Posted by

     Detroit-Area Coroner Links Heart Attack Case to Ritalin
     May or May Not Apply To Death of Boy, 13, at Ooltewah Middle

     by Dean Arnold,  Chattanooga Fax

         The chief forensic pathologist for Oakland County, Michigan has ruled
     that Ritalin use caused the heart attack death of Matthew Smith, 14, who
     was riding his skateboard in the suburbs of Detroit one year ago.

         Ooltewah Middle School’s Travis Neal, 13, had an enlarged heart, like
     Matthew, when he collapsed from a heart attack and died after running
     lapsin gym class on Nov. 24,1997. The Michigan coroner, after studying
     Neal’s autopsy provided by CFax, says the student’s heart was twice the
     normal size.

         "This type of condition generally has a congenital link," Dr. L.J.
     Dragovic told Chattanooga Fax. "Add a stimulant and you have a formula
     for disaster...If he were on Ritalin, it certainly aggravated any pre-existing

         The exact amount of Ritalin involved, however, remains in question.

         The day of Neal’s death, the Chattanooga Free Press quoted Ham.
     Co. Emergency Services Spokesman Bruce Garner that the death was
     from "cardiopulmonary arrest of unknown origen" and that "we don’t have
     any real indication of what happened....The teen had no history of
     obvious medical conditions or drug use."

         However, the local coroner’s report obtained this week by
     Chattanooga Fax lists the following under Medical History: "Attention
     Deficit Disorder, Rx Ritalin."

         Garner told CFax his statements were based on the information
     available to him that day. The Investigative Report listing Ritalin drug use
     is dated the following day and was conducted by Medical Examiner F.K.
     King, Jr. and Forensic Technical Specialist Karen Carter. Carter told
     CFax the entry for medical history was based on interviews with family,
     physicians, school officials, and others associated with the incident.

         The citation of ADD and Ritalin was not reported after the investigation
     was filed.

         Anti-Ritalin activist Redd Howe first approached the Hamilton County
     School Board one month after reading an 11/16/97 Free Press article 
     stating that "Hamilton County has the state's highest consumption of the
     drug Ritalin" and that Tennessee "exceeds the national average by about
     25 percent."

         Reporter Ken Spear wrote that there is "an increasing fear that the
     drug is being overprescribed to active children who don't need it, partly
     as a result of pressure from harried teachers and parents."

         TN Rep. Tommie Brown held special statewide hearings in Nashville
     on the Ritalin concerns one week before Neal’s death and Howe
     approached the Board with his concerns a week later. "Ritalin is being
     prescribed and the long term effects have never been established for any
     age group, especially children," said Howe, who believes officials are
     "downplaying the seriousness of the drugs recommended. Schedule II
     drugs include cocaine, morphine, and ritalin and are the most addictive
     class of drugs known to pharmacology. We're rolling the dice - big time,"
     he said.

         Howe told Chattanooga Fax several parents at Ooltewah Middle "told
     me it was common knowledge that Travis Neal was on Ritalin for years."
     However, CFax has not obtained that information from any primary

         The father, Mark A. Neal, told CFax that Travis was on Ritalin "one or
     two months in the third grade" and had not taken the stimulant in four

         Dr. Dragavic, who also serves as a professor of Neurology at Wayne
     State Medical School, was surprised by the father’s statement. "I have
     reason to believe this entry was made for reasons other than casual 
     exposure over a couple of weeks," he said. "He must have been on it for
     a longer period of time. He would have been on it for some time for it to
     be listed."

         Dr. Fred Baughman, a San Diego neurologist who testifies in national
     ADD cases, also believes that an entry on a coroner’s report would be
     based on harder evidence. "It’s much more likely that it is a still-current
     diagnosis for which there has been longterm treatment," he said, "rather
     than just a diagnosis requiring brief treatment in the 2nd or 3rd grade."

         Karen Carter with the Medical Examiner’s Office said no particular
     criteria govern what is entered for someone’s medical history. She said
     the report itself is public record and would not comment on whether the
     "ADD Rx Ritalin" determination originated from one or several sources.

         Dr. Dragovic’s ruling that links Ritalin to heart problems has caused a
     national stir. He was interviewed recently opposite an APA critic on
     Bryant Gumbel’s ‘CBS This Morning’ and appeared in a French
     documentary on the controversial subject.

         Dr. Joseph Biederman, professor of psychology at Harvard University
     and a longtime researcher of the use of stimulants, believes Dragovic's
     conclusion is unfounded. Pediatrician Dr. James Shaya said he has
     never heard of a similar case or similar side effect from Ritalin. Dr.
     Shaya, co-author of the book What You Need to Know About Ritalin,
     says "the use of Ritalin is well-known to be extremely safe. This doesn't
     seem very likely or plausible. I would draw into question the diagnosis."

         "We don’t come to conclusions through a democratic process," said
     Dr. Dragovic, who oversees five Forensic Pathogists in his labaratory.
     "There’s no way we can reverse anything. We are in law enforcement. 
     We follow the facts."

         Dragovic explained that stimulants work the heart muscles "like a car
     revving at 6,000 revolutions a minute. Eventually, you wear out the
     engine." He said Ritalin switches the heart to a higher gear. "When the
     heart is exercised, that cardiac reserve is exhausted."

         "If we don’t consider these facts, there may be another around the
     corner that will die from this," he said.

         Matthew Smith’s parents have filed a lawsuit and retained a nationally
     prominent attorney. Dr. Baughman is involved in cases of several deaths
     alleged to be connected to ADD prescription drugs.

         Dr. Dragovic urges extreme caution to parents and educators. "Be
     very careful. Monitor the child. Be sure the risk is justifiable. Be sure this
     type of aggressive treatment -- the use of stimulants I must say is 
     aggressive -- is worth it."

Leave a Reply

  • (will not be published)