A toddler dies from meningitis, governments need to block naturopathic pediatrics

Ezekiel Stephan died after being treated by a naturopathic doctor

You are probably aware of Ezekiel Stephan, a 19 month old boy, who died in 2012, after his parents chose home remedies and naturopathy for the treatment of viral bacterial meningitis. The parents currently are on trial in Canada for failing to provide the necessities of life.

Over the course of many days, Ezekiel’s condition rapidly deteriorated, but his parents chose to “give him as much natural product as possible,” including syrup, frozen berries and a mixture of apple cider vinegar, horse radish root, hot peppers, mashed onion, garlic and ginger root. By the time Ezekiel began slipping in and out of consciousness, a family friend, who is a registered nurse, examined the boy and instructed the parents to take him to the emergency room under the suspicion of meningitis.

Instead, the parents took Ezekiel to a licensed naturopath. His condition was dire. His mother recalled that his body was too stiff to be placed in a car seat, so Ezekiel was put on a mattress in the back of the car. The naturopath then gave a preparation of echinacea without performing a physical exam and did not instruct the parents to seek emergency medical attention. Ezekiel stopped breathing that evening.

Yesterday, we learned the identity of the naturopath who treated this child: Tracey (Pike) Tannis, a licensed ND in Alberta, Canada, and in “good standing.” She graduated from the Canadian College of Naturopathic Medicine in 2003, one of the seven “accredited” naturopathic schools in North America. Her practice interests include cancer, ozone therapy, chelation therapy, minor surgery, and pediatric care.


This story is absolutely heart-wrenching. The loss of a child is, understandably, devastating. And, I feel this sadness. My heart also partially feels for the naturopath who treated Ezekiel. She was faced with a scenario that overwhelmed her training. She had been tricked, like all NDs are, into thinking she was a competent primary care doctor who could use herbs to cure.

I have written about the poor training of licensed naturopaths previously for ScienceBasedMedicine.org, KevinMd.com, and here, at Naturopathic Diaries. In light of Ezekiel’s death complicated by a naturopath, I want to revisit a few points regarding naturopathic training.

Naturopathic students do not have the opportunity to practice on patients suffering from a wide range of illnesses. Instead, students often treat patients who are best described as the “worried well.” Naturopaths see patients who are typically healthy or who have minor health concerns. I never saw a child presenting with meningitis or even a patient with acute chest pain, shock, or lots of bleeding.

In order to meet graduation requirements, naturopathic students, at least at Bastyr University, are allowed to present vignettes of a medical case, and describe how to diagnose and treat these fictitious patients. This sort of training actually counts as “direct patient care” by the schools and by their accrediting agency. I presented cases for made-up patients suffering from HIV/AIDS, cancer, cardiovascular problems, and infectious diseases. I never had a chance to get any meaningful, first-hand training with patients actually suffering from these conditions. The ND treating Ezekiel probably didn’t either.

I can guess why this naturopath did not perform a physical exam before she made a diagnosis and dispensed a substance. Naturopaths are trained to work through imaginary cases rather than practice on real patients. I know why the naturopath recommended an herbal preparation even for something as serious as meningitis. Naturopaths, more frequently than not, attempt to treat viral infections and other aggressive diseases with herbs. I often used echinacea for ear infections and colds on my former patients of any age. My former boss was using all sorts of “natural” substances on patients with terminal cancer.

When the parents are naturalistic fanatics and against science-based medicine, it can be nearly impossible to demonstrate that their child needs urgent medical attention. It once took me hours to convince a mom to bring her lethargic, unresponsive child to the emergency room, whom I suspected had leukemia. I ended up being right.

I can sympathize with the force of the wake up call this Alberta naturopath must be experiencing. A child died, and she played a role. In part, this is a problem because the naturopathic establishment endorsed her as a competent doctor, and lawmakers bought the hype. As long as the naturopathic profession continues to assert that naturopaths are trained “just like medical doctors,” we are going to have issues.

I think the Alberta government, and every jurisdiction that licenses naturopaths, needs to take another look at who naturopaths really are. I recommend removing any kind of legal status as a “doctor” and requiring mandatory disclosure statements to patients about the sharp limits of naturopathic care. This will require some serious effort.

Immediately, however, licensed naturopaths should be restricted from seeing patients under the age of 18. I am happy to work with lawmakers and patient advocates to help enact these legislative changes. For some context, I completed one of the few “naturopathic residencies” in the United States, and I can honestly say that this training was inadequate to become a pediatrician. You’d be surprised to learn that there is a self-anointed naturopathic pediatrics board certification. Clearly, naturopaths do not have any humility.

There are many problems with the naturopathic profession. Let’s start by protecting the children.

