WELLINGTON — At least 14 horses died Sunday after collapsing before a polo match. Vets hooked up intravenous tubes to the sick horses and fought to help them breathe as the horses from the Lechuza Caracas team were stricken by an unknown illness, officials said.A bit farther down, we are told:
"Some died right away. Others lasted about 45 minutes," said veterinarian Scott Swerdlin, a member of the Palm Beach Equine Clinic who was at the scene and said 14 horses died.
The horses began breathing heavily and stumbling at the Lechuza equestrian facility before they were brought to the polo club, Swerdlin said he was told.So it does appear that 14 horses were involved, and that they are indeed deceased beyond any reasonable doubt, since their "carcasses" (couldn't they have said "bodies" or "remains"?) were taken to a state laboratory for necropsy. So why, then, did the brave Palm Beach Post not come right out and tell us that in the headline? Why did it feel obligated to use the adverb "reportedly" to modify the word "died"?
Necropsies and blood tests will be done on the dead horses at a state-run clinic in Kissimmee. The carcasses were taken intact to the facility Sunday afternoon. Results could come as early as today.
Swerdlin wouldn't speculate on what happened to the horses. "I don't guess," he said. "I wait for evidence."
So what happened? What might have caused these 14 apparently healthy polo ponies to sicken and die within 45 minutes or less? We have to read all the way down to the 10th paragraph to learn what the reporters "reportedly" found out – which then turns out to be a rehash of what some other reporters reportedly found out:
According to several sources, the horses had a reaction to a steroid derivative that may have been tainted with a cleaning solution, the Sun Sentinel reported. The shots apparently were administered by an Argentine vet not licensed in the U.S., it further reported.The truth, then, is not that these unfortunate horses "reportedly" died, but that they most definitely died after "reportedly" having been accidentally poisoned in a doping attempt involving an unlicensed veterinarian.
At least three more horses were affected.
One 10-year-old mare was gravely ill late Sunday afternoon. She was lying in a stall under the care of the medical staff at the Lechuza facility.
"They started getting dizzy," [polo club spokesman] O'Connor said of the scene at the polo club. "They dropped down right onto the grass."
If true, this allegation reflects very poorly upon the polo club and both the Federal and Florida state regulatory agencies which are charged with enforcing our animal protection laws. For many decades, incidents such as these were routine at horse racing tracks in third-world countries, but were almost unheard of in the United States and other first-world countries. Now, it appears that an individual who may or may not be licensed to practice veterinary medicine in Argentina, but was practicing illegally here, somehow managed to bring in enough of some illegal substance to kill at least 14 horses, then administer it to them by injection without being detected.
If this episode turns out to have unfolded approximately as related in the Palm Beach Post story, its significance cannot be overstated. It would represent a major failure in the regulatory systems upon which we rely to keep everyone honest, and would constitute further evidence, if any were needed, of our degeneration into a banana republic.
The importance of definitively ascertaining not only the precise cause of the horses' death, but the exact circumstances and, above all, the identities of those responsible, cannot be overstated. Regardless of who was involved, all of the people responsible for this outrage must be exposed, tried, convicted, and punished as severely as the law will allow. In addition, we must insist that our regulatory agencies use the authority they have been granted to enforce the laws which are supposed to prevent this sort of flagrant abuse.
Stay tuned.
4/20/09 10:34 AM UPDATE: According to the AP, 7 more horses have now died, for a total of 21. This story doesn't mention the allegation that an unlicensed Argentinian veterinarian had given the affected horses some type of steroid injections just before they fell ill, but does include this additional information:
A veterinarian who was at the scene said the tests will need to determine the trigger for what he believed was heart failure among the horses.
"Well clearly, it's an intoxication, clearly there's some sort of a poison," Dr. James Belden told NBC.
Belden said it remains to be seen "whether it's something in the environment or something that the horses were exposed to." He said the routine in the horses' stable ahead of the match was absolutely normal.
4/20/09 12:56 PM UPDATE: The Palm Beach Post has an updated story: Polo veterinarian: Tainted meds, performance drugs unlikely the culprit to 21 polo horses' deaths. Here's a snippet:
The horses, all from the same team, died one by one, "almost certainly of an intoxication of some sort that they consumed," said Lechuza Caracas team veterinarian James Belden, a local vet who was among those pumping intravenous fluids into the horses, trying to save them. Belden doesn't travel with the team but thought it unlikely that the horses would be given anabolic steroids because the team competes in England, where such drugs are prohibited.
"Almost certainly they don't use anabolic steroids," Belden said.
