A medical case report documents the time a man drank a big bottle of NOS Octane Booster, believing it to be an energy drink.
The 54-year-old man showed up at the emergency department in Washington, Seattle, after experiencing seizures and a state of agitation. Usually the onset of seizures would require a bit of investigation, but in this case there was an obvious cause for the new medical symptom: a bottle of NOS Octane Booster Racing Formula.
"His girlfriend brought the empty bottle and reported that he drank the product believing it to be an energy drink," the team explained in their report.
As well as being a damning indictment on the flavor of energy drinks that he didn't notice his mistake until the seizures kicked in, the man was in need of medical attention. The "drink", more traditionally used by racing cars and farming vehicles for its antiknock properties, contains methylcyclopentadienyl manganese tricarbonyl (MMT), which has been shown to cause pulmonary toxicity, seizures, and renal and hepatic toxicity in animal studies.
Before this case, there had not been reports of human ingestion of MMT.
"Manganese can cause irreversible Parkinsonian symptoms due to oxidative damage in the mitochondria of the basal ganglia. Significantly less is known about acute manganese toxicity, but no seizures or neurotoxicity were associated with either of the two reported cases of acute manganese poisoning in humans," the team explained. "MMT itself or its metabolites have been postulated as the cause of neurotoxicity in animal studies."
Far from giving him the extra horsepower promised by the packaging, the man continued to have seizures and was sedated and intubated. After four days, and a few more seizures, he was extubated once more.
"Our case highlights the importance of responsible labeling of consumables. Household products are a common source of unintentional poisoning, primarily in children. Our case demonstrates packaging similarities between toxic and non-toxic products or between food and non-food items can cause confusion," the team wrote in the study.
Though the case took place in 2020, the drink that the man ingested was similar in appearance to a bottle made by NOS in 2015. The NOS booster bottle does look similar to the energy drink NOS as it was in 2015, as they share the same branding.
"NOS was [...] the first automotive performance product to have a consumable food product to use its name and logo - NOS Energy Drink," parent company Holley Performance Products explains on their website.
The case was reported to the Food and Drug Administration's MedWatch program. Fortunately, after a day of confusion and dizziness, the man was able to go home and did not suffer any medical complications, other than (presumably) a bit more wariness of drinks that look like motor oil.
The case was published in the American Journal of Emergency Medicine.