Autism Complementary and alternative medicine Medicine Quackery

The complaint against Dr. Roy Kerry, negligent killer of Abubakar Tariq Nadama

After not having written anything about the case of Abubakar Tariq Nadama, the five year old autistic boy who died as a result of chelation therapy administered to him to “cure” him of his autism, I revisited the case last week in light of the State of Pennsylvania filing charges against Dr. Kerry, the “alternative medicine” practitioner who delivered the lethal dose. I’ve now gotten a copy of the full list of charges, and it makes for some interesting reading if you can stand all the legalese.

Here’s the note in Tariq’s medical chart from his initial consultation with Dr. Kerry:

We don’t have the entire record at all. Mother left her entire volume of his records home. But we have been in communication with Dr. Usman regarding EDTA therapy. He apparently has a very high aluminum and has not been responding 10 other types of therapies and therefore she is recommending EDTA, which we do on a routine basis with adults.

Note that Tariq had been subjected to ten different other forms of what was almost certainly non-evidence-based “therapy” before his parents found their way to Dr. Kerry’s office. Sadly, this is probably not atypical of parents so desperate for a “normal” chld that they will allow themselves to be seduced by any dubious treatments that come along. In addition, to me this sounds as though Kerry never treated a child with IV chelation before. There’s a saying in pediatrics: “Children are not just little adults.” It’s bad enough that Kerry was giving chelation therapy to treat autism, an indication for which it is most definitely not appropriate, but he didn’t even seem to know the dose for a child of Tariq’s size!

The note continues:

We therefore checked him to it … But on testing for the deficiency indicator we find him only indicating the need for EDTA at the present time. Therefore we agree with Dr. Usman’s recommendation to proceed with the treatment. She recommends 50mg per kilo. He is 42 pounds today. So we’ll treat him with a 20-kilo child and give 1 gram of EDTA. We diluted it 1:1 with saline. Started the IV with saline. After a good blood flow in the right antecubital fossa with 3 other assistants and mother controlling him and the papoose board. Had a good TV return flow. We then introduced the EDTA. Checked return flow frequently during administration. Gave the IV over approx. 5 minutes. Then rinsed with saline. He had no difficulty toleration it. No infiltration occurred. We’ll have mother collect the urine for 12 hours. The most important are the first six hours for toxic and essential minerals. When we get that report back we’ll proceed with further injections as indicated on approx. a weekly basis. Recheck the levels in 4-6 lV’s depending on his response … Initial impression: Autistic Syndrome, Heavy Metal Toxicity, Candidiasis, Multiple Food Allergies … Roy E. Kerry, M.D.

Odd, there’s no mention of mercury, even though this was also in Dr. Kerry’s notes:

wants to have iv … edta injection … an iv push. mother states Tariq is autistic due to immunization shots he was a normal pregnancy .. 1st shots were given the day he was born … no sx noted until age 18 mo … has had 12 other inoculation by time he was 18 mo old/…

Indeed, for the most part, all we see in the notes are mentions of lead. It just goes to show that, should the mercury militia finally be forced to accept that the evidence just doesn’t support their belief that mercury in the thimerosal used as a preservative in vaccines is the cause of autism, there’ll always be another bogey man in vaccines that will be blamed, as I mentioned over a year ago. The mercury militia is just a manifestation of a larger antivaccination movement.

Here is the chilling part of the complaint:

58. On August 23, 2005, a third and final round of Disodium EDTA chelation therapy was administered to Tariq.

59. Theresa Bicker administered the IV Disodium EDTA to Tariq.

60. Bicker requested Doctor Mark Lewis, D.O.) to come to the treatment room to help restrain Tariq for the 1V push of Disodium EDTA.

61. Respondent was not present when Tariq received chelation on August 23, 2005.

62. Theresa Bicker administered the Disodium EDTA pursuant to Respondent’s orders.

63. Tariq’s medical chart fur August 23, 2005 reads “TV push ordered by Dr. Kerry and his protocol…. prior to procedure patient was alert and oriented. No acute distress. Mother was present in room ….. ”

64. During the IV push, Tariq’ s mother, Marwa Nadama said that something was wrong.

65. Doctor Lewis took Tariq’s vitals and then Tariq went limp.

66. Bicker called 911 and helped with CPR while the ambulance was en route.

67. Tariq was taken by ambulance to Butler Regional Hospital.

68. On August 23, 2005, at Butler Memorial Hospital, Tariq was pronounced dead.

And so a five year old child who did not have to die died. He was held down for an IV push, went into cardiac arrest, and died. As we know, the cause of death was cardiac arrest due to a low calcium level, a known complication of chelation therapy. And here’s Kerry’s reason for using an IV push of EDTA:

74. Respondent admits that he used the TV push because he did not believe that Tariq would be able to remain still and tolerate the one and 1/2 hours it takes to have the IV drip complete and therefore he administered the drug via IV push.

