Finding into death of FJ L

24y · Male·Mixed drug toxicity (25C-NBOME, 4-fluoroamphetamine, LSD, MDMA, cocaine, ketamine)

A 24-year-old previously healthy male died from mixed drug toxicity after ingesting multiple substances (25C-NBOME, 4-fluoroamphetamine, LSD, MDMA, cocaine, ketamine) at a music festival. He presented to the Alfred Hospital ED with seizures, abnormal cardiac rhythm, hyperthermia, and rapidly deteriorated with serotonin syndrome features, multiorgan failure, and disseminated intravascular coagulation despite intensive ICU management. The coroner found no clinical care deficiencies but highlighted the absence of a drug checking service, which could have prevented exposure to novel psychoactive substances of unknown composition and dosage. Implementation of harm reduction services including drug checking remains critical.