ReviewForensic science, medicine, and pathology2026
4F-MDMB-BICA toxicity: a fatal case and literature review of synthetic cannabinoid fatalities.
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.
What it found
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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.
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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.
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Authors and funding
3 authors.
Funding
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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
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Registered trials
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 OpenQuestion graph.