According to news reports1,2 and one journal article3, one Danish man was hospitalized and another was killed by toxic effects of bromo-dragonfly in September, 2007. Pers Ståhl, 35, suffered convulsions, liver and kidney failure, and lost several fingers and toes, while his unnamed friend died within hours of taking the substance.

The two men reportedly ordered bromo-dragonfly from an internet vendor and took an unknown amount one evening. One of the men had previously taken bromo-dragonfly, while the other had not.

The two were found the next morning by Ståhl's brother. Ståhl was deeply disoriented and could not use his legs, and his friend was dead.

Ståhl was taken to the hospital, where he was awake but disoriented. He had no memory of the night before, and suffered from low blood pressure, pronounced chills, and poor blood oxygenation. His condition deteriorated and he experienced convulsions and difficulty breathing. He was administered 5 mg diazepam (IV) and norepinephrine (IV). He sufferred from respiratory and metabolic acidosis, which were successfully treated with assisted respiration and fluid replacement.

A urine sample taken on admission was later found to contain traces of bromo-dragonfly. Ståhl could not say how much they had taken. Erowid has received an unconfirmed report that they may have measured the dose by licking a fingertip and dipping it into a bag of bromo-dragonfly powder. If this is correct, this would probably deliver a dose many times greater than the threshold of activity, which is reported to be less than one milligram. (see Bromo-Dragonfly Dosage)

Ståhl showed severely inhibited circulation, and on the second day he began to show discoloration of the extremities and the nose.

Over the next few days he developed acute liver failure and renal failure. His liver failure was short-lived, and his kidneys responded favorably to treatment over the next three weeks.

Ståhl was administered nitroglycerin infusions, calcium inhibitors, ACE inhibitors, and prostacyclin analogues to dilate blood vessels. None of these treatments had any visible effect.

On his ninth day in the hospital, gangrene was detected in one foot.

Seven weeks after his admittence, the fingers of Ståhl's left hand and several toes had to be amputated.

Ståhl has been released from the hospital and appears to be back in good health.

It is believed that the circulator problems Ståhl experienced were caused by bromo-dragonfly's vasoconstrictive properties. That is, bromo-dragonfly can cause blood vessels in the extremeties to constrict, reducing blood flow to the limbs.

Bromo-dragonly's vasocontrctive effects are believed to be caused by prolonged stimulation of Alpha-1 adregenic receptors in the limbs. Activation of local serotonin receptors in blood vessels can also result in vasocontriction, and bromo-dragonfly is known to be a serotonin agonist.

Bromo-dragonfly's pharmacology has not been well-studied, and its effects are in part extrapolated from research on long-lasting phenethylamine hallucinogens such as DOB4.

This case is particularly troubling, owing to the possibility that the men consumed a relatively small dose of bromo-dragonfly. If they did in fact measure a bromo-dragonfly dose by licking a finger and putting it in a bag of powder, this could have produced a dose on the order of 5-10 mg, roughly ten to twenty times the minimum effective dose of bromo-dragonfly. This is probably larger than what most informed persons would intentionally take for a recreational dose, but not vastly larger - particularly for a material that is active in very small amounts (less than a single milligram). Such small quantities of material can be difficult to accurately measure.