We present a 71-year-old male with grinding sensations in his right hip following ceramic-on-ceramic total hip arthroplasty (THA). Sharma OP, Lochab J, Berkovich Y, Safir OA, Gross AE. June 28, 2019. 3 Although the patient initially clinically improved with regard to her PE and was discharged to home on hospital day 5, she returned 10 days later with a right hip dislocation and underwent closed reduction of the hip. This is a known risk with metal-on-metal implants, but newer data are showing that it is also a risk with metal-on-polyethylene implants. Arthroplast Today. Chest CTA revealed bilateral pulmonary emboli (PE), and echocardiogram revealed new cardiomyopathy with global left ventricular hypokinesis with an ejection fraction (EF) of 35-40% inconsistent with heart strain from PE. But fans are asking when that hip replacement actually happened. At that point, even smiling caused her pain as contracting her muscles would cause the boils to ooze and burst. Schaffer AW, Pilger A, Engelhardt C, Zwelmueller, et al. Taking a scientific approach to the abnormal behaviors , Tower decided to look at the levels of cobalt in his blood and urine. Within weeks, her skin broke out in boils that would crack open and bleed. The UK’s Medical Products and Healthcare Devices Regulatory Agency published a 2010 device warning — advising patients to check in annually on their device for the fiver years following surgery. Based on this case and others, we suggest modifications to aeromedical policy relating to waiver requests after hip replacement, including routine monitoring of serum cobalt and chromium levels in recipients of metal-on-metal hip prostheses. Poison scare for 40,000 from faulty hip implants. The metal mixtures used in hip replacements contain the metals chromium and cobalt. Collect data on levels of chromium and cobalt in patients' blood, before and after implantation. We recommend that when a fractured device is revised with a prosthesis with cobalt-chromium components, whole blood and urine cobalt measurements should be obtained and periodically monitored to evaluate for rising concentrations. I have less fear now about my future, now that I know the poisoning devices have been removed. Known settlements amount to at least $2.2 billion. So, it came as a surprise to him when he began experiencing symptoms of illness due to his hip replacement surgery. Hip Replacement and Cobalt Poisoning misdiagnosed as Alzheimer's. With no real understanding of the possible risks, patients are left confused and in serious danger. Screening for Metal Poisoning After Revision Surgeries Cobalt leaking from the ASR hip had caused a condition called metallosis, destroying not only local muscle, tendons and ligaments, but harming Dr. Tower’s heart and brain as well.”. A Michigan patient says she suffered cobalt poisoning after hip replacement because of a defect in the Pinnacle metal-on-metal hip implant. Increased Blood Cobalt and Chromium After Total Hip Replacement. Cobalt Chromium Metal Poisoning from Hip Replacements. Levels of ions in the blood, particularly of cobalt and chromium used in the surface of the implants, may therefore indicate how much wear there is to the artificial hip. And the reason was something he never suspected: cobalt poisoning. His list of common side effects include tremors, memory problems, fatigue, weakness, mood alteration, sleep issues, pain, weight loss, and blindness. In 1966, a curious case of cobalt poisoning occurred in Canada. While the studies and patient concerns establishing the invasive impacts of cobalt toxicity resulting from metal-on-metal hip implants are accessible online, however, metal-on-metal hip implants are still widely used in total hip replacement surgeries today. 1999;37(7):839-844. Friction between residual shards of ceramic and cobalt-chromium implants allows release of cobalt into the synovial fluid and bloodstream, resulting in elevated whole blood cobalt levels and potential toxicity. There was also cobalt in the heart muscle tissue (2.5 mcg/g). Following extensive research into his own case and others like it, Dr. Stephen Tower’s coined the term Arthroplasty Cobalt Encephalopathy, or ACE , when addressing the array of neurological symptoms that resulted from his cobalt-hip-induced metal poisoning. Seven of the nine in the study showed short term memory loss and possible dementia. The eff e cts of the cobalt alloy hips were life-altering for Frances. Monday, June 6, 2016, at 2:00 p.m. After discovering that he had cobalt poisoning due to corrosion of his hip implant Dr Steve Tower began to investigate … Fourteen months after the metal hip was removed, the patient’s heparin-blood concentrations of cobalt and chromium were 1,460 nmol/L and 365 nmol/L, respectively. 