The average vape consumer buys their eliquid from a professional vendor. Most vendors get their liquids from manufacturers, or are manufacturers themselves. But a fair amount of vapers choose to do it themselves; mixing base, flavoring, and nicotine at home. This trend has grown increasingly popular in Europe, where EU regulations limit the bottle sizes and nicotine strengths sold in stores. Most of the time things go fine. But in this case things got deadly.
The 42-year old man was not named in this case study published by the Dutch Journal of Medicine. He suffered cardiac arrest after apparently drinking only a few milliliters of home-mixed eliquid. The nicotine strength of which was rated at 450 mg/ml. That's more than ten times the concentration of even some of the highest concentrations available in stores. The average vaper uses between 3mg and 18mg strength. European laws limit the maximum available in stores to 20mg/ml in a maximum size of 10ml bottles.
It is unclear whether the man, who suffered from bipolar disorder, drank the liquid accidentally or on purpose. Authorities say he was rushed by ambulance to the hospital after his heart stopped. He received cardiac massage and a shot of adrenaline.
When he reached intensive care, the level of nicotine in his blood was 3 mg per liter. That's more than 60 times greater than a normal nicotine user according to the paper, which states typical blood-nicotine level for a smoker is 0.01-0.05 mg / L. Doctors and staff were able to successfully revive him for a few days until he eventually succumbed to what is known as post-enoxic encephalopathy, or neurological damage caused by the brain being deprived of oxygen during the nicotine-induced cardiac arrest.
According to Prof. Bernd Mayer of the University of Graz (Austria), a fatal dose for an adult is likely 0.5 g (500 mg) or more of ingested nicotine.
DIY liquid has existed since people first figured out the basic ingredients in eLiquid. Most DIY mixers never deal with a nic concentration above 100mg/ml. how the man came into possession of 450mg/ml concentration is unclear; but what we do know is that home-mixed bottles and flavors carry an increased risk when mixed by non-professionals. The risk is even higher if they lack the proper tolls and training to mix accurately.
Such a story certainly gives pause and thought to the effects of over-regulated markets and caps on bottle sizes and strengths. Considering most of the ingredients are widely available, it is reasonable to assume that more vapers will go the DIY route if restrictions on size, strength and flavoring options continue to expand.