A South Carolina teen with no history of heart trouble drank three highly caffeinated beverages within two hours, then collapsed at school in April from what the county coroner called a "caffeine-induced cardiac event."
Davis Allen Cripe, of Chapin, South Carolina, was dead within three hours of consuming a Diet Mountain Dew, an energy drink and a latte. He was 16.
The teen's grieving father is urging parents to talk to their children about the danger of energy drinks, although health officials stress that it was not one drink, but the caffeine overload of consuming three within two hours, that caused Cripe's heart to stop, according to TheState.com. And the same combination of drinks in the same time frame would not be fatal for everyone.
“You can have five people line up right here and all of them do the exact same thing that happened with him that day — drink more — and it may not have any kind of effect on them at all,” Richland County Coroner Gary Watts said at a Monday news conference where autopsy results were released.
So what are the risks of caffeine and how does it affect the heart? And are energy drinks uniquely dangerously for children? Here's what parents should know.
The effects of caffeine
The president of the South Carolina Coroners Association said in USA Today that this is the first caffeine-related death he's seen in the state.
Elsewhere, however, other deaths have been blamed on the effects of caffeine. An Ohio athlete and prom king died in 2014 after ingesting powdered caffeine, and families of several young people who have died after drinking energy drinks have blamed the products, which are often marketed as a way to improve athletic performance. The motto of one, Red Bull, is "Red Bull Gives You Wings."
The Richland County coroner's office said Cripe likely died from arrhythmia, or an erratic heart rate, brought on by excessive caffeine consumed in a short period of time. Arrhythmia can involve either an abnormally fast or slow heart rate, and it affects the heart's ability to pump blood throughout the body, according to the Cleveland Clinic.
Symptoms include a racing or fluttering sensation in the heart, and feeling dizzy or lightheaded. Before he collapsed, Cripe told classmates he felt lightheaded, The Washington Post reported.
Yet nearly three-quarters of American youth consume caffeine, most without significant health consequences, and more than 80 percent of Americans consume caffeine every day, according to the Food and Drug Administration.
The substance occurs naturally in coffee beans, tea leaves and cacao pods, and is synthesized in labs. It's sometimes called the world's most common drug, and regularly consuming as little as two cups of coffee (or three cans of soda) a day is enough to get you so hooked that stopping the habit can cause withdrawal symptoms, Murray Carpenter, author of "Caffeinated" said in Men's Journal.
In small amounts, caffeine makes us feel good, but "it is a drug whose strength is consistently underestimated," Carpenter says.
"A quarter teaspoon will lead to bodily unpleasantness — racing heart, sweating and acute anxiety. A tablespoon will kill you," he wrote in "Caffeinated."
That's far more than the maximum safe level given by most health officials: 400 milligrams a day, roughly the amount in 4 cups of brewed coffee, 10 cans of cola or two energy drinks, the Mayo Clinic says.
Through his friends, investigators learned that Cripes consumed a large Diet Mountain Dew, a McDonald's Cafe Latte and 16 ounces of an unspecified type of energy drink within two hours.
Because the specifics were not disclosed, it's not possible to calculate how much caffeine the teen took in before he collapsed in his art class. But according to the Center for Science in the Public Interest, a 20-ounce Mountain Dew contains 91 milligrams of caffeine; and energy drinks, anywhere from 50 to 357 milligrams, depending on the size and brand.
The McDonald's website says, "We don't currently report the amount of caffeine in our coffee — but we can promise you a bright and balanced cup."
Families and energy drinks
Nationwide, sales of soda, the most typical source of caffeine for children, are declining, while energy drink sales are growing. On Tuesday, the day after Cripe's autopsy results were made public, a U.S. market-research company released a report that said sales of energy and sports drinks topped $25 billion in 2016, and that sales are especially robust in households with young children.
"Having a single child in the home is sufficient to see this bump in reported usage, and energy drink usage tends to increase with each additional child," the marketing company, Packaged Facts, said about its report. "These findings suggest that many initially seek out energy drinks as a tool to keep up with the demands of caring for young children."
Parents concerned about their children's caffeine intake might want to rethink that practice. Some studies have found that children mimic the eating and drinking behavior of their parents, and having energy drinks in the house can lead to accidental consumption.
The American Academy of Pediatrics says children and adolescents shouldn't consume energy or sports drinks at all and instead should be drinking water.
Of more than 5,000 cases involving energy drinks that were reported to U.S. poison control centers between 2010 and 2013, nearly half the children did not know what they were drinking, according to research presented to the American Heart Association in 2014. In many cases, children 6 and younger consumed a drink they found in the refrigerator, or one left lying around the house by a parent or older sibling.
The drinks are considered nutritional supplements and thus are not regulated by the Food and Drug Administration. But the FDA does invite consumers to file reports of adverse reactions, and it investigates these reports and sometimes takes action against manufacturers. For more than a year, the agency has been reviewing safe levels of caffeine and whether manufacturers should be required to disclose how much is in their products.
"Existing rules never anticipated the current proliferation of caffeinated products," said former FDA official Michael Taylor, who left the agency last year.