He also said tainted medication - a concern raised late Sunday - was not a likely culprit because the horses are cared for diligently.
"I've been in practice 50 years," Belden said. "I've never seen anything like this."
There's also another story with some intriguing information about the horses' owner, Venezuelan multi-millionaire Victor Vargas, Wicked-rich owner of dead ponies has local ties:
The man has literally vanished since some of his horses laid down and died on the turf. One source at the United States Polo Association told me Vargas hopped on one of his three private jets Sunday afternoon and flew overseas.
Vargas, who also has oil interests, owns homes in the Dominican Republic and his native Venezuela, where he is considered close to President Hugo Chavez.
Looks as though there are a few rocks out there that need turning over to expose all the slugs hiding underneath. Let's hope that between them, the Feds and the Florida state authorities can come up with the cojones to do the job.
4/20/09 1:24 PM UPDATE: The Orlando Sentinel has another relevant story, Kissimmee vet will try to determine what killed polo horses:
KISSIMMEE - Terry McElroy, a spokesman with the Florida Department of Agriculture, Division of Animal Industry, confirmed the number of dead horses as at least 21. Of those, 10 to 15 have been sent to the division's main laboratory in Kissimmee. The others might be sent to a similar facility at the University of Florida in Gainesville, McElroy said.
"Animals died en masse and we need to know why," McElroy said. "The Kissimmee facility is the leading lab in the state, and one of the top ones in the nation for this type of investigation. That's why they went there."
McElroy said the entire necropsy process might take up to a week. It is very much like an autopsy: the body is dissected and fluid and tissue samples are collected.
"It might take the better part of the week or even longer because of toxicology reports," McElroy said.
4/20/09 4:42 PM UPDATE: And now the law is involved: Palm Beach County Sheriff's Office now investigating death of horses in Wellington.
In the meantime, the Florida Department of Agriculture and the U.S. Polo Association have launched investigations into the deaths, as has the Palm Beach County Sheriff's Department.
"As we find out more, we'll talk to more people, but right now we don't anticipate this being anything other than these animals accidentally ingested something or were accidentally poisoned," said Capt. Greg Richter, the commander of the Wellington district.
Wouldn't it be better if Capt. Richter, like Dr. Swerdlin, waited for the evidence to come in before jumping to the conclusion that this was all a terrible accident?
4/20/09 6:36 PM UPDATE: Sissy Willis was kind enough to draw my attention to this new article in the South Florida Sun-Sentinel, PBSO and state investigations launched in deaths of 21 horses in Wellington. The most significant bit of information I got from it is contained in the accompanying video. In it, a veterinarian correctly points out that the clinical signs exhibited by the horses which died are completely consistent with monensin poisoning.
Monensin, sold by the Elanco division of Eli Lilly and Company under the trade name Rumensin, is a special-purpose antibiotic used in ruminants and poultry as a feed efficiency improver and coccidiostat. It has long been known to be deadly poisonous to horses, and should never be mixed into any feed to which they might have access. While anything is possible, in my opinion, it would be highly unlikely that anyone would be so careless as to accidentally feed monensin-containing feed to high-value horses such as these. If monensin should turn out to be the causative agent of these horses' deaths, I would hope that the law enforcement personnel working on the case will thoroughly investigate the possibility that it was mixed into the horses' feed deliberately.
Another consideration is the matter of exposure. Generally, all of the horses in a barn are fed the same feed, with only the quantity being tailored to the individual horse. Therefore, if monensin had been introduced into the feed, normally all of the horses which consumed it would have been affected.
At this time, it is vitally important for everyone involved to keep an open mind and avoid jumping to conclusions which may turn out to be wrong. While we all want to know exactly what happened and who was to blame, we need to be patient and give the veterinary pathologists time to perform their detailed and painstaking examinations.
The time for recriminations is not yet at hand.
4/21/09 2:14 PM UPDATE: Here's the latest – first from the Sun-Sentinel:
State officials hope to finish examinations of dead horses by tomorrow
WELLINGTON - State officials today said they hope to finish necropsies on all 21 polo horses that died in Wellington by tomorrow. But so far, the deaths remain a mystery.
Terance McElroy, spokesman for the Florida Department of Agriculture and Consumer Services, said the physical examinations should be finished by Wednesday morning at the latest.
"But then we will begin toxicology tests," McElroy said.
As for the examinations that have taken place, McElroy said: "No conclusions [have been] drawn so far."
The state and Palm Beach County Sheriff's Office opened parallel investigations into the horses' deaths and are waiting for blood and tissue test results along with an analysis of everything the horses came in contact with that could have been toxic.