Disclaimer: Please keep in mind this post is dated March 10, 2016. I am not updating the article continuously to reflect ongoing legal proceedings against Mr. and Mrs. Stephen. Any person that relies on any information obtained from this article does so at his or her own risk. 

Image source: Facebook, via Ottawa Sun.
  • demodocus

    Doing case studies count as direct contact?! Am i reading that right? Because that doesn’t even count for student teachers.

    • carbonUnit

      It’s worse! Doing made up case studies!!!

      • demodocus

        that’s what we had mostly. But then, teaching kids is different than treating kids

    • carbonUnit

      It’s worse! Doing made up case studies!!!

    • https://www.naturopathicdiaries.com Britt Hermes

      That is correct.

  • carbonUnit

    Sick, deluded “doctors”…

  • carbonUnit

    Sick, deluded “doctors”…

  • David

    Although naturopaths and chiros often say there training is equal to a medical doctor, it is quite clear that they do not know what training a medical doctor receives. This was evident again in Adam’s comment (in the comments of the previous post), that an R1 observing in an ICU does not constitute working. My R1 year was my internship. In that year, I basically lived in the hospital, and after 6 pm, we were responsible to treat everything that occurred whether it was cardiac arrests or pronouncing patients dead. Medical school training is 99% hospital based. If anything, it is lacking in primary care office based training. When we see a patient, the first questions that come to mind, “is this life threatening” and “does this require hospitalization”. If both the answers are no, then we give a sigh of relief and proceed with further examination. This is why, often PCP may appear callus. Once we realize that the condition is not dangerous, then often we acknowledge that most other things can better with time and may seem less interested. This is where naturopaths etc shine as they take these non dangerous complaints and elevate them to great worrisome entities and through hand holding and placebo treatments, guide the patient to wellness.

    • PrimaryCareDoc

      Agreed, 100%. I couldn’t believe it when I saw what he wrote. So arrogant, ignorant, and deluded to think that an internship consists of “observing”. I would like to see a naturopath last for even an hour in the ICU. They would run screaming for the hills.

      • David

        The scary thing is that I would put Adam on the more reasonable side when it comes to the delusional spectrum of naturopaths.

    • http://www.hempista.com/ Hempista

      They get guided to bogus IgG tests for “food and environmental sensitivities.” Then they go on to create “patients” with fake allergies and sensitivities that endanger the lives of REAL IgE and type 1 sensitivity patients that carry epipens.

      Our illness is rare and very few of us die every year from anaphylaxis, so we’re like invisible for the most part. When people hear allergies they think you are full of crap. IgG bs testing creates an even more hostile environment for real food allergy patients in particular. Oh they’re “allergic too.” No they aren’t. sheesh. I want to write a rant about this now. lol.

  • http://www.hempista.com/ Hempista

    Some of this stuff gives me pause because it feels like a bunch of narcissists and psychopaths making this stuff up–and it literally doesn’t matter who it kills. How can your conscience not get to you giving herbs to a stiff kid that is barely breathing instead of calling the ambulance? They want so badly to be right about all of this woo stuff that they’ll sacrifice a baby for it. I’m often skeptical of the FDA (the European version of the FDA is much better than ours, just my opinion) and you know some of that stems from having to deal with a rare disease–but anyways, if you can’t ever be wrong then you aren’t practicing science or medicine you are practicing faith.

    I’ve never seen any Naturopathic school or institution that contributes to the larger body of science or in any scholarly journals. I could be wrong, but I have not seen it in all of the time I have spent on PubMed and elsewhere pursuing scientific plant information. It’s always the evil allopathic doctors or scientific botanists doing the herbal research and publishing it in medical and science journals.

    • Marcel

      Studies by naturopaths on the pharmacology of medicinal plants are relatively rare. To my knowledge, there are no strictly naturopathic journals indexed by PubMed. The last study by naturopaths that I examined (a clinical study conducted at Bastyr) was fraught with flaws. The material used for the study was incorrectly described and neither fully characterized or independently tested; the subjects were not matched for age; and there was no placebo control group.

      • JGC

        There’s also the fact that studies by naturopaths on the pharmacology of medicinal plants don’t offer a unique contribution to our body of knowledge: there’s an entire scientific field (pharmacognosy) dedicated to the systematic identification and characterization of biologically active molecules from natural sources like plants, bacteria and fungi.

        • Marcel

          These days, the pharmacognosenti are often supporters of naturopaths because they are employed by manufacturers of herbal products. Pharmacognosists are largely versed in taxonomy and methods of determining the presence of constituents in natural substances. They may also be involved in the characterization of constituents, but when it comes to establishing biological activity, pharmacologists do the heavy lifting.

