A teenager in the US died because he consumed too many high-caffeine drinks in a short space of time, a coroner has said.
Davis Allen Cripe died last month, about an hour after collapsing in his high school near Columbia, South Carolina. The 16-year-old had consumed a latte from McDonald’s, a large Mountain Dew drink and a highly caffeinated energy drink in just under two hours, Richland county coroner Gary Watts said.
Doctors said Davis died from a “caffeine-induced cardiac event causing a probable arrhythmia”, according to Watts.
He added that the teenager was considered healthy and the autopsy showed no sign of an existing undiagnosed heart condition.
“This is not a caffeine overdose,” said Watts. “We’re not saying that it was the total amount of caffeine in the system, it was just the way that it was ingested over that short period of time.”
Davis weighed about 90kg but would not have been considered morbidly obese, according to Watts, who added that he would have been unharmed by the same amount of caffeine on another day.
“We’re not trying to speak out totally against caffeine,” said Watts. “We believe people need to pay attention to their caffeine intake and how they do it, just as they do with alcohol or cigarettes.”
The particular energy drink Davis drank was not known but a witness said it was from a container the size of a large soft drink.
According to caffeineinformer.com, a McDonald’s latte has 142 milligrams of caffeine, a 20-ounce Mountain Dew has 90mg, and a 16-ounce energy drink can have as much as 240mg.
The US Food and Drug Administration and European Food Safety Authority (EFSA) both say that caffeine consumption of up to 400mg a day – about four or five coffees – is believed to be safe for adults. The EFSA says 200mg a day is safe for women who are pregnant or breastfeeding and that single doses of up to 200mg do not give rise to safety concerns. The American Academy of Pediatrics discourages the consumption of caffeine and other stimulants by children and teenagers.
Caffeine has been linked to previous deaths, although the cases are few and far between and the link not always clear-cut. In 2011, 14-year-old US schoolgirl Anais Fournier, who had a pre-existing heart condition, died after drinking two cans of Monster energy drink, containing a total of 480mg of caffeine. The company denied any responsibility.
In 2015, two students at Northumbria University, were were left fighting for their lives after they were accidentally given the equivalent of 300 cups of coffee in a botched experiment. They eventually made a full physical recovery.
Tony Heagerty, professor of medicine at Manchester University, said it was likely that Davis had a genetic heart condition, which may not have revealed itself in the autopsy, and that the caffeine put stress on his heart.
“I think the caffeine must have interacted with something wrong with this heart,” he said. “If you are an unfortunate person with a pre-existing condition and put yourself in a stressful situation by drinking too much caffeine you are in danger.”
But he said the levels consumed by Davis would not be harmful to the overwhelming majority of people, except for making them feel strange.
Mike Knapton, associate medical director at the British Heart Foundation, said: “It is well known that caffeine increases a person’s heart rate but it can also trigger more serious effects, including heart palpitations, in those who are more sensitive to caffeine.
“People with cardiac abnormalities, including inherited heart conditions, and those who drink toxic amounts of caffeine are more susceptible to the side-effects of caffeine. Tragic accidents like this are rare but, with increasingly strong coffees and caffeinated drinks on the market, moderation is key to monitoring your caffeine intake.”
The World Health Organisation recognises caffeine use disorder and caffeine dependence as illnesses.
Drinking large amounts of coffee can lead to unpleasant side-effects such as irritability, problems sleeping, restlessness, according to the NHS.
It can also result in babies having a low birth weight, which can increase the risk of health problems in later life, or miscarriage.
Caffeine constricts the coronary arteries, leading to a temporary rise in blood pressure. If drunk in sufficient quantities it causes calcium to be discharged from inside cells and causes the heart to beat faster. In the most extreme cases – caffeine toxicity – it causes major organs to shut down.
Symptoms of a caffeine overdose include dizziness, nausea, vomiting, convulsions and a high heart rate.