Guess what? It was the MDMA that killed her.

I am grateful to occasional reader and commenter Klem for putting me on the track of an older story. Klem was trying to argue that the authorities in Canada have long been issuing warning about non-MDMA content of “Ecstasy” and about the methamphetamine in particular. This is not news to me, of course. I am not unaware of the problem of non-MDMA psychoactive content of putative “Ecstasy” obtained on the illicit market. What I attempt to address, of course, is the seeming default assumption in the news reporting and subsequent reader comments that every case of Ecstasy fatality must have been caused by something (anything) other than 3,4-methylenedioxymethamphetamine.
Klem cites some 2005 reporting out of Vancouver and I was struck by this comment in the story.

A 13-year-old girl died in September when she took what she and friends believed was ecstasy they bought from a street dealer in Victoria.
Richard Stanwick, chief medical health officer for Vancouver Island, said an amphetamine overdose was suspected in Mercedes-Rae Clarke’s death.

The tone is typical bait that is found irresistible by YHN. Statements that are more or less true in isolation adding up to a synthetic conclusion on the part of the reader that is just not justified at all. In my view, this type of report gives the reader the overwhelming impression that that bad scary drug they know as “Crystal Meth” (c’mon if it is in the common ecstasy preparation of a tablet or hydrochloride powder it is most assuredly not crystal) and not the totes safe and benign MDMA is at fault here.
Reporting on another incident a year later mentioned this case, again in the context of conveying the notion that methamphetamine in supposed “Ecstasy” was really at the root of medical emergency and death. Going to the Google, I find quite a number of followup re-postings of this essential story, including on what look to me like user forums. [You know, Duwayne, alleged harm reduction forums? Just sayin’..] Most of which follow this common thread of assuming or insinuating that if someone takes purported Ecstasy and goes into some sort of crisis it must be something other than MDMA.
As you know by now Dear Reader, I like to counter this impression.
The strongest way to do so is to point to available epidemiological evidence. Also, sometimes the Case Reports go out of their way to emphasize that all that was found was MDMA. Unfortunately this is far from universal. Some of the older Case Reports fail to cover much about the drug in question and, especially, fail to emphasize that they went looking for a host of other suspect compounds in addition to MDMA, if they even bothered to do so.
I like to point out, however, that in some of the deaths reported in the mainstream media, there will be followup stories confirming MDMA as the cause once the toxicity reporting comes out. Remember this story out of Edmonton? Well that area had another Ecstasy-related death last month and the story mentions the prior case without any inclusion of postmortem toxicity data which are surely available by now! Very regrettable that.
At any rate, the case of Mercedes-Rae Clarke from 2005 does have a followup which I found here.

She was with two girlfriends; one had tried ecstasy before and said it was fun. That girlfriend had bought three pills for about $10 each from a guy on the street in downtown Victoria.
When the three girls swallowed the little pink pills, Mercedes began almost immediately to vomit. Soon she complained of a terrible headache and that she couldn’t see. Then her eyes rolled back into her head, and her body contorted in a seizure. One of the girls ran to the nearby house of a family friend to get help.
When [Mercedes’ mother] arrived at the hospital about 90 minutes later, her child was unconscious, medical staff working around her. Mercedes never woke up again. Over the next 24 hours, she continued to have seizures, her blood pressure skyrocketed, her temperature soared, she had multiple heart attacks and resuscitations. She was placed on life-support on Sunday night. Everyone prayed a miracle would save her.
By late Monday night, Mercedes’s brain scan showed no activity: The tiny pink pill had rendered her brain-dead.

Not atypical. The Case Reports often contain seizure or seizure-like symptoms as the first thing noticed and the trigger for someone calling emergency medical services in. This seems to be a universal for when toddlers are found to have accidentally ingested their parents’ stash, btw. This story on Clarke is datelined in Sep 2006 so all subsequent news reporting which mentions this case should have considered the following. Right?

[Mercedes’s mother] says the coroner’s office told her a few weeks later that the drug was pure ecstasy–not laced with crystal meth, as rumour had it. Sherry also wants the world to know: “Ecstasy is seen as the fun drug, the one to take to a party and have a good time with, not nearly as bad as crystal meth. But ecstasy can kill, too.”

Yes, yes it can.