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					Caffeine toxicity from energy drinks
cited in Anais Fournier's death
Teen's family wants regulation of energy drinks

By Denise Bonura
The Record Herald
Posted Jan 26, 2012 @ 12:10 PM
Last update Jan 27, 2012 @ 11:07 AM

Editor's note — A previous version of this article said Anais' friends dared
each other to see who could drink the most energy drinks. Anais' friends
have since told her mother Anais had one 24-ounce Monster energy drink
on Dec. 16, and another one less than 24 hours later before she went into cardiac arrest.

Fourteen-year-old Anais Fournier was drinking energy drinks at the mall with her friends on Dec. 16. Six days
later, the South Hagerstown High School student was pronounced brain dead. Her death certificate lists the cause
as a heart arrhythmia due to caffeine toxicity. Anais drank two Monster energy drinks in less than 24 hours.

She went into cardiac arrest inside of her Hagerstown home on Dec. 17, according to her mother, Wendy
Crossland of Hagerstown. “She was at the mall with her friends the night before, and had a 24-ounce energy
drink,” Crossland said. “She drank another one less than 24 hours later, even though she knew I do not allow them
because I know they are bad for you. She went into cardiac arrest three hours later at home. I just want people to
know these drinks are considered dietary supplements and are not regulated by the FDA. These drinks are
dangerous, especially for teenagers.”

She was flown to Baltimore’s Johns Hopkins Hospital from Meritus Medical Center where doctors induced a
coma to keep her brain from swelling. Tests showed a complete lack of oxygen to Anais’ brain and she never
regained consciousness. She was pronounced brain dead on Dec. 22. Her family said they donated her organs
because of her love of all people and because Anais felt organ donation should be required of everyone. A letter
from the Maryland Eye Bank said two blind patients had their sight restored thanks to Anais.

Crossland, her family and Anais’ friends are pushing to have energy drinks regulated by the U.S. Food and Drug
Administration. The drinks are considered dietary supplements and do not fall under the FDA’s guidelines for
caffeine limits. Reports published in medical journals, such as Pediatrics, indicate the drinks are very dangerous,
especially for children and teenagers and people with underlying heart problems. Crossland said doctors could
find no underlying health problem that caused Anais’ arrhythmia — a problem with the rate or rhythm of the
heartbeat.

Energy drinks are a multi-billion-dollar industry that continues to grow. They are generally marketed to younger
audiences, but the companies say the labels on the cans warn the products are not recommended for children,
pregnant or nursing women or those sensitive to caffeine. Some say they are not suitable for are not suitable for
consumers under age18.

According to kidshealth.org, the ingredients in the drinks are said to “do” something extra like increase energy
and alertness, boost nutrition or even enhance performance in young athletes.

Doctors continue to urge parents not to let their children and teens drink them because of the potential harmful
effects like high blood pressure, seizures and sometimes death.

Anais’ boyfriend, 18-year-old Ethan Frusher of Westminster, Md., said he has sworn off energy drinks, and has
urged his friends to do the same. “I despise that they aren’t regulated by the FDA,” he said. “They can put
anything in them (the drinks). What really sickens me is that they get away with it. Since there have been multiple
deaths linked to them, there should be age restrictions on them.”

Crossland is circulating a petition to push for the regulation of the drinks.
Caffeine levels
Energy drinks contain high levels of caffeine and ingredients like guarana seed extract and Taurine, both herbs
that contain caffeine.

The following appeared in a Jan. 31, 2011, New York Times article: Studies done on energy drinks show that the
common ingredients — such as sugar, sodium and caffeine — are dangerous when taken in high dosages for
diabetics and for people with high or low blood sugar. Even an average person consuming an energy drink that’s
extremely high in sugar can feel like they’re trapped in a speeding, out-of-control elevator that’s crashing to the
ground when a sudden drop in insulin levels kicks in. Think what it would do to a person with underlying heart
conditions.”

In a Feb. 14, 2011, article in Medscape News, the writer cites a study done by the Department of Pediatrics and
the Pediatric Integrative Medicine Program at the University of Miami, Leonard M. Miller School of Medicine in
Florida:
“The authors note that because energy drinks are categorized as nutritional supplements, they avoid the limit of
71-milligrams of caffeine per 12 fluid ounces that the U.S. Food and Drug Administration has set for soda, as well
as the safety testing and labeling that is required of pharmaceuticals. As a consequence, energy drinks can contain
as much as 75 to 400 milligrams of caffeine per container, with additional caffeine not included in the listed total
often coming from additives such as guarana, kola nut, yerba mate, and cocoa.”

The American Beverage Association, whose members produce such popular energy drinks as Rockstar, AMP and
Full Throttle, had this to say about energy drinks in a Nov. 22 news release: “There is nothing unique about the
ingredients in energy drinks, including caffeine. In fact, most mainstream energy drinks contain about half the
caffeine of a similar size cup of coffeehouse coffee. So if you are enjoying a coffee at the corner coffeehouse, you
are getting about twice as much caffeine as you would from an energy drink.”
The release also said:
    — Energy drinks and their ingredients are safe and approved by the U.S. Food and Drug Administration.
    — It’s important to keep the caffeine content of energy drinks in perspective. Most mainstream energy
         drinks contain about half the caffeine of a similar size cup of coffeehouse coffee. Energy drinks typically
         contain 60-100 milligrams of caffeine per 8-ounce serving, whereas a similar size coffeehouse coffee
         generally contains 104-192 milligrams.
    — Energy drinks are non-alcoholic beverages that are specifically marketed with an energizing effect and a
         unique combination of characterizing ingredients. While their ingredients and labeling comply fully with
         all regulatory requirements, they are not intended for young consumers.
    — Importantly, our member companies market and distribute all of their beverages responsibly. As an
         association, we have adopted a number of voluntary policies pertaining to energy drinks over the last
         several years.

Her family
Crossland said she and her family — Anais’ twin brother, Dorian, younger sister, Jade Smith and stepbrother,
Sheldon Crossland — are all still in shock. The twins are also the children of Richard Fournier of Hagerstown.
“I still wait for her to come down the stairs,” Crossland said. “We’re going to bereavement counseling. We cry a
lot. I go to the cemetery at least once a day. All of her friends have sworn off these drinks.”

“She was very sweet, thoughtful and caring. I have lost my other half,” Dorian said of his twin.

“She was the best sister in the world,” Jade added.

“She was very happy,” her grandmother, Faith Kline of Hagerstown, said. “If she had any idea that could happen
she would have never drank them.”

				
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