Richard Barraclough QC was instructed to prosecute as a homicide, regulatory and food law specialist.
Author: Richard Barraclough QC
2.4 DINITROPHENOL (‘DNP’) AND THE DEATH OF ELOISE PARRY
R v KENNEDY (no 2) EXPLAINED
PROSECUTIONS FOR MANSLAUGHTER OF THOSE ENGAGED IN THE SUPPLY OF DRUGS AND LEGAL HIGHS
The case of REBELO concerned a business run by the Defendant (D) which sold the highly toxic chemical DNP as a food supplement which promoted weight loss. On 4th April 2015, a 21 year old woman, called Eloise Aimee Parry (EP) purchased 250mg DNP tablets from him through the internet. She subsequently died on 12th April 2015 as a result of having taken them. She died of DNP toxicity. That was the verdict of HM Coroner and the finding of the jury. D was prosecuted by the Harrow Council within whose area D’s centre of distribution was located. RICHARD BARRACLOUGH QC and GORDON MENZIES were instructed to prosecute as homicide, regulatory and food law specialists.
The defendant was convicted of selling unsafe food and manslaughter and sentenced to 7 years imprisonment.
This case may impact on the reluctance to prosecute for manslaughter of those who supply drugs and so called legal highs to young or vulnerable individuals who then die.
2.4 DINITROPHENOL (‘DNP’)
2.4 Dinitrophenol (‘DNP’) is a synthetic benzene related chemical. It was originally used in the manufacturing of dyes, wood preservatives, photographic developers, explosives and insecticides. However, it has also been consumed as a ‘fat burning’ and weight reducing drug. This is because the chemical blocks the normal processes by which energy is stored in the body which, in turn, causes energy to be released as heat. The result is that body temperature, metabolic rate, glycolysis (breakdown of glycogen energy stores) and lipolysis (breakdown of fat energy stores) all increase. As Professor Simon Thomas Professor of Clinical Pharmacology and Therapeutics at Newcastle University said:
‘The drug works by preventing the cells in the body from making ATP. This is the chemical which stores energy in the cell. You need this for certain chemical reactions. You cannot make fat. You cannot do anything with the energy so it is released as heat. The heat is damaging. But also the lack of energy is also damaging as the body cannot do anything else’.
The uncontrolled release of heat can result in high fever, and in some cases, multi-organ failure and death. Toxic effects arising from the use of DNP include: initial agitation, flushing, hyperthermia, sweating, abdominal pain, nausea, vomiting and diarrhoea progressing to worsening hyperthermia (high fever), rapid breathing and heart rate, dehydration, thirst, muscle rigidity and breakdown (rhabdomyolysis), acidosis and other chemical disturbances of the blood (for example high potassium or blood glucose). Kidney failure, liver failure, myocardial ischaemia or infarction, circulatory shock, coma, convulsions or cardiac arrest can occur in more severe cases.
The data available in relation to the effects of DNP are limited although experience indicates that DNP can cause fatalities after use of very modest doses. Most fatalities in the UK have occurred in the context of an acute overdose, although there have also been cases of death reported apparently arising from regular use. Studies quoted by Professor Thomas, identify that the doses involved in fatal acute ingestions were reported as 2.8g to 5g. The lowest weight adjusted dose reported in association with a fatality was stated to be 4.3mg/kg. Although there have been no specific studies which address the differential toxicology of DNP according to patient characteristics, Professor Thomas suggests that it is reasonable to assume that the risk of toxicity with DNP will be related to weight. The Head of Toxicology at the Food Standards Agency stated that case reports indicate lethality from doses of 3-50mg/kg bw/day. For example, for a 60kg/9.5 stone person 3mg/kg bw/day would be 180mg. A single capsule of 250mg of DNP could therefore provide the minimum lethal dose
Professor Thomas says:
“DNP is a chemical which can produce severe and potentially fatal toxic effects when consumed by humans. Risk is highest with larger doses, for example after acute overdose, but serious effects and deaths have occurred after use of doses recommended on websites.
DNP has not undergone appropriate development as would be appropriate for a pharmaceutical/medicinal drug. As a result of this lack of research no ‘safe’ dose has been established and there is no reliable evidence available on which to base dosing recommendations. Any human use of DNP may therefore be regarded as hazardous.”
In his evidence to the Court he described DNP as a frightening chemical because its effects were so unpredictable. Consuming DNP has been likened to playing Russian roulette. As Professor Thomas reported, ‘Between 15% and 17% of those that referred (including those asymptomatic) will die. That is an enormous mortality. I cannot think of another poison which causes that amount’.
