The parents of 21-year-old college student Sarah Katz, who had severe arrhythmia, are suing a US company after alleging its lemonade played a role in her death.
Katz had long QT syndrome type 1, diagnosed when she was five-years-old, so she avoided energy drinks, the complaint stated.
However, she had consumed a Panera Bread’s Charged Lemonade, a large cup of which contains more caffeine than cans of Red Bull and Monster energy drinks combined, according to the lawsuit.
The Charged Lemonade was “offered side-by-side with all of Panera’s non-caffeinated and/or less caffeinated drinks” and was advertised as a “plant-based and clean” beverage that contained as much caffeine as the restaurant’s dark roast coffee, according to photos of both the menu and beverage dispensers in the store, which were included in the wrongful death lawsuit.
It also has guarana extract, another stimulant, as well as the equivalent of nearly 30 teaspoons of sugar.
Katz went into cardiac arrest hours after drinking it.
The legal complaint in the Philadelphia Court calls the beverage a “dangerous energy drink” and argues that Panera failed to appropriately warn consumers about its ingredients, reports MedPage Today.
The American Heart Association describes long QT as a disorder of the heart’s electrical system that can cause abnormal heart rhythms as a result of exercise or stress; it can be well-managed with medication.
About one in 2 000 people have congenital long QT syndrome, with some showing no symptoms and others fainting or experiencing heart palpitations in response to triggers such as exercise or being startled, said Dr Charles Berul, an electrophysiologist at Children’s National Hospital in Washington, who is on the board of trustees of the Sudden Arrhythmia Death Syndromes Foundation, an advocacy organisation for those with heart rhythm abnormalities.
“It’s fine to have a Coke or a small coffee each day. But some studies have shown that energy drinks – that have caffeine plus other ingredients like taurine, other things – might be a little riskier,” he told NBC News.
‘Not recommended’
The drink Katz consumed had up to 390mg of caffeine in around 890ml, along with other stimulants and the huge amounts of sugar – but lawyers aid Panera didn’t properly disclose its caffeine content and it wasn’t advertised as an energy drink.
Panera has since issued a warning that the drink should be used in moderation and isn’t recommended for “children, people sensitive to caffeine, (or) pregnant or nursing women”.
Dr Guy Mintz, of Northwell Health Sandra Atlas Bass Heart Hospital in New York, told MedPage Today that individuals with long QT are strongly advised to limit caffeine intake.
“The recommendations are either avoiding it or extreme caution in patients and young people with long QT syndrome,” he said.
Studies of energy drink consumption among patients with long QT syndrome have showed a “significant increase in blood pressure, both the systolic and the diastolic numbers, and these correlated with the amount of caffeine that was in the blood”, he added.
Mintz noted that caffeine can increase blood pressure and heart rate, and can cause palpitations. It can also lead to dehydration, and has vasoconstricting properties that can actually lead to reduced blood flow.
“For instance, if you have underlying heart disease and you drink a lot of caffeine, and then decide to exercise, like take a walk, you actually may decrease the blood flow within the heart.”
All of these factors can put more stress on the heart, which can be especially problematic for those with arrhythmias and other heart conditions.
Mintz suggested people with long QT syndrome moderate caffeine intake. Some medications – including antibiotics, antipsychotics, and antifungals – can also prolong the QT interval; adding caffeine to that mix can increase risks, he said.
The FDA considers 400mg per day – or about four to five cups of coffee – to be a safe amount of caffeine for the average person. Toxic effects such as seizures are possible with consumption of around 1 200mg in a short period of time, the agency said.
“People can consume 200 to 300 milligrams of caffeine a day and be perfectly fine,” Mintz added.
“But energy drinks can raise blood pressure based on caffeine content: they can cause volume decrease, and extra heartbeats, and people with underlying heart disease – and bear in mind some patients may not know they have underlying heart disease – should be cautious in consuming large quantities of caffeine.”
MedPage Today article – How Dangerous Is Caffeine for People With Severe Arrhythmias? (Open access)
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