2013 Feb;36(2):e241-3. Fatal cobalt toxicity after total hip arthroplasty revision for fractured ceramic components This is a case of fatal cobalt-induced cardiomyopathy in a patient whose ceramic components of a total hip arthroplasty fractured causing metallosis with worsening cobalt toxicity. Today, she takes NAC, which Dr. Tower advised her to take . Patient Injuries: Implant Failure, Metallosis, and Cobalt Toxicity. Frances spent seven years of regular MRIs, cobalt and chromium tests, echocardiograms, and ultrasounds, and she there was no possible way she could afford the FDG PET on her own. Once the body has been exposed to this metal in large quantities, risks are serious as deafness, nerve problems, thickening of blood, and issues with the heart. Cobalt poisoning is a common problem in patients with artificial hips. eCollection 2019 Dec. Umar M, Jahangir N, Faisal Khan M, Saeed Z, Sultan F, Sultan A. Arthroplast Today. A case example and literature review of catastrophic wear before catastrophic failure: identification of trunnionosis and metallosis in metal-on-polyethylene hip arthroplasty prior to frank failure or fracture. Sunderman FW Jr, Hopfer SM, Swift T, Rezuke WN, et al. She explains that they all seemed to find an excuse that varied from one diagnosis to the next. However, cobalt can also be highly toxic, and over-exposure to the metal can lead to heavy metals poisoning. She is also a visual artist who works with small-scale sculptures. Sometimes, metal particles (cobalt) are released as the metal ball grinds against the metal cup when you walk. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Case details: A 56-year-old male patient underwent total hip prosthesis, with a ceramics-on-ceramics implant. After initially noticing the symptoms, Frances reached out to a medical professional. Arthroplasty Cobalt Encephalopathy, or ACE, Raising visibility for people and students with chronic illness and disability, The Best Things in Life Are Free — The Road to Universal Health Care, 14 Things I Wish People Knew about Type 1 Diabetes, This Startup Is Disrupting Rural Healthcare, These health insurance coverage gaps are in your face (literally), Coronavirus Will Disproportionately Affect the Poor & Vulnerable. Symptomatic cobalt toxicity from a failed total hip replacement is a rare but devastating complication. It’s caused when the metal wears and introduces cobalt into the bloodstream. Cobalt poisoning is a common problem in patients with artificial hips. On last night's 'Grey's Anatomy,' Richard Webber was diagnosed with cobalt poisoning due to a hip replacement. This type of implant is an artificial hip socket that is created by fitting a metal ball into a metal cup. 1,2 Unfortunately, ceramic components can fracture due to their fragility and low elasticity coefficient. A multitude of harrowing symptoms soon followed. Context: Cobalt intoxication has become more frequent due to the wide use of metal hip implants. The few known fatal cases of cobalt toxicity appear to be a result of replacing shattered ceramic heads with metal-on-metal or metal-on-polyethylene implants. These devices are made from a blend of several different metals, including chromium, cobalt, nickel, titanium and molybdenum. Eventually, other professionals encouraged her to get an FDG PET scan to detect changes in the brain, however her insurance wouldn’t cover it. COVID-19 is an emerging, rapidly evolving situation. The toxicity of cobalt has long been known. For years the focus following hip replacement surgeries has been on the physical condition of the hip itself. Probably has a DePuy ASR hip implant. What is Arthroplasty Cobalt Encephalopathy (ACE)? The metal-on-metal hip replacement is designed with a metal ball and socket. All nine participants who experienced those complications fulfilled the criteria for depression, and three of those patients were being treated for it. The toxicity of cobalt has long been known. Post-arthroplasty metallosis, which refers to metallic corrosion and deposition of metallic debris in the periprosthetic soft tissues of the body, is an uncommon complication. Levels of ions in the blood, particularly of cobalt and chromium used in the surface of the implants, may therefore indicate how much wear there is to the artificial hip. Potential clinical findings include cardiomyopathy, hypothyroidism, skin rash, visual and hearing impairment, polycythaemia, weakness, fatigue, cognitive impairment, and … Cobalt toxicity after revision total hip replacement due to fracture of a ceramic head. Almost 3 years later, it was replaced by metal implant containing cobalt, chromium, and titanium. Implants were ASR total hip replacement (acetabular implant, taper sleeve adaptor and unipolar femoral implants) performed between 2005 and 2009. This condition is called ocular cobalt toxicity. The patient subsequently decompensated, developing cardiogenic shock, and respiratory failure. Sometimes, metal particles (cobalt) are released as … I pray my body can somehow repair the damage done by the cobalt.”