Monster Beverage Corp. is being sued by the parents of a 14-year old girl who died from caffeine toxicity after consuming the company’s energy drink. The Food and Drug Administration is also investigating reports of five deaths in the past year linked to consumption of Monster energy drinks. The rising recreational abuse of energy drinks among teens has led to calls for stricter FDA regulation of caffeine content and package labeling.
Caffeine toxicity and Monster deaths
Emergency room visits involving energy drinks increased to 13,114 in 2009, a ten-fold increase since 2005. About half those visits, made by patients 18 to 25 years old, also involved drugs or alcohol, according to the Substance Abuse and Mental Health Services Administration.
The five deaths were among 37 adverse reactions reported since 2004 implicating Monster energy drinks, according to FDA records. Symptoms in the reports mentioning Monster included heart attack, chest pain and vomiting.
The family of California 14-year-old Anais Fournier filed a lawsuit Oct. 19 accusing Monster of failing to caution about the dangers of abusing the energy drink. The lawsuit said that after drinking two 24-ounce cans of Monster Energy on consecutive days, Fournier went into cardiac arrest. She died a few days later from “cardiac arrhythmia due to caffeine toxicity” that complicated an existing heart disorder.
The spike in life-threatening incidents involving energy drinks suggests recreational abuse of Monster and other similar products is becoming a serious problem. According to the FDA, caffeine in energy drinks can range from 160 to 500 milligrams. Healthy people can handle the caffeine content from a single serving, but if someone, such as Fournier, has an underlying heart condition, it could be lethal.
According to an article published in the Medical Journal of Australia cited in EMax Health, the lethal dose of caffeine is about 150-200 milligrams per kilogram of body mass—or the equivalent of guzzling about 80 to 100 cups of coffee, which is impossible to do. But if a kid looking for a buzz drank five energy drinks, the total caffeine intake could be as high as 2000 milligrams. That may not be enough to kill them, but more than enough to send them to the emergency room.
Monster a dietary supplement?
The FDA considers soft drinks with up to 71 milligrams of caffeine per 12 ounces safe. Monster and other energy drink makers such as Red Bull don’t have to follow FDA guidelines because their products are sold as dietary supplements. Therefore, Monster doesn’t list the amount of caffeine. The label only states that caffeine is present along with the plant extract guarana (which packs an additional dose of caffeine) and the amino acid taurine.
The FDA can challenge the claim that Monster is a dietary supplement. But it’s up to the agency, not Monster, to determine if energy drinks are a significant health risk. According to rules in place, “To restrict the use of a dietary ingredient in a dietary supplement the FDA must demonstrate that the ingredient adulterates the product under the dietary supplement provisions under the FD&C Act; e.g., because the ingredient presents an unreasonable risk of illness or injury under the conditions of use recommended in the labeling of the supplement.”
Hard lessons in caffeine abuse
Based on the rising incidence of caffeine toxicity in emergency rooms, the need to change the label requirements of energy drinks seems obvious. The FDA said plans to consult with energy drink companies in an effort to update regulations.
But given that the majority of consumers in the multi-billion dollar energy drink market are teens–likely destined to learn about the consequences of caffeine abuse the hard way—it’s questionable whether changing the label will make a difference.
To prevent another tragedy like that of Anais Fournier, perhaps it’s the caffeine content, not the label content, that should be addressed.