Evidence map›Paper›PMID 41557087›Full record

ReviewForensic science, medicine, and pathology2026

4F-MDMB-BICA toxicity: a fatal case and literature review of synthetic cannabinoid fatalities.

Ingo von Both, Glen K Shoemaker, Craig N Chatterton

Abstract readCase ReportsReview
PubMed Publisher
In one paragraph

Review in Forensic science, medicine, and pathology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Ingo von BothOffice of the Chief Medical Examiner, 7007, 116 Street NW, AB, Edmonton, T6H 5R8, Canada. ingo.vonboth@gmail.com.
Glen K ShoemakerOffice of the Chief Medical Examiner, 7007, 116 Street NW, AB, Edmonton, T6H 5R8, Canada.
Craig N ChattertonOffice of the Chief Medical Examiner, 7007, 116 Street NW, AB, Edmonton, T6H 5R8, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We report the death of a 32-year-old woman with a history of tobacco smoking who was found dead in her car after being investigated 18-days prior in hospital following a road traffic accident. Postmortem examination showed no evidence of recent injury. The most significant finding on internal examination was severe single-vessel coronary atherosclerosis. The remainder of the autopsy showed smoking-associated lung changes. Toxicologic studies were negative for common medications, usual street drugs and alcohols, but specialized analytical testing, developed in-house, identified the indazole-based fluorinated synthetic cannabinoid (SC) 4F-MDMB-BICA and its butanoic acid metabolite in blood, vitreous fluid and urine. An unlabeled package of a herbal smoking mixture, located in the personal belongings of the deceased, was found to contain 4F-MDMB-BICA. The potency of 4F-MDMB-BICA is reported to be much higher (up to several 100-fold) than marijuana. Reported fatalities related to SCs suggest that their effects are unpredictable and, due to the limited studies available, no clear threshold for a lethal dose has yet been determined. Adverse central nervous system effects documented for 4F-MDMB-BICA include auditory and visual hallucinations, paranoia, agitation, confusion, and insomnia. Euphoria, irregular heartbeat, chest pain and myocardial infarction in teenagers have also been described. SCs pose a substantial risk for cardiac toxicity, with mechanisms involving CB

Indexed as

CannabinoidsDesigner DrugsIndazolesAdultFatal OutcomeFemaleForensic ToxicologyHumansCannabinoidsDesigner DrugsIndazoles4F-MDMB-BICACannabisCardiovascular toxicityDrug abuseForensic diagnostic algorithmMarijuanaSpiceSynthetic cannabinoid

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.