Death following intentional ingestion of e-liquid

Introduction:
This text discusses a case report of a death resulting from intentional ingestion of concentrated liquid nicotine intended for e-cigarette use. The reader will learn about the potential toxicity associated with e-liquid and the importance of regulatory measures to ensure public safety.

Key Points:

* The case report describes a 24-year-old woman who intentionally ingested up to 3000 mg of liquid nicotine intended for e-cigarette use.
* The patient's toxicologic testing revealed plasma nicotine and cotinine levels each > 1000 ng/mL, consistent with severe nicotine toxicity.
* The patient died due to multiple acute infarcts consistent with severe anoxic brain injury.
* E-liquid exposure cases have been increasing in the United States, resulting in moderate or severe outcomes and even deaths.
* The US Food and Drug Administration (FDA) has proposed authoritative oversight of e-cigarette and e-liquid sales, which would require product approval, addition of warning labels, and packaging requirements.
* Emergency providers and poison control centers should anticipate a continued increase in cases of e-liquid exposures and poisonings.
* Published fatalities from e-liquid poisoning are exceedingly rare, but the potential for lethal overdose is a concern due to its wide availability and increasing popularity.

Main Message:
The text highlights the potential toxicity associated with e-liquid and emphasizes the importance of regulatory measures to ensure public safety. As e-cigarette use and e-liquid exposure cases continue to increase, it is essential to monitor and regulate e-cigarette and e-liquid sales to prevent nicotine poisoning and fatalities. The FDA's proposed oversight of e-cigarette and e-liquid sales would be a crucial step in ensuring the safety and well-being of the public.

Chen, Betty C., Steven B. Bright, Amit Raj Trivedi, and Matthew Valento. “Death Following Intentional Ingestion of E-Liquid.” Clinical Toxicology 53, no. 9 (October 21, 2015): 914–16. https://doi.org/10.3109/15563650.2015.1090579.