In other words, Kerry recklessly used a dangerous IV push of disodium EDTA just because he didn’t think Tariq would sit still, and Tariq’s heart stopped because it dropped the calcium level in his blood to levels that interfere with the proper electrical activity of the heart. Among the actual charges, it still irritates me, for the same reason that it irritated me when Dr. Mary Jean Brown of the CDC blamed Dr. Kerry for using the “wrong” kind of EDTA, rather than blaming him for using chelation therapy at all for a condition for which it is not indicated and for which there is no evidence of efficacy. Unfortunately, several of the counts perpetuate this mistake. For example:

7. The Board is authorized to suspend or revoke, or otherwise restrict Respondent’s license, or impose a civil penalty under 40 P.S. sections 1303.905 and 1303.908 in that Respondent was negligent in the care of Tariq because Respondent breached the standard of care when he did any or all of the following acts, 1) practiced medicine negligently by repeatedly ordering chelation by way of IV push of Tariq with the drug Disodium EDTA when there are specific warning not to rapidly infuse a pediatric patient, 2) used Disodium EDTA to chelate Tariq for metal toxicity which should be treated with CaNa2EDTA instead, and 3) he treated his patient with EDTA when this type of EDTA it was not indicated in the first place.

And another example:

93.The Board is authorized to suspend or revoke, or otherwise restrict Respondent’s license, or otherwise restrict Respondent’s license or impose a civil penalty under 63 P.S. § 422.41(8) and 49 Pa Code Section 16.61(a) (3) in that Respondent engaged in unprofessional conduct in that he performed a medical act incompetently or performed a. medical act which the physician knows or has reason to know that he is not competent to perform, in that Respondent treated his patient with EDTA when this type of EDTA it was not indicated in the first place.

The above would me correct if it read that “Respondent treated his patient with EDTA when EDTA was not indicated in the first place.” I can see chelation advocates using these complaints as “evidence” that Dr. Kerry shouldn’t be considered incompetent for using chelation therapy for autism, but rather for using the “wrong” chelation therapy for autism and giving it too fast, even though the complaint suggests otherwise:

44. Respondent obtained a “post provocative” urine sample from Tariq on July 22, 2005.

45. A “post provocative” sample is a urine sample taken after the patient has been subject to drug therapy or chelation.

46. The laboratory report of this sample was completed on July 29, 2005 and sent to Respondent.

47. This laboratory report listed Tariq’s lead level as “elevated” but not in the “very elevated” reference range.

48. It should be noted that this laboratory report has a notation in bold print that reads “Reference ranges are representative of a healthy population under non-challenge or non­provoked conditions.”

49. Tariq had a minimal elevation of his lead level.

Post-provocative urine samples are meaningless. If you give a chelating agent to random people on the street, it will elevate the lead level in their urine. That’s what chelating agents do. They bind heavy metals and cause them to be excreted in the urine. In fact, if Tariq’s “post-provocation” urine test showed only mildly elevated lead, that suggests to me that his lead levels were probably in reality in the normal range! In any event, Kerry should not have been chelating children for autism, period, because it is not indicated. In this light, that his cluelessness cost the life of a child is all the more tragic. On the other hand, I’m almost OK with all this if in the end Dr. Kerry is stripped of his license, fined to the maximum extent of the law, and subject to a massive malpractice and/or wrongful death lawsuit.

Justice demands that Kerry suffer a penalty for his incompetence and reckless disregard for the safety of his patients. If the law won’t allow him to be sent to jail for killing Tariq, at the very least he should never, ever be allowed near a patient, particularly a child, again.

ADDENDUM: Autism Diva has more, and Not Mercury comments on what we hope is the end of the thimerosal-autism hypothesis. Unfortunately, I’m not so optimistic. Pseudoscience has a way of hanging on for incredibly long periods of time in spite of the evidence against it.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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