Very Important!! Prior Issues with Creative Compounding in Wilsonville Oregon

CDC Morbidity and Mortality Weekly Report, March 2006, 55(08);204-207

Deaths Associated with Hypocalcemia from Chelation Therapy

Oregon

In August 2003, a woman aged 53 years with no evidence of coronary artery disease, intracranial disease, or injury was treated with 700 mg IV EDTA in a naturopathic practitioner's clinic. The EDTA was provided by a compounding laboratory (Creative Compounding, Wilsonville, Oregon) and was administered by the practitioner to remove heavy metals from the body. The practitioner had provided a similar treatment to the patient on three previous occasions, once in June 2003 and twice in July 2003. Approximately 10--15 minutes after treatment began, the patient became unconscious. Cardiopulmonary resuscitation was initiated, and an emergency services team was contacted. Attempts to revive the patient en route to and in the ED were unsuccessful. The medical examiner determined the cause of death to be cardiac arrhythmia resulting from hypocalcemia associated with EDTA infusion and vascuolar cardiomyopathy. The patient's ionized calcium level during code was 3.8 mg/dL (normal value for adult patients: 4.5--5.3 mg/dL) after one IV injection of calcium gluconate administered by emergency medical technicians en route to the hospital and another IV injection of calcium chloride in the ED. The Oregon State Naturopath Licensing Board is conducting an investigation to determine whether Na2EDTA or CaEDTA was administered to this patient.