Source · Prevention of Future Deaths

Valdotas Gerbutavicius

Ref: 2020-0184 Date: 25 Sep 2020 Coroner: Nadia Persaud Area: East London Responses identified: 0 / 1 View PDF

Inadequate legislation and a lack of internet sales prohibitions allow dangerous DNP 'diet pills' to remain readily available online, leading to numerous deaths among vulnerable people.

Date 25 Sep 2020
56-day deadline 20 Nov 2020
Responses identified 0 of 1
Other related deaths

Coroner's concerns

AI summary
Inadequate legislation and a lack of internet sales prohibitions allow dangerous DNP 'diet pills' to remain readily available online, leading to numerous deaths among vulnerable people.
View full coroner's concerns
1. Evidence was heard during the course of the Inquest that from 2007, to date, there have been at least 32 deaths from DNP toxicity. Many of those affected are young and vulnerable individuals.
2. In the UK, the lead organisation tasked with the disruption of the supply of 2, 4-dinitrophenol, for human consumption is the Food Standards Agency. The Inquest received information from the Deputy Head of the National Food Crime Unit (part of the Food Standards Agency). He confirmed that "the views of the FSA Chief Executive and FSA Chair individually, is the current legislation is wholly inadequate and in no way an appropriate means by which to deal with offences that can result in the deaths of those who consume it (DNP) and these individuals are often young and vulnerable people".
3. Evidence was given at the Inquest that DNP is still readily available over the internet, as diet pills.
4. Prohibitions are in place on search engine algorithms used to prevent delivery of search results for TNT. 2, 4 ­ dinitrophenol is also used as an explosive, but there are no such internet protections in place to prohibit its sale.

Report sections

Investigation and inquest
On the 31st January 2019 I commenced an investigation into the death of Vaidotas Gerbutavicius. The investigation concluded at the end of the Inquest on the 22nd September 2020. The conclusion of the Inquest was a narrative conclusion: From 2016 to 2018 Vaidotas Gerbutavicius purchased slimming pills containing 2,4 dinitrophenol. It is unlawful to sell 2,4 dinitrophenol for human consumption, as it is an extremely harmful substance, but Vaidotas was able to purchase these pills over the internet. On the 10 March 2018, Vaidotas ingested a large amount ofpills containing 2,4 dinitrophenol. He ingested these whilst under the influence of alcohol. His actions appear to be impulsive and he had the lethal compound immediately available to him. He was taken to hospital where supportive measures were taken. There is no antidote available. Sadly, he could not be saved and he passed away from 2,4 dinitrophenol consumption.
Circumstances of the death
Vaidotas Gerbutavicius was 21 years old when he passed away on the 10 March 2018. Vaidotas had never taken any action to deliberately harm himself prior to the 10 March 2018. From the age of 18, he was able to access slimming pills on the internet containing the lethal compound 2, 4 ­ dinitrophenol. He obtained these pills from a variety of internet suppliers.

On the 10th March 2018, following a row with his girlfriend and having drunk half a bottle of vodka and half a bottle of rum, Vaidotas ingested a number of pills containing 2, 4 ­ dinitrophenol. He called his father and his girlfriend promptly after this ingestion. Emergency medical assistance was then sought. Paramedics attended and took Vaidotas to Whipps Cross Hospital. Supportive measures were put in place, in accordance with the Toxbase Guidelines. There is no antidote to DNP poisoning. Sadly, Vaidotas suffered an asystolic cardiac arrest and passed away in Whipps Cross Hospital at 13:32 hours on the 10th March 2018.
Copies sent to
involved in the Inquest. I will also provide a copy of this report to the local Director of Public Health

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Report details

Reference
2020-0184
Date of report
25 September 2020
Coroner
Nadia Persaud
Coroner area
East London

Responses identified

Responses identified 0 of 1
1 response not yet linked

Organisations named in PFD reports are normally expected to respond within 56 days. Deadline: 20 Nov 2020.

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