The first reported death from accidental ingestion of a concentrated nicotine product was just reported.

These products can be extremely concentrated, up to 36mg of nicotine per ml. The fatal dose has been reported as low as 0.5 mg/kg, although it usually requires larger doses to be fatal.

Initial symptoms are going to be non-specific and include fatigue, malaise, nausea and vomiting. This progresses  to hypertension and tachycardia. Fasciculations may be present. Later signs of severe intoxication are bradycardia, hypotension, paralysis (including respiratory muscles) and seizures.

Treatment is going to be supportive. With seizure control and respiratory management being paramount. Vasopressors and chronotropes may have limited benefit, so please contact the Tox group as early as possible for a sick patient. 55711 or 800 222 1222