Bos’ Autopsy Links Death to Earlier Attack, Not Diet

Otto Bos, Gov. Pete Wilson’s longtime aide, had unknowingly suffered a heart attack before the one that killed him earlier this month, the San Diego coroner’s office concluded in a report released Tuesday.

County Medical Examiner Brian Blackbourn said the previous heart attack and not Bos’ liquid diet, Optifast, contributed to Bos’ heart failure. Bos died as a result of a heart attack caused by narrowed arteries, Blackbourn said.

At his death, Bos’ heart was 25% larger than normal--posing a further strain on an already weakened coronary system, Blackbourn said. The three main arteries leading to Bos’ heart had become so clogged with fatty deposits that their blood-carrying capacity was reduced by 95%, Blackbourn said.

“The fact that he suffered a previous heart attack without knowing it is not that uncommon,” he said.

Bos, 47, performed warm-up exercises and was playing soccer with friends at a University City elementary school June 2. At halftime, he complained of a cramp in his side, which did not seem unusual to him or the other players after the strenuous exercises, the report said.

At 4:30 p.m., 25 minutes into the second half of the game, Bos kicked the ball and collapsed, turning ashen. Efforts to resuscitate him were unsuccessful.

Bos knew he had an elevated cholesterol level. Apparently, he had occasionally complained to his wife, Florence, of pain in his neck and left arm. But Bos had “no known prior cardiovascular disease, hypertension or any known malignancies,” the report stated.

Bos saw a doctor May 31, two days before his death, but no warning signals were detected during that checkup, the report said.

Because Bos’ death was so unexpected and came at a relatively young age, the coroner investigated whether his liquid diet contributed to his death.

During the 1970s, liquid diets were found to be responsible for at least 58 deaths, according to Dr. Wayne Callaway, an associate professor of medicine at George Washington University’s School of Medicine and a member of the Dietary Guideline Advisory Committee. The committee devises guidelines for the U.S. Department of Agriculture and the Department of Health and Human Services.

The Journal of the American Medical Assn. has said liquid diets are inappropriate for people, such as Bos, with less than 40 pounds to lose.

About four years ago, Bos went on an Optifast diet and lost about 25 pounds. Remembering that success, Bos recently decided to put himself back on the diet. This time, his diet was unsupervised by a doctor.