        • Marcel

          These days, the pharmacognosenti are often supporters of naturopaths because they are employed by manufacturers of herbal products. Pharmacognosists are largely versed in taxonomy and methods of determining the presence of constituents in natural substances. They may also be involved in the characterization of constituents, but when it comes to establishing biological activity, pharmacologists do the heavy lifting.

  • PrimaryCareDoc

    Testimony confirmed that the baby died of bacterial meningitis, so likely either Hib or strep pneumo.

    Both vaccine preventible.

    • knotfreak

      I’m sure you know this, but to be clear to readers, the child was (not surprisingly) UNvaccinated.

  • David
  • David Grant

    Thanks Britt. This is a very disturbing and troubling story that is in my backyard. I am very disturbed at the acceptance of pseudoscience in our society and the ignorance of the potential dangers. I defend any adult who decides to make these kinds of decisions, but when it comes to children, society has to step in. In the past, courts have ruled against parental rights when it comes to parents who prevent their children from medical care on religious ground and the courts could do the same. I think the Alberta government should block this treatment for children under 18, as per Britt’s recommendation, and hopefully she will provide whatever expertise she can in this matter. By the way, Dr. Tim Caulfield, from the University of Alberta, is true hero as he spoken out against this lunacy. Marketplace and the Fifth Estate have done a lot of journalism exposing the flaws in CAM and I hope that they continue to do so in the future.

  • knotfreak

    I really, REALLY hope your offer gets noticed by someone who matters. That little boy suffered horribly back in 2012, however, and so far, what?

  • David
    • Marcel

      Yes, and it raises the question of why the naturopath would dispense a substance to a patient without first conducting an examination.

  • Ames

    “Naturopathic students do not have the opportunity to practice on
    patients suffering from a wide range of illnesses. Instead, students
    often treat patients who are best described as the “worried well.”
    Naturopaths see patients who are typically healthy or who have minor
    health concerns. I never saw a child presenting with meningitis or even a
    patient with acute chest pain, shock, or lots of bleeding.

    In order to meet graduation requirements, naturopathic students, at
    least at Bastyr University, are allowed to present vignettes of a
    medical case, and describe how to diagnose and treat these fictitious
    patients. This sort of training actually counts as “direct patient care”
    by the schools and by their accrediting agency. I presented cases for
    made-up patients suffering from HIV/AIDS, cancer, cardiovascular
    problems, and infectious diseases. I never had a chance to get any
    meaningful, first-hand training with patients actually suffering from
    these conditions. The ND treating Ezekiel probably didn’t either”

    I am a naturopathic medical student, a third year and my first year in clinic. This paragraph is sadly true. I cannot speak for community clinics, but the clinic on campus does NOT have patients suffering from life-threatening diseases. Therefore, we are not trained on how to treat them naturopathically or to know when to refer to a conventional doctor I AM indeed all for vaccines and medications. I would have referred this child over. That is abuse!). We have a summer clinic requirement, and I had to do it because it’s required for graduation. We only had to do one summer, thank God because it was depressing and I never want to do that again. Next summer, I’ve declined to do it. Also, I am not missing anything because the supervisors are terrible and I would hate to have shifts with them. My classmates were thinking I am doing a disservice to myself because instead of not doing summer clinic, I am going to preceptor in hospitals and have a life and travel, so I can see a wide variety of diseases. I feel sad for them. They are going to be in clinic all summer, not learning a thing, and deteriorating more and more. While I, gain more experience and relax. A lot of the patients in clinic are people that complain about the same problems, over, and OVER again. Most of the time, they are patients that are lonely and have nothing better to do but to come to clinic every week for little problems. We see the same cases (physical medicine, UTI, headache, weightloss, etc) and our treatment plans get us nowhere. Another thing I hate about our clinic education is that, when we have an idea, it would be swept under the rug. By doing that, I am not learning anything and I am not sure if my treatment plans would have work! It’s all about what the supervisor believes and their treatment plans don’t always work. Anyways, Our clinic training is lacking in many areas and it needs to improve. That is why, I love to preceptor. I was able to hear and help out in cases I would have never done if I relied on our clinic shifts.

    • Thomas Mohr

      Ames, “the clinic on campus does NOT have patients suffering from
      life-threatening diseases. Therefore, we are not trained on how to treat
      them naturopathically or to know when to refer to a conventional docto”. Re naturopathic treatement of life threatening diseases, that can be summarized in four words: DO NOT DO IT. Re not trained to recognize when to refer to a real doctor: Exactly this ability is the requirement of a primary physician. PCs are a triage point and the first question a PC has to answer is: Is it life threatening ? If not -> does it require referal to a hospital or a specialist ? However, the problem with naturopathy is that the entire philosophy is severely flawed. Take for instance one fundamental claim: Naturopathy cures causes, convetnional medicine quenches symptoms. (Textbook of Naturopathy, I am sure you know that). Nothing is more wrong. Take f.i. homeopathy. Homeopathy ignores the entire field of differential diagnosis (i.e. differentiating between diseases dispalying the same symptoms). Anal bleeding f.i. can mean a simple wound (a fissure) or colon cancer. Treating colon cancer the same way as an anal fissure is akin to signing a death warrant for the patient.

