Misattributing CAM Errors

The Pittsburgh Post-Gazette reported on a new theory about why an autistic boy who was being treated with chelation therapy died.

Dr Mary Jean Brown, an expert on the treatment of lead poisoning, suggested that the boy was treated with disodium EDTA rather than calcium disodium EDTA. Both are chelating agents. Treatment with the former agent could have resulted in an acute decrease in the blood level of calcium, a medical emergency. This could explain the low blood calcium level found at autopsy.

Thus, the news article's headline was "Drug Error, Not Chelation Therapy, Killed Boy, Expert Says." The Associated Press version of the story also attributed his death to a "drug mixup."

But hold the phone, here. As the Post-Gazette reported, "Though its [calcium disodium EDTA] only approved use, according to the U.S. Food and Drug Administration, is for lead poisoning, Dr. Brown said she is aware that iti is used by some people for other medical problems, ranging from clogged arteries to autism. She said there have been no reputable medical trials demonstrating the effectiveness of chelation as a therapy for anything but lead poisoning." Furthermore, "In recent months, chelation treatments of a wide variety ranging from IV to oral to topical have been gaining popularity for autistic children due to anecdotal information from parents indicating a reduction in symptoms."

Chelation therapy for conditions other than lead poisoning has been advocated widely in the complementary and alternative medicine (CAM) community, as per this post in Quackwatch. It is easy to find CAM web-sites that tout chelation therapy for autism, e.g., here and here. There is no good evidence from clinical research to support the use of chelation with calcium disodium EDTA for autism. Substituting a similar, but more dangerous medication for an anecdote-based CAM treatment was not a medical error, because it did not occur in the course of conventional medical treatment. So perhaps it should have been called a "CAM error."

Physicians who attempt to base their practice on science have already been saddled with the responsibility for innumerable medical errors. They do not deserve to also be made responsible for the misadventures of alternative practitioners.