Fatal Intravenous Injection of Electronic Nicotine Delivery System Refilling Solution

Introduction:
This text presents a case report of a fatality associated with the intentional intravenous injection of electronic nicotine delivery system (ENDS) refilling solution, also known as "eLiquid." The reader will learn about the potential dangers of eLiquid, its composition, and the symptoms and clinical course of the individual who injected it.

Key Points:

* The popularity of ENDS and eLiquid is increasing, and some eLiquid solutions contain potentially fatal amounts of nicotine.
* The individual in this case report was a 29-year-old man who injected eLiquid intravenously as a suicide attempt.
* He had a history of depression and was a smoker who had been attempting to quit by using ENDS.
* The individual experienced multiple symptoms, including seizures, cardiac arrest, and hypoxic encephalopathy.
* Blood tests showed elevated levels of nicotine and cotinine, and a urine drug immunoassay was positive for amphetamines, although none were detected in comprehensive serum drug testing.
* The actual product that was injected was not available for testing.
* The individual's blood nicotine level was 2,000 ng/mL, which is consistent with prior reports of death from intentional nicotine exposures.

Main Message:
This case report highlights the potential dangers of eLiquid, particularly if it contains high levels of nicotine. As the use of ENDS and eLiquid continues to grow, it is crucial to raise awareness of the potential hazards and take measures to prevent accidental or intentional exposure. It is also essential to ensure that eLiquid products are appropriately labeled and regulated to minimize the risk of harm. This case underscores the need for further research into the safety and toxicity of eLiquid and the importance of regulatory oversight to protect public health.

Thornton, Stephen L., Lisa Oller, and Tama Sawyer. “Fatal Intravenous Injection of Electronic Nicotine Delivery System Refilling Solution.” Journal of Medical Toxicology 10, no. 2 (June 2014): 202–4. https://doi.org/10.1007/s13181-014-0380-9.