Misuse of super-strength Botox paralyzes victims

The misuse of a super-strength botulinum toxin by an osteopath in America, rendered him, his girlfriend and two of his patients so ill that they were paralyzed and hospitalized for months in 2004.

It seems the toxin the Florida doctor injected in himself and three others for cosmetic purposes two years ago was up to 40 times more lethal than is needed to kill a person.

Fortunately all four survived life-threatening illnesses following the injections and the doctor involved has since been sentenced to three years in jail for using an unapproved drug.

Apparently staff at the clinic where the incident occurred had deliberately diluted the pure nerve toxin.

Weakened versions of botulinum bacteria have become popular for smoothing facial wrinkles and the two licensed in the United States for such purposes are Botox and Myobloc/Neurobloc.

Bach McComb who was an osteopathic physician who was continuing to practice in Oakland Park, Florida, after his license had been suspended, did not use a medical version of Botox; instead he gave himself and the three others, four to six injections of a preparation of paralyzing botulinum toxin that was 2,800 times stronger than that commonly used on patients.

It was an unlicensed preparation of botulinum toxin A, intended for laboratory research and labeled that way.

Dr. Christopher R. Braden, a medical epidemiologist at the U.S. Centers for Disease Control and Prevention, and the author of the report on the incident, says the fact that a clinical practitioner was using an unlicensed product was very disturbing, and needs to be highlighted and the issue dealt with so that it does not recur.

According to the report a 100-microgram vial of toxin taken from the same manufacturer's lot as the toxin administered to the case patients, contained a toxin amount sufficient to kill approximately 14,286 adults if disseminated evenly.

McComb, his two patients, Eric and Bonnie Kaplan, and McComb's girlfriend, Alma Hall, were each paralyzed by the time they were admitted to hospital.

Although all eventually survived, they were hospitalized for months and required assistance for basic functions such as breathing, speaking and walking.

Experts say the incident does not reflect on the safety of standard treatments of Botox, as Botox is carefully packaged by its manufacturer, Allergan, and comes in a vial that does not have an excessive dose.

They do advise however that patients use only certified plastic surgeons, and as with any medical procedure, including Botox, ask questions regarding material being injected into their body and even ask to see the container or the material.

Consumers are also warned about bargain-hunting where " Botox- like" medications are offered.

The report is published in this week's issue of the Journal of the American Medical Association.