The autopsy performed Tuesday on Baltimore Orioles pitcher Steve Bechler uncovered several factors that contributed to his death from heatstroke, but Broward County medical examiner Dr. Joshua Perper placed significant blame on a weight-loss drug containing ephedrine.
Perper reported that Bechler was suffering from moderate hypertension and found some evidence of liver dysfunction. The 23-year-old pitcher also had little food in his digestive system, which caused the medical examiner to conclude that he had been on a strict diet.
Though the results of toxicological studies will not be available for two weeks or more, Perper said that he had determined through interviews that Bechler was using an over-the-counter weight-loss drug called Xenadrine RFA-1 and had ingested three capsules before he collapsed during a workout on Sunday afternoon.
The product contains ephedra, an herbal substance that contains the stimulant ephedrine. The drug is banned by the NFL, the International Olympic Committee and most major sports federations, but it is not on the list of controlled substances prohibited under Major League Baseball’s drug policy.
“It says very clearly on the label that individuals with heart problems, hypertension and liver problems should not take this medication,” Perper said. “He was probably on a diet and ate very little. He was taking part in conditioning exercises in hot, humid weather. All of these factors may have contributed to his unfortunate death.”
Perper said it would be impossible to quantify the effect of each factor in the catastrophic case of heatstroke that caused Bechler’s major organs to shut down, but that didn’t stop him from joining the chorus of criticism directed at Major League Baseball for failing to effectively restrict the use of ephedrine-based products.
“The National Football League, the Olympic Committee and other sports organizations have banned the use of ephedra among their athletes,” Perper said. “Suffolk County, N.Y., has passed legislation to ban the sale of ephedra. There have been a number of deaths reported from ephedra. I would like to think that this very unfortunate death would wake people up and (baseball officials) would ban its use by their athletes.”
Major League Baseball did attempt to include ephedra and ephedrine on a list of banned substances during the labor negotiations that led to the sport’s new steroid-testing policy, but met with resistance from the Major League Baseball Players Association.
Ephedra has become very popular among athletes who wish to lose weight and pick up energy. Though available at health food stores, it is similar to amphetamines “speed” and works by speeding up the body’s metabolism and thus its production of heat.
Dr. Bill Howard, a sports medicine expert at Union Memorial Hospital in Baltimore, said it can turn deadly when taken by someone who is exerting himself heavily on a humid day, when sweat cannot dry fast enough to keep the body cool.
“It’s an absolute tragedy that a guy 23 years old is gone,” Howard said. “I’m sure there are other people we don’t hear about, who don’t happen to be major-league prospects.
“I think this is a dangerous product.”