Coronial
WAhospital

Inquest into the Death of Steven John COLLOFF

Deceased

Steven John COLLOFF

Demographics

47y, male

Date of death

2015-11-22

Finding date

2018-03-22

Cause of death

Organ failure following use of synthetic cannabinoids and consequent hyperthermia

AI-generated summary

A 47-year-old man died from organ failure following synthetic cannabinoid use and consequent heat stroke. After smoking synthetic cannabinoids (AB-CHMINACA and 5F-AMB), he became confused and dehydrated in a hot environment, developed uncontrollable seizures, and severe hyperthermia (42.2°C). Despite aggressive ICU management including mechanical ventilation, he developed disseminated intravascular coagulation and multi-organ failure. Clinical lessons: synthetic cannabinoids are extremely dangerous and unpredictable substances with potency far exceeding natural cannabis; they commonly cause severe seizures, cardiovascular effects, and fatal heat stroke; medical staff appropriately recognised the presentation and provided maximal supportive care, but by hospital admission irreversible organ damage had already occurred. Prevention required public awareness that synthetic cannabinoids are not safe alternatives to cannabis.

AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.

Specialties

toxicologyintensive careemergency medicinepsychiatrypharmacology

Drugs involved

ab-chminaca5f-ambsynthetic cannabinoidsmidazolamrisperidonecitalopramrivaroxabanmetoprolol

Clinical conditions

heat strokehyperthermiastatus epilepticusseizuresrhabdomyolysisdisseminated intravascular coagulationmulti-organ failureacute kidney injuryelectrolyte disturbancemetabolic acidosiscardiac arrhythmiatachycardiahypertensionbipolar disorderagoraphobiaanxiety and depressionchronic obstructive pulmonary diseaseemphysemahepatitis Cdeep vein thrombosisdehydration

Procedures

intubationmechanical ventilationintravenous fluid administration

Contributing factors

  • synthetic cannabinoid intoxication (AB-CHMINACA and 5F-AMB)
  • dehydration in hot environment
  • uncontrollable seizure activity
  • severe hyperthermia (heat stroke)
  • disseminated intravascular coagulation
  • rhabdomyolysis
  • underlying bipolar disorder and mental health vulnerability
  • chronic obstructive pulmonary disease and emphysema
  • difficulty sourcing natural cannabis leading to substitution with synthetic cannabinoid

Coroner's recommendations

  1. Public awareness campaigns regarding the dangers of synthetic cannabinoids and that they are not safe alternatives to natural cannabis
  2. Education that synthetic cannabinoids are unregulated, untested, and potentially lethal substances with increasing potency and toxicity
  3. Continued advancement of detection and quantification methods for synthetic cannabinoids at ChemCentre WA
  4. Recognition that synthetic cannabinoids have become more diverse in chemical composition despite regulatory efforts
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