"There is no indication at this time of any criminality, any criminal intent, foul play," Sheriff's Office Capt. Greg Richter said today. "There's every indication these horses ingested or were injected with something that caused them to pass away."
The bodies of the horses arrived Monday at the University of Florida's College of Veterinary Medicine in Gainesville and a state laboratory in Kissimmee so scientists could examine them for answers. State officials quickly ruled out infectious diseases.
"Because of the very rapid onset of sickness and death, state officials suspect these deaths were a result of an adverse drug reaction or toxicity," McElroy said Monday, in a written statement.
Dr. John Harvey, assistant dean of the University of Florida College of Veterinary Medicine, said a necropsy is much like an autopsy: The body is checked for visible trauma, and fluid and tissue samples are collected after a preparation process that takes two to three days.
"The suspicion here is toxins because of how sudden these animals died," Harvey said. "But since we don't know what we're looking for, there are literally thousands of things we can test for. It could be like looking for a needle in a haystack."
The Palm Beach Post has this:
UF animal pathologists will examine remains of all 15 polo ponies taken there
GAINESVILLE — A team of University Florida animal pathologists and technicians is working as quickly as possible to determine the exact cause of death for the 21 polo ponies from Wellington.
At UF's College of Veterinary Medicine, four pathologists and three technicians are examining blood and tissue samples from the remains of the 15 horses they received Monday.
"As soon as the horses got here, we started processing them," Sarah Carey, spokeswoman for the college of veterinary medicine, said today. "But it's not like we have a huge, huge facility. This is a stress for us as well."
Preliminary results could be available by the end of this week, said Dr. John Harvey, executive associate dean of the College of Veterinary Medicine.
Initially, pathologists were going to examine only the eight horses that were insured. But Carey said that the UF school was asked to test all 15 horses - "possibly because of the sensitive nature of this case, and the fact that it is under investigation," she added.
As of this morning, necropsies had been performed on the eight insured horses, with the seven others scheduled next.
The bodies of the other six horses from the Lechuza Caracas team are being examined at the Florida Animal Diagnostic Lab in Kissimmee. Agriculture Department spokesman Mark Fagan said the two sites are communicating regularly on the exams.
"We are trying to expedite this (process) to get something conclusive as quickly as possible," Fagan said from Kissimmee. "It's hard to say it's going to be a week, or two weeks, but it's going to be done as quickly as we can."
Arrival at a definitive diagnosis may well depend upon the completion of the toxicology tests. If so, this may take a while.
4/22/09 5:58 PM UPDATE: Here's the latest from the Palm Beach Post:
State investigators: Dead Wellington polo horses had hemorrhaging lungs:
With the necropsies on the 21 horses that died in Wellington on Sunday nearly complete, the Florida Department of Agriculture confirmed today that the horses suffered from hemorrhaging of the lungs.
"The thing that is consistent with all the horses is hemorrhaging and pulmonary edema," said Mark Fagan, spokesman for the agricultural department. "That's consistent through all the necropsies so far, and we certainly expect that with the remaining few necropsies."
Fagan said that an official cause of death wouldn't be released until the toxicology reports are completed - those results aren't expected until the end of the week, at the earliest.
Fagan said that investigators are following a report in the La Nacion newspaper of Buenos Aires where a captain of the Lechuza Caracas polo team said the horses were injected with a vitamin supplement called Biodyl that is not approved for use in the United States, Fagan said.
Pulmonary edema and pulmonary hemorrhage in all 21 horses – sure sounds like it'll turn out to be some sort of a mass poisoning. Now, they'll determine what substance or mixture of substances was involved. Once that's been established, it will be a matter of good old-fashioned detective work to ascertain with legal certainty how it got into the horses, and who was responsible.
I'd be extremely surprised if the death of all these horses turns out to have a natural cause. It's a virtual certainty that one or more humans was involved. The investigators will have to figure out who did this, then whether it was some sort of terrible accident – or intentional and malicious.
Let's be patient while the veterinary pathologists complete their necropsies and forensic analyses. It sh ouldn't be too much longer.
4/23/09 2:53 AM UPDATE: The Palm Beach Post is now reporting FDA: Supplement, allegedly injected into Wellington polo horses that died, illegal in U.S..
The 21 polo ponies that died in Wellington were all injected before Sunday's match with a government-banned vitamin supplement designed to fight off exhaustion, and polo team members believe a tainted dose caused their deaths, the team's captain said.
