Andrew Johnson, a personal trainer at the Fitness First gym in York, died unexpectedly at the age of 34 years old on February 22, 2015. An inquest determined that he died of a heart attack that resulted from a massive infection in his heart. In the absence of any other obvious causes, the use of anabolic steroids was the only thing left to blame.
Bacterial endocarditis
Coroner Jonathan Leach issued a verdict of “accidental death” during the inquest at New Earswick Folk Hall on February 16, 2016. Since Johnson was a bodybuilder known to use anabolic steroids to build and maintain his muscular physique, the inquest examined the role steroids may have played in his death.
Consultant pathologist Andrew Clarke concluded that Johnson died because he failed to wipe the rubber stopper of a vial of injectable anabolic steroids with a sterile alcohol prep pad. Clarke speculated that the outside of the stopper was contaminated with bacteria and puncturing the stopper with a needle could have introduced the bacteria into the injectable steroid solution. An injection from this vial effectively introduced the bacteria into his body.
The infectious endocarditis was caused by clostridium limosum, a bacteria widely found in soil and feces. The stopper could have been contaminated by something as simple as touching it with a dirty finger.
“There was no form of sterilizing swab, which was unusual given all the other paraphernalia there. Although he was using sterile needles, there was no mechanism of cleansing the vial or the rubber cap to the vial of liquid he was injecting himself with. It is most likely the cap got infected…
“If it had been diagnosed, it would have been treatable. The problem is that when an organism grows through the conducting tissue of the heart it interrupts the conducting mechanism of the heart and stops the natural beating and death is instant.”
The coroner’s verdict suggested that Johnson was careless with proper injection procedures. However, the testimony of Johnson’s mother and girlfriend contradicted this portrayal. They testified that Johnson was “fastidious” about proper hygiene and injecting procedures and always used sterile needles and safe injecting equipment.
Sterile alcohol prep pads
Clarke recognized that Johnson meticulously organized his sterile injecting paraphernalia. But in spite of Johnson’s apparent attention to safe injecting procedures, investigators were unable to find any sterile alcohol prep pads in his home. Based on the absence of the wipes, Clarke concluded the infectious endocarditis was the result of a contaminated intramuscular injection of steroids.
Of course, Clarke’s hypothesis would have been conclusively affirmed or disproved if investigators had actually tested the vial in question for bacterial contamination. This apparently wasn’t done.
Obviously, the incidence of fatal infectious endocarditis in steroid-using bodybuilders is exceedingly rare. Intravenous drug abusers who share needles are more likely at risk of such infections. But not so much for injectable steroid users.
Sterile injection equipment
What are we to make of such a sensationalistic case report? Is it nothing more than scare tactics? Is it yet another example of anti-steroid propaganda that overstates and exaggerates the risks associated with steroid use? Or is it a public service announcement intended to reduce the risk of harm in steroid users?
It’s probably all of the above.
Millions of bodybuilders have used and will continue to use injectable steroids without becoming afflicted with infectious endocarditis. This is a rare event. Nonetheless, it is good for bodybuilders to never assume they will be like most steroid users.
If nothing else, the current case could serve as a strong reminder for steroid users to pay proper attention to sterile injection procedures; to be more concerned about the quality and safety of the underground products they are injecting in their body; and to take any injection-related injections more seriously.