San Diego Union Tribune

The San Diego Union-Tribune
Section: Sports

Probing a deadly trend

Ephedrine linked to Bechler's death
Reporter: Bill Center

FORT LAUDERDALE, FL - The controversial drug ephedrine, taken in the form of a diet supplement, probably contributed to the death of Orioles pitching prospect Steve Bechler.

That is the preliminary finding of Dr. Joshua Perper, the Broward County medical examiner who conducted the autopsy yesterday.

Perper said Bechler, 23 , died Monday morning of complications of heatstroke caused by multiorgan failure. Bechler suffered the heatstroke Sunday after a conditioning run.

"This tragic death was the result of a convergence of factors," said Perper, who added that Bechler had a "history of borderline high blood pressure" and "liver abnormalities detected two years ago."

Other contributing factors, said Perper, included Bechler's weight and conditioning and the fact the pitcher was working out while on a strict diet. "There was very little solid food in his digestive tract," Perper said.

But the focus of Perper's comments focused on ephedrine, although his final report won't e made until the toxicology reports are completed in two to three weeks.

Ephedrine is the active substance of the plant ephedra, which is used in many over-the-counter diet pills.

"My understanding from a source is that Bechler took three tablets of an over-the-counter diet drug Sunday morning," said Perper. He identified the drug as Xenadrine RF-1, which contains ephedrine. The maximum prescribed dosage on the bottle is two pills twice a day.

Bechler might have taken the pills to address his weight after being reprimanded by Orioles manager Mike Hargrove on Saturday for being overweight and out of shape.

Hargrove said he had "a discussion with Steve about his weight" on Saturday after the pitcher failed to complete the running portion of a workout. The 6-foot 2 right-hander weighed in at 249 pounds when he reported Friday. His listed weight is 239, and his high school coach said he weighed "180-185" five years ago.

"He was overweight but not sloppily overweight," said Hargrove. "What we were doing was not that strenuous."

Matt Riley, Bechler's teammate in Class AAA last year, said he also talked with Bechler on Saturday.

"He was distraught when he couldn't complete his running," said Riley. "He was sitting there with his head in his hands, When I sat down next to him, Steve said: 'I messed up … I want to make a change.'

"He wanted to change his work ethic. He didn't work out in Baltimore over the offseason as much as he should have. I had talked to him abut his weight a couple of times before. But I don't know about the dieting pills. All of us are baffled. It wasn't that hot Sunday. I've seen him run on a lot hotter days. Something must have been wrong."

Orioles outfield prospect Larry Bigbie was Bechler's roommate last year at Class AAA Rochester (N.Y.) and the two shared an apartment at times this winter in Baltimore so they could participate in the club's nonmandatory conditioning workouts. Hargrove said Bechler "wasn't a regular" at those workouts.

Bechler was married in October and his wife, Kiley, is 7 1/2 months pregnant.

Bigbie said Bechler had discussed diet pills with his wife.

"I know she wasn't for it," said Bigbie. "There was a lot of pressure on him about his weight. He was a big guy. And I know there was a health history in his family. I know he had a brother who passed away with a heart condition. And he went home last year when his father had a problem.

"He always had a thing about his weight. He never liked the condition he was in. But he wasn't great about working out. I told Steve he needed to change his eating habits and go to the weight room. He ate a lot of fast foods.

"He and his wife would talk about the other stuff. I heard him ask her once, 'What about Rip Fuel?' She was on top of it and against it. She never encouraged him about pills. She would tell him to trust the trainers. I don't know about if he did or when he started using pills."

But apparently he did.

"The warnings on the labels of those ephedrine pills were directed toward people like Mr. Bechler," said Perper.

"It says do not take this kind of medicine if there is a history of hypertension or heart problems. People are not aware of their own risk factors. Combine exercise, diet, drugs and history … a number of factors work in unison.

"Perhaps if he had not used ephedrine, it would not have happened."

Perper did take note of Bechler's 106-degree body temperature when he arrived at the hospital. His temperature later rose to 108.

"Ephedrine increases body temperature for the faster burning of fat," said Perper.