      • Ames

        Yeah, I don’t have a clue what you are talking about and it has nothing to do on what I am trying to say, haha.There are some things in naturopathic medicine that are correct actually and have been effective. Not all of it is wrong but not all of it is right either. That is every medicine, even in conventional. To say it is only in naturopathic medicine is sheer ignorance. I am saying, when it comes to infectious and life-threatening situations, we are lacking in that when it comes to our treatments because we lack the training. We are a new profession and things need to get better on our end. I think our curriculum and clinic education needs a makeover.

        • Thomas Mohr

          Sorry, it is called the the Textbook of Natural Medicine written by Pizzorno and Murray which I am sure you know. If you read the first chapters, the entire concept is crap and shows that neither Pozzorno nor Murray really know what medicine is or what causal treatment is. They use concepts and arguments that where true two centurie ago. Re your argument about things being wrong in both medicine and naturopathy. Sure, nothing is perfect. However, given the estimated correctness of what you study (homeopathy 0%, herbal medicine maybe 20%, [there are studies about that], nutrional thingies maybe 15% given how much Naturopaths dig into detoxing etc.) the probability that you as ND misdiagonse and mismanage a patient is by far greater compared to a proper MD. This is not restricted to infectious or life threatening diseases. This goes for everything.

          If you scrap naturopathic medicine of ineffective or suboptimal treatments, conventional medicine remains.

          Finally, you are NOT a new profession. Naturopathy is at least 200 years old and if you study the history of naturopathic medicine you will see that many fields have made no progress whatsoever despite a huge leaps forward in our understanding of pathology. What you are learning are treatment modalities dated back to the 19th, 18th and even older centuries baes on the fallacy of an argumentum ad traditionem. This is akin going to the dentist and he uses this instrument (dated from 1870)

          http://www.unfassbar.es/wp-content/uploads/2014/09/uhrwerkbohrer.jpg

        • Thomas Mohr

          Sorry, it is called the the Textbook of Natural Medicine written by Pizzorno and Murray which I am sure you know. If you read the first chapters, the entire concept is crap and shows that neither Pozzorno nor Murray really know what medicine is or what causal treatment is. They use concepts and arguments that where true two centurie ago. Re your argument about things being wrong in both medicine and naturopathy. Sure, nothing is perfect. However, given the estimated correctness of what you study (homeopathy 0%, herbal medicine maybe 20%, [there are studies about that], nutrional thingies maybe 15% given how much Naturopaths dig into detoxing etc.) the probability that you as ND misdiagonse and mismanage a patient is by far greater compared to a proper MD. This is not restricted to infectious or life threatening diseases. This goes for everything.

          If you scrap naturopathic medicine of ineffective or suboptimal treatments, conventional medicine remains.

          Finally, you are NOT a new profession. Naturopathy is at least 200 years old and if you study the history of naturopathic medicine you will see that many fields have made no progress whatsoever despite a huge leaps forward in our understanding of pathology. What you are learning are treatment modalities dated back to the 19th, 18th and even older centuries baes on the fallacy of an argumentum ad traditionem. This is akin going to the dentist and he uses this instrument (dated from 1870)

          http://www.unfassbar.es/wp-content/uploads/2014/09/uhrwerkbohrer.jpg

  • Ames

    “For some context, I completed one of the few “naturopathic
    residencies” in the United States, and I can honestly say that this
    training was inadequate to become a pediatrician. You’d be surprised to
    learn that there is a self-anointed naturopathic pediatrics board certification”.

    Naturopathic residencies, are a joke. One-year of training, fresh out of naturopathic medical school is highly competent to treat everything? Especially when it comes to pharmaceutical rights. Don’t get me started! You think, one-year of additional training in pharmaceutical drugs, puts you at the same level as an MD who has completes 4+ years of residency, seen life-threatening cases, and trained extensively and constantly treating pharmaceuticals on patients?

  • Sycamore

    Large decreases in morbidity and MORTALITY from modern mainline treatment with menningitis. Thanks Britt for posting another wake-up call that I fear the “naturopath” world will brush off and continue with their anti-vaccine tirade.

  • David

    I thought this was a well written article about Ezekiel and the general danger of licensing and increasing the scope of practice of naturopaths.
    http://news.nationalpost.com/full-comment/alheli-picazo-when-naturopathy-kills