When Katherine Bibeau's body arrived at the morgue, she was covered in large, deep purplish-black bruises. But she had not been beaten, Coroner Gary Watts discovered. Rather, she had massive internal bleeding after receiving an unconventional treatment for multiple sclerosis.
Intravenous infusions of hydrogen peroxide, administered by physician James Shortt, had produced bubbles in Bibeau's bloodstream that started her down a fatal spiral into multiple organ failure and cardiac arrest, Watts concluded. The death, he ruled, was a homicide.
This case and the death of another infusion patient have put Shortt at the center of a controversy over a treatment that its opponents say has no proven benefits -- and serious risks.
About 100,000 infusions of the chemical, a refined form of the first-aid kit standby, are given each year nationwide as a treatment for a variety of diseases, according to proponents.
Shortt, fighting to keep his medical license, denies harming anyone. "I might be the world's greatest lunatic," he said, but "I'm not going to do anything to my patients that I think might hurt them."
At the root of hydrogen peroxide's purported power is the same action that makes it foam when placed on a cut.
Proponents of oxidative or "hyperoxygenation" therapy believe many diseases, including cancer and HIV, can be linked to oxygen deficiency. They say infusion or ingestion of substances such as hydrogen peroxide, ozone and germanium sesquioxide deliver an "oxidative burst" that can kill cancer cells and viruses, and boost the immune system. Shortt, 58, says he has been a believer since infusion guru Dr. Charles Farr helped him save a lupus patient's blackened toes from amputation.
Shortt says he has administered as many as 1,800 hydrogen peroxide treatments, and has seen people in the midst of severe asthma attacks "go from gray to pink" during an infusion.
Recently at his clinic, Health Dimensions, patients occupied two of the dozen black leather chaises arranged in a lounge off the waiting room. They watched videos as IV bags of yellowish and clear liquid emptied slowly into veins in their left hands.
Many patients, Shortt says, come to him when conventional medicine has run its course.
"We go to work from this point where you're hopeless," he said.
But health experts say injecting hydrogen peroxide into the bloodstream can cause convulsions, acute anemia and deadly gas emboli.
The American Cancer Society says treating certain tumors directly with hydrogen peroxide "remains an area for responsible research." But as for infusion of the chemical into the bloodstream, there is "no scientific basis for the regimens utilized by the oxymedicine promoters."
In September, the National Multiple Sclerosis Society's website posted a medical alert saying: "Hydrogen peroxide, administered either orally or by intravenous infusion, is not a recommended or approved treatment for multiple sclerosis...."
Physicians in Missouri, North Carolina and Tennessee have had their licenses suspended or revoked for giving patients intravenous hydrogen peroxide.
Katherine Bibeau, 53, a mother of two from Cottage Grove, Minn., was diagnosed with multiple sclerosis in 2001.
The knitter, gardener and baker was a breast cancer survivor and, says her husband, David, "June Cleaver with an attitude." So when confronted with a degenerative and incurable disease, she embarked on an open-minded search for ways to combat it. That led her to Shortt.
"Hydrogen peroxide would be very good to kill whatever's in there," Shortt told her in a February phone call, according to a transcript of the taped consultation. "Because, right now, we don't know what it is."
On March 9, she sat in one of those leather chairs in West Columbia as a 0.03% solution of hydrogen peroxide coursed through her veins. That first treatment lasted 90 minutes.
Afterward, Bibeau complained of abdominal pain and nausea, according to a federal lawsuit the family filed against Shortt. Two days later, the suit contends, she returned to Shortt's clinic extremely weak, with bruising at the infusion site and severe vaginal bleeding.
The lawsuit alleges that Shortt ignored these signs of "acute hemolytic crisis" and failed to order a blood workup for Bibeau, or to refer her to another physician. Shortt, while acknowledging that hydrogen peroxide therapy can destroy red blood cells after repeated treatments, denies those allegations.
By the time she arrived at the emergency room March 12, Bibeau was in multiple-organ failure. Two days later, she was dead.
In July, a second patient of Shortt's died. Michael Bate, 66, a retired engineer, had advanced prostate cancer.
Bate's wife, Janet, said he received eight hydrogen peroxide infusions, along with other treatments. (Bate also obtained the banned, discredited drug laetrile. Shortt acknowledges showing Bate how to use it after Bate made it clear that he intended to do so against Shortt's advice.) In this case too, the physician has denied doing anything to harm his patient.
In September, state and federal officers raided Shortt's office and confiscated his files. Later that month, the South Carolina Board of Medical Examiners asked a judge for an emergency suspension of his license.
Seeking support, Shortt traveled to the October conference, in Atlanta, of the International Oxidative Medicine Assn., which developed the regimens he used. The group found that Shortt had followed its "well-established" protocols.
In its position paper, the group's president, Dr. Robert Rowen, instead zeroed in on two FDA-approved drugs that Bibeau had previously been prescribed: the MS drug Copaxone and Tegretol, used to treat seizure disorders.
Rowen noted that among Copaxone's listed side effects are "metorrhagia (profuse uterine bleeding), thrombosis, bruising, clotting problems and infections." An Internet site dedicated to Tegretol warns of "easy bruising, or reddish or purplish spots on the skin" as possible "signs of a blood disorder brought on by the drug." Rowen says it is "more than reasonable to conclude" that the interaction of these two drugs was "the proximate cause of this death."
Shortt says he knew of no reason that his treatment would react negatively with the drugs Bibeau was taking. He did not suggest that she drop them.
Richland County forensic pathologist Clay Nichols says Bibeau had been on both drugs for more than a year "with no adverse effects."
As the investigations go forward, Shortt has voluntarily ceased performing hydrogen peroxide infusions. The South Carolina medical board has scheduled a Jan. 21 hearing to revisit his case.