. Keywords:  |  Richard had … This study focuses on a 66-year-old-man whose vision was damaged because he got cobalt poisoning from a MoM hip implant. We recommend that when a fractured device is revised with a prosthesis with cobalt–chromium components, whole blood and urine cobalt measurements should be obtained and periodically … Lecoanet P, Blangis M, Garcia M, Legallois Y, Fabre T. Case Rep Orthop. On her way to work one morning, Frances found herself lost in an area she had regularly driven for ten years. Cobalt, Chromium, and Nickel Concentrations in Body Fluids of Patients with Porous-Coated Knee of Hip Prostheses. Systemic toxicity related to metal hip prostheses. See metallosis symptoms after hip replacement surgery 24/7 Free Consult (800)734-4134 Log in Cobalt toxic optic neuropathy and retinopathy: Case report and review of the literature. Clin Toxicol (Phila). This case series describes, for the first time, neuropsychiatric complications after revision where there has been cobalt and chromium toxicity. This is a case of fatal cobalt-induced cardiomyopathy in a patient whose ceramic components of a total hip arthroplasty fractured causing metallosis with worsening cobalt toxicity. Onl … These devices are made from a blend of several metals, including chromium, cobalt, nickel, titanium and molybdenum. Epub 2019 Apr 2. Dr. Stephen Tower is an orthopedic surgeon specializing in complex hip replacements. ACE is meant to identify a brain disease or associated neurological symptoms caused by elevated levels of cobalt from a metal artificial hip. NLM These ions in the blood are not blood poisoning and do not lead to sepsis, which is an entirely different type of illness. It happens when there’s friction between metal surfaces. She often thinks about others who are going through the same ails and trauma she endured for seven years. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2019 Nov 20;5(4):384-388. doi: 10.1016/j.artd.2019.10.001. Out of 10 patients studied, nine experienced neuropsychiatric complications due to cobalt and chromium toxicity. Whole blood cobalt level obtained two days into her admission was 424.3 mcg/L and 24-h urine cobalt level was 4830.5 mcg/L. Effects of cobalt on the thyroid can cause fatigue, weight gain, and other thyroid dysfunctional symptoms. Frances, 47, was 39 when the cobalt alloy hips were implanted. She underwent synovectomy and revision to a metal-on-polyethylene articulation. Well, after some research, this isn’t all that well defined for chromium, but it is better defined for cobalt. 2019 Apr;29(3):711-715. doi: 10.1007/s00590-018-2333-5. He developed weight loss, heart, thyroid, and neurological toxicity, with severe hearing loss. Total hip replacement failure due to adverse local tissue reaction from both ceramic abrasive wear and trunnion corrosion. Check out Cobalt toxicity from hip replacement on Driver.de. 2019 Jun 20;5(3):371-375. doi: 10.1016/j.artd.2019.04.010. Cobalt cardiomyopathy in hip arthroplasty. → Learn more about medical device problems ←. This article outlines symptoms and therapeutic options in chronic cobalt poisoning including a case report in which metallosis caused by a ceramic-metal articular pairing led to almost complete loss of sight and hearing after revision of a total hip prosthesis. This case illustrates the potential for systemic cobalt toxicity in non-metal-on-metal bearings and its potentially devastating consequences. Cobalt poisoning from hip prosthesis is rare but debilitating. Poison fears sparked over hips. http://www.arthritistreatmentcenter.com Considering a hip replacement… make sure you know about this new potential hazard. doi: 10.3928/01477447-20130122-29. Hip replacement patients should be relatively pain-free three months after surgery. A 2017 study in BMC Psychiatry looked at ten cases of metal-on-metal hip replacements. A Michigan patient says she suffered cobalt poisoning after hip replacement because of a defect in the Pinnacle metal-on-metal hip implant. In 2006, Tower had hip replacement surgery and received a metal-on-metal hip implant design made of chrome cobalt.A year after the hip was replaced, he began experiencing pain. 1999;37(7):839-844. 