Juan Martin Nero, captain of the Lechuza Caracas polo team, told the Argentine newspaper La Nación that all of the horses received injections of Biodyl before getting sick and dying.
"We don't have any doubts about the origin of the problem," Nero said. "There were five horses that weren't given the vitamin and they are the only ones that are fine."
Biodyl, a French-made supplement, is banned by the federal Food and Drug Administration, and its sale or use in the United States is generally illegal, an FDA spokeswoman said.
But veterinarians say the supplement is usually harmless and would have been unlikely to kill the horses unless it had been somehow contaminated.
This information is interesting, but leaves us no closer to a definitive answer. Despite the polo team captain's certainty, investigators are going to rely upon the results of laboratory tests to reach their conclusions.
4/23/09 3:21 PM UPDATE: According to the Palm Beach Post, Pharmacy admits it incorrectly mixed supplement linked to deaths of 21 Wellington polo ponies.
WELLINGTON — The head of an Ocala-based pharmacy today admitted that it incorrectly mixed a medication that was given to 21 horses that mysteriously collapsed and died last weekend.
Jennifer Beckett, chief operations officer for Franck's Pharmacy, said an internal investigation revealed that the strength of an ingredient in the medication was flawed. In a written statement, she did not name the medication or the ingredient involved.
"We will cooperate fully with the authorities as they continue their investigations," she wrote. "Because of the ongoing investigations, we cannot discuss further details about this matter at this time."
The news came as the politically-connected Venezuelan multi-millionaire who owns the 21 horses indicated that he suspects his team's own veterinarian may have played a role in the deaths of some of the polo ponies, according to a letter from a Philadelphia lawyer.
In a letter to polo team veterinarian Dr. James Belden, an attorney representing an insurance company says its investigation revealed that a generic compounded version of Biodyl was administered to 12 ponies prior to their deaths before a match at the International Polo Club Palm Beach on Sunday. It is unclear why the letter references only 12; 21 horses are believed to have received the supplement.
Attorney William Gericke wrote that Belden ordered the compound from Franck's Pharmacy in Tallahassee.
The Sun-Sentinel has a similar report including a few more details, Ocala pharmacy says it incorrectly prepared medication for 21 polo horses that died:
WELLINGTON - University scientists think they have identified the chemical that likely killed 21 polo horses in Wellington, but are withholding the information until it can be reviewed by the state.
"We believe the likely chemical responsible has been tentatively identified, but pending review by the state veterinarian and state law enforcement, we cannot comment any further at this time," said Sarah Carey, spokeswoman for the University of Florida's College of Veterinary Medicine in Gainesville.
She did not know when the results would be released.
That accompanies news today that an Ocala pharmacy has taken responsibility for botching a vitamin compound given to the horses just hours before they died.
If a compounding pharmacy's mixing error is indeed the proximate cause of what happened, the lawyers are going to have a field day.
Veterinarians commonly use various drugs for "off-label" purposes. This practice is necessary because it's economically unfeasible for pharmaceutical manufacturers to pay for all of the testing which would be necessary in order to get each drug approved by the FDA for every conceivable purpose. Therefore, we are permitted to use any licensed drug we can legally obtain for any legitimate medical purpose on non-food-producing animals.
When we use drugs for off-label purposes, we don't have the legal cover of a multi-billion dollar pharmaceutical company backing us up. Quite the contrary, in fact – when we do this, we are on our own; we assume full responsibility for the consequences of our actions. Therefore, it's wise to:
- be absolutely certain that according to our best medical knowledge, we are using an appropriate drug at the correct dosage;
- take every precaution to avoid known drug incompatibilities;
- use our best judgment to decide whether to do it ourselves or entrust the compounding job to a trusted licensed pharmacist experienced in dealing with veterinary prescriptions;
- make sure that the client is fully informed at every step of the way, specifically informed about the risks involved in using an off-label drug upon his animal – and that he signs a release form to that effect
It will be interesting to find out whether the veterinarian responsible for ordering the compounded mixture from the pharmacy had explained the risks to the owner of the horses and gotten him to sign a release. If not – he'd better have some super heavy duty malpractice insurance, because the chances are pretty good that he'll be needing it.
In this case, the pharmacy has already admitted fault, so assuming that the laboratory test results confirm that their compound caused the deaths of the horses, they will have to share in the liability. As the saying goes, IANAL (I Am Not A Lawyer), but it was always my understanding that whenever I was using off-label drugs, anything that might have gone wrong was upon my head; the buck stopped with me. In this case, the team veterinarian allegedly prescribed the mixture, ordered it to be compounded by Franck's Pharmacy, and either administered it personally or supervised its administration. So it's unlikely that he'll be able to transfer the entire responsibility for the deaths of the 21 horses to the compounding pharmacist.
