The case of Abubakar Tariq
Story of Abubakar Tariq
This is a tragic story that, somehow, did not make it to the local press when the news broke in August 2005, even though it attracted international attention.
Yet the story is still worth telling now, because of an unusual new twist that developed recently.The story is about Abubakar Tariq Nadama, a five-year-old boy who died during medical treatment, in his doctor's office. He was no ordinary boy and the treatment he received was not ordinary either.
Abubakar was autistic. And he died while receiving an unconventional and controversial medical treatment called chelation therapy.
Chelation is a method of removing toxic heavy metals, such as lead, arsenic and mercury, from the body. It is a medical procedure approved by the US Foods and Drugs Administration for the treatment of heavy metal poisoning, but not for the treatment of autistic children.
A small group of doctors believe, however, that autism is biomedical condition due to factors that include food sensitivity, yeast infection, nutritional deficiency and heavy metal poisoning. They note, for example, that autistic children tend to have higher levels of mercury in their hair, urine and stools compared to normal children.
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But this group of doctors represent a small minority. Even in the UK, where Abubakar Tariq lived, chelation therapy for autistic children is not widely available and the boy's parents had to take him to the US for treatment.
So the story is not just about a boy who died, but about his parent's great determination to find a cure for autism.
Abubakar Tariq's death sparked intense debates about the safety of chelation therapy and even about the ethics of doctors who practise it.
Further debates erupted over whether Abubakar's parents had been too determined in trying to treat their autistic child's condition, to the extent that they risked the child's life.
Yet Abubakar Tariq was reportedly responding exceedingly well to chelation therapy – which was why his parents took him for a third course of treatment. This tragic story did not end there, however. Now for the latest news – which also did not make it to the local press.
Autopsy report of Abubakar Tarig
On 20 January 2006, Associated Press reported that a US Federal official, Dr Mary Jean Brown, chief of the lead poisoning prevention branch at the Centers for Disease Control and Prevention, had reviewed Abubakar Tariq's autopsy and found that the boy did not die of chelation.
Abubakar Tariq died, perhaps more tragically, from an accident. He was given the wrong drug. He should have been given a drug called Calcium Disodium EDTA but was given Disodium EDTA instead.
The two drugs look alike and have names that sound alike. Abubakar was supposed to receive a drug that removes lead from his body. He was given a drug that removed calcium from his body!
This latest revelation will not put a stop to the debates. Instead, it raises more questions and calls for more reflection.
First, what if Abubakar Tariq did, in fact, die from chelation?
Well, if he did, he would have been among the rare few, if not the only one.
The medical profession, and the media, often highlights isolated cases of death arising from unconventional treatment, be it chelation or some form of alternative medicine.
Yet thousands of people routinely die from conventional medical treatment – from the side effects of drugs, drug overdose, unnecessary surgery, infection picked up in hospitals, etc.
The medical term for this is iatrogenic death, meaning death from medical treatment. In July 2000, Dr Barbara Starfield reported in the Journal of the American Medical Association (JAMA) that iatrogenic deaths numbered at least 225,000 per year in the US, making it the third leading cause of death in the country.
Dr Lucian Leape, in a 1994 JAMA paper, “Error in Medicine” found an iatrogenic death rate of “only” 0.56 percent. This seemed a low and acceptable figure. But it translated to 180,000 people dying each year - equivalent to three jumbo jet crashes every two days!
Seen against such numbers, one chelation death out of thousands who have received the treatment is actually very safe. But that number has now been revised - to zero.
Another question to ponder is: To what extent should parents of autistic children seek to treat their children's condition?
Some parents feel that since autism is not a life-threatening disease (unlike cancer), it does not warrant "taking risks” by seeking non-conventional treatment.
Look at it another way: If a child has cancer, the child dies and the parents mourn. When a child is autistic, the parents die and the child is left unable to care for himself or herself. That is a greater tragedy.
John Yeo Kee Chiang
An edited version of this article was published as a commentary in
TODAY newspaper, on 13 February 2006