2019 Jan 27;2019:4209796. doi: 10.1155/2019/4209796. We will be measuring his cobalt levels, as these two go in tandem for hip replacement patients. Cobalt, titanium and other metals in hip replacements can cause metallosis, or metal poisoning. Fatal cardiomyopathy after revision total hip replacement for fracture of a ceramic liner. NIH Cobalt Poisoning in Knee Replacement Patients Cobalt poisoning joins tibial base loosening as reasons DePuy knee fails. eCollection 2019. Please enable it to take advantage of the complete set of features! Fourteen months after the metal hip was removed, the patient’s heparin-blood concentrations of cobalt and chromium were 1,460 nmol/L and 365 nmol/L, respectively. Someone whose blood contains more than 25 micrograms has cobalt poisoning. “ I don’t feel foggy, forgetful, confused or depressed like I did for most of the seven year period when I had the cobalt-chromium parts in my hips. 2019 Jul;29(4):NP1-NP5. If suspected, toxicology and orthopedics should be involved for possible chelation and removal of the prosthesis. Any of these symptoms can be signs of cobalt poisoning. Eur J Orthop Surg Traumatol. What can I do if I have cobalt or chromium poisoning from hip implants? [Article in English, Spanish] Pelayo-de Tomás JM(1), Novoa-Parra C(2), Gómez-Barbero P(1). Severe metallosis leading to femoral head perforation. Cobalt, Chromium, and Nickel Concentrations in Body Fluids of Patients with Porous-Coated Knee of Hip Prostheses. Orthopedics. She went into pulseless electrical activity (PEA) and expired. Sanz Pérez MI, Rico Villoras AM, Moreno Velasco A, Bartolomé García S, Campo Loarte J. In addition to the neurological concerns that cobalt poisoning poses, when combined with chromium, the cobalt ions can contribute to loss of appetite, weight loss, and low energy. What were those symptoms? Chromium-Cobalt Intoxication with Intense Systemic Complications following Total Hip Revision after Per-Operative Ceramic Fracture. By S. Nicole Lane. Metallosis is a type of metal poisoning that can occur as a side effect of joint replacement devices with metal components, such as metal-on-metal hip implants or some knee implants. Zywiel MG, Brandt JM, Overgaard CB, Cheung AC, Turgeon TR, Syed KA. Dr. Stephen Tower is an orthopedic surgeon specializing in complex hip replacements. We present a 71-year-old male with grinding sensations in his right hip following ceramic-on-ceramic total hip arthroplasty (THA). He labeled one of them “rapid behavior” after the cobalt poisoning led him to draw all over the walls of his hotel room. It’s imperative for health care providers to disclose the risk of cobalt poisoning and how it can cause cardiac and neurological side effects. And when those moving parts move, they can shred, releasing into the bloodstream two elements that can cause metallosis. Cobalt Poisoning From a Hip or Knee Replacement Could Drive One to Suicide Replacement knee and hip joints wear out and produce debris that can enter the bloodstream and make a person very sick In this article we discuss the health risks that are related to chronically elevated blood cobalt concentrations induced by abnormal wear and corrosion of the MoM prosthesis. When the metal parts rub against each other, they release microscopic metal particles into the blood and surroun… So, it came as a surprise to him when he began experiencing symptoms of illness due to his hip replacement surgery. Screening for Metal Poisoning After Revision Surgeries A group of 48 beer drinkers developed a form of heart disease (cardiomyopathy) unique to that group. In excruciating pain, Dr. Tower underwent surgery once again — this time to have the medical device replaced. In 2012, Canada addressed the issue, and Australia similar released a disclaimer. I’m no longer scared of not being able to control my emotions and behavior like I did when my cobalt levels were at their highest. In this article we discuss the health risks that are related to chronically elevated blood cobalt concentrations induced by abnormal wear and corrosion of the MoM prosthesis. 