Sudden death associated with intravenous injection of toad extract.
Forensic science international July 1, 2009 Chris Kostakis, Roger W Byard 56 citations
A 24-year-old man died after injecting what he believed was MDMA (ecstasy), but toxicology revealed no MDMA in his blood or the injected material. Instead, low levels of bufotenine—a toxin from toad secretions—and three bufadienolides (resibufogenin, cinobufagin, bufalin) were found in the injected substance. The presence of paracetamol, promethazine, and diclofenac matched ingredients in Chan Su, a traditional Chinese toad-venom product often adulterated with pharmaceuticals. This case highlights the risks of unknown street-drug compositions and the challenges of detecting low-level organic toxins in postmortem samples, requiring targeted screening guided by scene information.