary supplements," according to a report by Glen Colbourn and Mark Zwolinski on WayMoreSports.com. The reporters noted that in light of the Orioles player's death, the general manager of another baseball team--the Toronto Blue Jays--said he will warn players to drink plenty of fluids and to avoid "unregulated supplements." Colbourn and Zwolinski also stated, "Baseball should take the NFL's [National Football League] lead and ban ephedrine, just as the NCAA [National Collegiate Athletic Association] also has done."
In the wake of Bechler's death, the Food and Drug Administration (FDA) has gotten involved in investigating whether ephedra was a factor, according to a report from the AP. Commissioner Mark McClellan told the AP researching the herb's safety, particularly its use in sports, is a high priority, and will be a factor in whether to ban sales.
Aside from the possibility of ephedrine's involvement in Bechler's death, the athlete was also reportedly overweight and out of shape when he arrived at spring training, where weather conditions were very hot and humid. Orioles team manager, Mike Hargrove, told the Miami Herald (www.herald.com) that Bechler's athletic condition was "not good." Based on Bechler's reportedly less-than-stellar athletic shape and the possibility that he was taking an ephedrine-containing supplement, the Herald reporter wrote, "A problem arises when athletes do not stay in shape but then try to get in shape quickly, or artificially, through dietary supplements."
And, compounding the situation, Bechler was suffering from several medical conditions, including an enlarged heart, abnormal liver function and borderline hypertension, according to Perper, who was quoted by The New York Times. Perper also told the Times Bechler had apparently placed himself on a strict diet, having eaten very little solid food for several days before his death.
Michael Silver, writing for Sports Illustrated (www.si.com), suggested ephedra may not have been solely responsible for Bechler's death. He wrote, "It's so much easier to blame the drug--and, by extension, the athlete who chose to use it--than it is to examine the culture that caused Bechler and Stringer [Korey Stringer, the Minnesota Vikings tackle who died in 2001] to push their bodies to the limit ... Those concerned with the welfare of major leaguers might want to consider prohibiting players who are out of shape when they report from suddenly and severely restricting their food intake, then sweating off more pounds in the heat and humidity."