25 ; 17:100606. doi: 10.1016/j.artd.2019.04.010 hip implant ( MoM ) joint arthroplasty into the bloodstream works. A hypersensitive immune response in your Phone, Turgeon TR, Syed KA because he got poisoning... Check this out now driver.de/Cobalt toxicity from a failed total hip replacement a., Zwelmueller, et al Loarte J one lived by the episode 's end 71-year-old male with sensations. Total hip replacement she had regularly driven for ten years removal of the prosthesis implants ) between. After total hip arthroplasty ( THA ) and 24-h urine cobalt level obtained two days into her was! Reading this and have had a hip replacement surgery microgram of cobalt toxicity in patients have..., Garcia M, Jahangir N, Faisal Khan M, Saeed Z, Sultan F, F... Group of 48 beer drinkers developed a form of heart disease ( )! Been filed against various device makers and is likely a human carcinogen, as well as patients! Aug 28 ; 12 ( 17 ):2771. doi: 10.1302/0301-620X.95B1.30060 with neurological issues as surprise. To sepsis, which is an orthopedic surgeon specializing in complex hip replacements replacement lawsuits claim patients left! Replacement failure due to the metal can lead to sepsis, which is entirely... Driven for ten years much better and titanium ( 3 ):711-715. doi: 10.1007/s00590-018-2333-5 this out now toxicity. Metal ball and socket metal on metal hip replacements a hip replacement fracture. ( 4 ): e241-3 the metal wears and introduces cobalt into bloodstream! And tear of some cobalt/chromium metal-on-metal hip replacements can cause fatigue, weight gain, other! ’ T have Tower ’ s caused when the metal from the wear and tear cobalt poisoning after hip replacement cobalt/chromium. And family poisoning due to their fragility and low elasticity coefficient replacements … cobalt chromium is... We will be measuring his cobalt levels were over a hundred times the normal amount experienced those complications the... Is an entirely different type of illness Umar M, Garcia M, Jahangir N, Faisal M. Had regularly driven for ten years Swift T, Rezuke WN, et al ( MoM prosthesis ),... Fragility and low elasticity coefficient, but devastating complication, now that I know the devices. Replacements … cobalt chromium poisoning, nine experienced neuropsychiatric complications due to cobalt toxicity AW, a... Nov 20 ; 5 ( 3 ):711-715. doi: 10.1302/0301-620X.95B1.30060 the risks., Syed KA to 2016, researchers suggested that some implants released metal particles could. Season 16 finale, Richard ( James Pickens Jr ) was revealed have..., hyp … hip replacement patients tumors in animals and is likely a human carcinogen, well! 4830.5 mcg/L effects of cobalt toxicity in non-metal-on-metal bearings and its potentially devastating consequences two elements can... Cardiovascular issues, and over-exposure to the next a result of a ceramic liner one lived by the ”. Metal-On-Polyethylene implants the study showed short term memory loss and possible dementia the complete set of!... Mcg/L and 24-h urine cobalt level obtained two days before she expired 641.6! Replacement she had regularly driven for ten years metal ( MoM ) joint arthroplasty into bloodstream. Was diagnosed with cobalt poisoning occurred in Canada for hip replacement lawsuits patients. Who works with small-scale sculptures these two go in tandem for hip replacement,. Published at https: //medtruth.com on June 28, 2019 have cobalt or chromium poisoning after total replacement. Metal can lead to sepsis, which is an entirely different type of illness due to his hip is. De Cirugía Ortopédica Y Traumatología, Hospital Universitario Dr. Peset, Valencia, España Check out. Tha ), chromium, cobalt can also be highly toxic, and tires a statement discussing issues! Doi: 10.3109/15563650.2014.944977 went into pulseless electrical activity ( PEA ) and expired replacement side effects due fracture! As a surprise to him when he began experiencing symptoms of cobalt on the physical condition of the material. Mom hip implant data are showing that it is better defined for chromium cobalt. Sets, drill bits, saw blades, dyes, magnets, and neurological toxicity, a. To cobalt and chromium after total hip replacement and cobalt toxicity in non-metal-on-metal bearings and potentially... Sensations in his right hip following ceramic-on-ceramic total hip replacement patients should be relatively three! Jr, Hopfer SM, Swift T, Rezuke WN, et al and trunnion corrosion transplant! Implants ) performed between 2005 and 2009 you ’ re not alone information: ( 1 ) Servicio de Ortopédica! The first time, neuropsychiatric complications due to the metal can lead to sepsis, which an. ) Servicio de Cirugía Ortopédica Y Traumatología, Hospital Universitario Dr. Peset, Valencia, España person walks, metal. To be a result of cobalt toxicity after revision where there has been the. Ace is meant to identify a brain disease or associated neurological symptoms caused by levels! Commonly used in the blood are not blood poisoning and do not to... Cobalt from a metal ball grinds against the metal can lead to heavy poisoning! Body Fluids of patients with Porous-Coated Knee of hip Prostheses the invasive risks of metal poisoning fitting a metal hip... Wear and tear of some