At least, thankfully, it is beginning to appear as though the deaths of these horses were not caused by a deliberate act.
4/24/09 2:51 PM UPDATE: Both the Palm Beach Post and Sun-Sentinel have some new information today.
From the Palm Beach Post comes High selenium in supplement mix could be to blame in death of 21 Wellington polo ponies
WELLINGTON- — Did too much selenium kill 21 polo ponies on Sunday?
As the polo world waits for test results to be released by state investigators, speculation has focused sharply on the naturally occurring chemical element.
Before dying Sunday and early Monday, the Lechuza Caracas team's horses were injected with a generic lab-made version of a banned French vitamin supplement that contained sodium selenite, a selenium-based salt.
Citing anonymous sources, the Argentine newspaper La Nacion reported today that the horses' lab-made supplements included 5 milligrams per milliliter of sodium selenite instead of the prescribed 0.5 milligrams.
Then there's this from the Sun-Sentinel: Ocala pharmacy says it incorrectly prepared medication for 21 polo horses that died
WELLINGTON - Five days after 21 polo horses mysteriously died in Wellington, university scientists Thursday singled out a chemical they think killed the ponies.
They just weren't ready to reveal it quite yet.
Still, clues have come together as an Ocala-based pharmacy acknowledged it incorrectly mixed a vitamin compound given to the horses just hours before they died -- a compound the Lechuza Caracas polo team says an unidentified Florida veterinarian requested.
The U.S. Food and Drug Administration says the compound is of questionable legality and attorneys say there could be costly consequences for its use.
Citing anonymous sources, La Nacion newspaper of Argentina, reported today that the formula given to the horses contained ten times the correct amount of selenium. The newspaper reported that 0.5 mg/ml was prescribed but the compound actually contained 5 mg/ml.
Conceding that definitive conclusions are still a bit premature, it is nevertheless becoming more apparent that these horses died because of a pharmacists's medication mixup. It looks as though the person who mixed the ingredients made a decimal error resulting in a formulation containing 10 times the prescribed dose of selenium.
This type of error is unfortunately all too common in both human and veterinary medicine. For example, in a widely publicized incident, actor Dennis Quaid's twin babies were inadvertently given a huge overdose of the anti-clotting medicine heparin – in Cedars-Sinai, one of the most respected hospitals in the country. Even at the finest institutions, human carelessness can still occur. People in a hurry don't always stop to read a label, but far too often grab a vial from a certain spot on the shelf, quickly noting the color and, perhaps, the drug name on the label, but not the concentration of the active ingredient. Thus, an infant can accidentally receive an adult dose of heparin one thousand times greater than the correct dose ordered by the neonatologist.
Similarly, a pharmacist in a hurry can slip a decimal point when calculating the quantity of sodium selenite to add to a medication he is compounding in order to fill a veterinarian's prescription. If neither he nor a second person catches the error, 21 horses can die agonizing deaths as a result.
Selenium is pretty unforgiving stuff. It's a trace mineral which is essential in minute amounts in the diets of both humans and animals. Yet, in somewhat larger amounts, it becomes a deadly poison. That in itself is not unusual – many elements, such as zinc and copper, are essential in tiny doses but toxic in large amounts. The unique thing about selenium, though, is that the difference between the essential amount and the toxic amount (expressed mathematically as the therapeutic index) is very small.
Then the case would seem to be pretty cut-and-dried, no? The pharmacist made a careless mistake causing the deaths of 21 beautiful horses; therefore he's responsible. But it's not quite that simple. In this case, the pharmacist was filling a veterinarian's prescription which might well not have been legal – which, at the very least, falls into that "gray area" mentioned in the news accounts.
Prescription compounding can be an invaluable tool. It can be useful to provide an otherwise unavailable medication for a specific patient with a problem which cannot be adequately managed with the licensed drugs already on the market. It is also very handy when the commercially available dosage forms are unusable or impractical for administration to an animal. However, it appears that in this case, compounding was being used to get around the law by formulating a medication which is not licensed for use in the United States. Furthermore, it was not for the purpose of treating any medical condition, but instead for the far more nebulous purpose of injecting healthy performance horses, analogous to human professional athletes, with a vitamin/electrolyte mixture.
In this case, it would seem that the apportionment of blame between the prescribing veterinarian and the compounding pharmacist will be a task calling for the wisdom of Solomon.
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