Monster Energy Has a Monster Problem With Adverse Events

There’s been a lot of news lately about energy drinks, and none of it’s good. We recently wrote about how little is known about their contents, and their link to heart disease and high blood pressure.

Now, as reported in the New York Times, five people died in the last three years after drinking Monster Energy. And the parent of a 14-year-old Maryland girl has sued Monster Beverage, its manufacturer, for failing to warn consumers about its risks after her daughter died of heart arrhythmia.

The FDA released an incident report (which doesn’t prove Monster Energy caused the deaths or any other health issues) about the high-caffeine beverage, which was obtained by Wendy Crossland, the teenager’s mother. The girl had drunk large cans of Monster Energy on two consecutive days. In addition to the five deaths, the FDA has received a report of a nonfatal heart attack possibly associated with the drink.

Other incident reports, according to The Times, included other adverse events including abdominal pain, vomiting, tremors and abnormal heart rate. The reports covered the period from 2004 to June 2012; all the deaths occurred in 2009 or later. According to Bloomberg News, there were 37 adverse reaction reports since 2004 that mentioned Monster drinks.

The reports are not exhaustive-they aren’t clear for example, if the incidents involved other factors, such as alcohol or drugs. The reports are voluntary, so generally the number the FDA receives about any product it regulates represents only a fraction of all incidents.

Monster Energy is only one representative of the energy-blast product niche. Others include Red Bull, Rock Star and 5-hour Energy. Monster Energy has several derivative drinks-Monster Rehab, Monster Assault and Monster Heavy Metal. As their names indicate, the target market is teenagers and young adults. An FDA statement said manufacturers were responsible for investigating reports of death or injuries associated with their products, and that the agency had not established a causal link between the deaths and the beverage.

Still, the report raises concern about how well manufacturers monitor their products for safety and whether the feds exercise oversight of them. Product labels indicate that they’re “not recommended” for children under 12 and people “sensitive” to caffeine. The stimulant can pose risks for people with heart disorders, so there’s a lot of real estate between not being recommended and being deadly.

Manufacturers are not obliged to disclose caffeine content, and it is they who decide whether to call them drinks or dietary supplements. The latter are not subject to FDA oversight for ingredients and labeling.

Anais Fournier, the Marylander teen who died, drank 24-ounce cans of Monster Energy that each contained 240 milligrams of caffeine. An 8-ounce cup of brewed, generic coffee has about 133 mg of caffeine, according to the Center for Science in the Public Interest.

The lawsuit filed on her behalf, The Times reported, quoted autopsy and medical examiner reports that she had died of “cardiac arrhythmia due to caffeine toxicity” that had exacerbated an existing heart problem. Fournier apparently had Ehlers-Danlos syndrome, which can affect blood vessels. She and her family were aware of her underlying heart condition but apparently her doctors had not told her to restrict her physical activities or her caffeine use.

In April, Sen. Richard J. Durbin invoked Fournier’s death in a letter urging the FDA to enforce caffeine levels in energy drinks. In August, agency officials said that there was insufficient evidence to take action on caffeine levels in energy drinks, noting, however, that it had not received medical reports related to Fournier’s death. According to Bloomberg News, emergency room visits involving energy drinks increased tenfold from 2005 through 2009. About half of them, according to Bloomberg, were patients 18 to 25 years old and some involved drugs or alcohol,

If you want Congress to impose stricter ingredient and labeling practices on the energy drink industry, contact your representative. You can find out who and where they are by linking here. To report a problem with a food, drug or dietary supplement, contact the FDA’s MedWatch program.

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