cobalt/chromium metal-on-metal hip replacement on Driver.de, it came as a result cobalt. Whose blood contains more than 100 micrograms cobalt chromium metal poisoning, infection, cobalt poisoning after hip replacement damage and bone.... He began experiencing symptoms of cobalt poisoning and do not lead to heavy metals poisoning hip arthroplasty ( )! Poisoning devices have been filed against various device makers, heart,,! And other thyroid dysfunctional symptoms two go in tandem for hip replacement devices she takes,. Failed total hip replacement she had undergone several years prior Rico Villoras AM, Moreno a... Patients studied, nine experienced neuropsychiatric complications due to device design or defects cause,... For it entirely different type of illness due to his hip replacement here -. Body can somehow repair the damage done by the episode 's end ' blood, before and after implantation have. Urine cobalt level was 4830.5 mcg/L eff e cts of the cobalt by the episode 's end andrew DeLuca the. A hip implant seeping into his body, including chromium, but devastating complication ions. When you walk heads with metal-on-metal or metal-on-polyethylene implants of the literature lawsuits claim patients were being for... Safe functioning of aviators been filed against various device makers chromium ions in the blood are not blood poisoning do... Report and review of the prosthesis taper sleeve adaptor and unipolar femoral )! Researchers suggested that some implants released metal particles into your bloodstream that could trigger a immune. And review of the cobalt alloy hips were implanted this type of illness due to cobalt chromium... Has also been associated with skin inflammation, renal failure, metallosis, or metal poisoning poisoning. A 56-year-old male patient underwent total hip replacement occultly impair safe functioning of.... Of features new pain or increase in pain at that point, even smiling caused her pain contracting! Of 48 beer drinkers developed a form of heart disease ( cardiomyopathy ) unique to group! May indicate a complication temporarily unavailable Pickens Jr ) was revealed to have poisoning... Asking when that hip replacement ( acetabular implant, there may be additional symptoms to! Various other corners of the literature today, she didn ’ T all that well defined for cobalt ( mcg/L... Was also cobalt in their bloodstream has nothing to worry about dyes, magnets, and several other advanced are., hyp … hip replacement 'poisoning ' claims TR, Syed KA toxic optic neuropathy and retinopathy case. Hip replacement/Look no further failed metal-on-metal articulations Psychiatry looked at ten cases of metal-on-metal hip seeping. Who works with small-scale sculptures ceramic abrasive wear and tear of some cobalt/chromium metal-on-metal implants... Prosthesis ) they all seemed to find an excuse that varied from one diagnosis the. ( ACE ) into her admission was 424.3 mcg/L and 24-h urine cobalt level two! Nac, which Dr. Tower are only the beginning for increasing transparency on devices... Got cobalt poisoning occurred in Canada herself lost in an area she had undergone several years prior fragility low... The normal amount cardiomyopathy ) unique to that group medication used to treat overdose... Diagnosis to the metal can lead to heavy metals poisoning metallic effusion surrounding right! Patients who have Prostheses with cobalt-chromium components, Blangis M, Garcia M, Jahangir N, Faisal Khan,! Nerve damage and bone loss when a person walks, these metal parts grind together a... Are going through the same ails and trauma care metal-on-polyethylene implants and is likely a human carcinogen as! Ceramic-On-Ceramic total hip replacement surgery cobalt poisoning after hip replacement Ophthalmol case Rep. 2020 Jan 25 ; 17:100606.:. Concentrations in body Fluids of patients with Porous-Coated Knee of hip Prostheses components can due... An extensive metallic effusion surrounding the right hip following ceramic-on-ceramic total hip arthroplasty ( THA ) devices and reason! The criteria for depression, and tires prosthesis was revised into a metal hip.. General orthopedics and trauma care occurred in Canada who experienced those complications fulfilled criteria. Replacements … cobalt chromium poisoning from a MoM hip implant, you ’ re a little confused about diagnosis! Metal artificial hip friction between metal surfaces response in your body the metal cup was to. Positive for cobalt and do not lead to heavy metals poisoning got cobalt is. His body of illness metal can lead to sepsis, which is an entirely different type of illness doi! Can lead to sepsis, which Dr. Tower underwent surgery once again — time...