Prior to 2012, this type of poisoning was very rare. Thereafter there has been an increase in the number of reported cases which suggests a rise in the use of DNP. The available statistics show that of the 87 reported cases of DNP poisoning between the years 2007 and 2017, 12 resulted in death. There were 6 deaths in 2015 alone.
Sharing of the available data collected by the National Poisons Information Service with Public Health England (‘PHE’) and the Food Standards Agency (FSA) resulted in warnings being published in November 2012, August 2013 and October 2013. The FSA, police and local authorities have also acted to restrict the illegal sale of DNP, focusing on internet sales. Educational work was also carried out, targeting places where DNP might be sold, such as gyms. Warnings were also provided to health professionals by PHE and Chief Medical Officers.
On 17/6/2003 the FSA issued “urgent advice on consumption of “fat burner” capsules containing DNP” in the following terms:
“The Food Standards Agency is issuing urgent advice to the public…following the identification of a serious problem with “fat burner” capsules containing DNP. This industrial chemical is known to have serious short term and long term effects on human health when eaten.
Independent toxicological experts advise that these capsules are extremely dangerous to human health.
Taking as few as three or four of these capsules (1000 mg of DNP) in one dose could result in death.
Smaller amounts (less than one capsule a day) taken over longer periods of time are known to have caused serious human health effects such as cataracts
The Food Standards Agency is therefore advising consumers not to take any product containing DNP at any level”.
By 1/11/2012 the advice had developed and the FSA issued a “warning about “fat burner” substances containing DNP” in the following terms:
“Urgent advice has been issued by the Food Standards Agency to the public…following the deaths of two people believed to have taken a “fat burner” substance in tablet or powder form.
The substance contains DNP, an industrial chemical known to have serious short term and long term effects which can be extremely dangerous to human health.
The Food Standards Agency is therefore advising consumers not to take any product containing DNP at any level. This chemical is not suitable for human consumption…Depending on the amount consumed signs of acute poisoning could include nausea, vomiting, restlessness, flushed skin, sweating, dizziness, headaches, rapid respiration and irregular heartbeat, possibly leading to coma and death. Consuming lower amounts over longer periods over longer periods could lead to cataracts and skin lesions and effects on the heart and nervous system. Anyone who believes they may have taken DNP should seek medical advice immediately.”
The 2015 report of the National Poisons Information Service reported:
“DNP is an industrial chemical with a legitimate use in biomedical research and in the manufacture of other chemicals. Although not licenced as a medicine, DNP is sometimes taken orally by body builders to promote “fat burning” and may also be used more generally as a weight reducing agent. This is of great concern because DNP is highly toxic, causing fever which can be severe and lead to multi organ failure and death in spite of optimum medical treatment. Because of its severe toxicity the NPIS has been monitoring enquiries relating to DNP in recent years. Steep increases in the numbers of ….enquiries and TOXBASE accesses in 2012 and 2013 were reported in our annual report for 2012/13. These prompted warnings to the public from the FSA and actions by the Police and local authorities to restrict the illegal sales of DNP…..The FSA’s national Food Crime Unit also launched an operation during 2015 to tackle online sales of DNP and close several websites….The situation needs to be kept under close review because of the severity of toxicity associated with DNP. Of 77 cases discussed in telephone enquiries with NPIS since 2008 11 (14% 7 male 4 female) are known to have died including six reported to NPIS during 2015.”
On 29/4/2015 Interpol issued an Orange Notice in respect of DNP describing DNP as:
“a dangerous and well known substance which is also used as a base material in the composition of certain explosives. This product was used in the 1930s to stimulate metabolism and induce weight loss but was quickly withdrawn because of its severe side effects and specifically its high risk of mortality which resulted in the deaths of numerous patients. In the 1980s medical teams attempted to reintroduce DNP as a nutritional supplement. However it was once again withdrawn following the death of a patient and the doctor responsible was convicted. Over the past several years and even very recently DNP has resurfaced on the black market. The product’s toxicity and the significant risk of mortality associated with its consumption remain a cause for concern for pharmaceutical and medical specialists. Not only is consuming the product dangerous in itself but combining it with other performance enhancing drugs…multiplies the risks for the consumer. Besides being inherently dangerous the risks of consuming DNP are compounded by the fact that DNP is usually produced in clandestine laboratories in questionable sanitary conditions. Manufacturers not only have a poor grasp of the preparation process but they also expose consumers to risks of potential overdose…In the present case the DNP had been ordered from the website “drpharmaceuticals.com”…The following was printed on the box: “Health and Beauty Turmeric capsules Extra Strength 125 mg each capsule. Contains 125 mg of Turmeric Powder”.