plaintiffs in lawsuits against Matrixx asserted that Zicam “destroyed delicate smell tissue when the drug’s pump bottles drove the viscous gel into the top of the nose with propulsive force,” but Matrixx countered by stating that the spray is only supposed to be used in the lower part of the nose and does not reach high enough into the nasal passages to inflict the type of damage claimed. (In Fall 2005, Matrixx changed Zicam’s packaging to include a new “control tip sprayer” that prevents the gel from being forcefully expelled from the bottle. The company maintained that the new sprayer had been in the works for several years and that its introduction was unrelated to current litigation against the company.) Matrixx has stated that the anosmia experienced by some Zicam users was likely caused by viruses rather than the product itself.
The strengths of this individualized approach resulted in optimal health care for the patient. In a clinical setting, however, there were limitations, such as the inability to test the expelled material from the skin. Had this material been assessed for its contents, it might have illustrated a possible link to the production of biofilm. In the end, the patient also opted to self-treat by stinging herself with live bees. This was more affordable for the patient and allowed her to administer BVT on a more frequent basis. While this also allowed her to inject venom without procaine (and thus compare it to the use of venom with procaine), it also resulted in less clinical observation. In general, there seemed to be no difference to the patient when she no longer received the procaine, though this may have been offset by the increased frequency of stings. Greater levels of clinical observation might have been helpful in more closely monitoring, evaluating, and categorizing her improvements. The improvement experienced by the patient suggests that this treatment could be useful; however, it should be evaluated in larger-scale studies in a more controlled setting.