A 22-year-old student from China who overdosed on weight loss pills collapsed midway through a song at the K-Box at Cathay Cineleisure and died in hospital shortly after.
Ms Huang Guo, who stood at 1.54m and weighed 54kg, yielding a body mass index of 22.8, had likely bought most of the prescription- only pills from the websites of a clinic and a hospital in Thailand, with no dosage instructions given. A BMI of 22.8 is considered to be healthy.
Yesterday, State Coroner Marvin Bay found her death last June to be an unfortunate misadventure.
"Ms Huang's sad demise underscores the perils of undertaking a drug-based weight-loss regime without consultation, support and supervision of a qualified medical practitioner," said the coroner. "These weight-loss regimes should be undertaken only after prior clinical assessment and a commitment to continued follow-up throughout the duration of the regime."
Ms Huang's blood had about eight times the therapeutic limit for Phentermine, a stimulant used for short-term weight loss.
The amount of Fluoxetine, an anti-depressant that is sometimes also prescribed "off label" for weight loss as its side effect is the loss of weight, was about 6½ times the drug's therapeutic limit.
A forensic pathologist certified her cause of death to be acute toxicity from the two drugs.
Said Coroner Bay: "The 'off-label' use of medications like Fluoxetine for an unsupervised and unmonitored weight-loss programme is already inherently hazardous in departing from the actual pharmaceutical intent for which these drugs were formulated.
"This risk is raised exponentially if the medications intended for such 'off label' use are illicitly procured from unregulated sources from the Internet, where police and health regulators face obvious limitations to holding cross-border suppliers accountable in the event of an adverse outcome."
Ms Huang collapsed at about 11.50pm on June 27 last year and two friends called for an ambulance. Resuscitation was done en route to hospital, where she was pronounced dead at about 2am.
A police investigator found 41 packets of medication in Ms Huang's bedroom. They contained almost 400 pills of about 10 different drugs. Some were found to be for weight loss, while others were for countering the latter's side effects.
And some were the same drugs packaged differently. For example, Fluoxetine was found in three separate packets as three differently coloured capsules.
Based on the labelling of the plastic bags and packaging information, most of the pills likely came from a clinic and a hospital in Thailand. Ms Huang received a SingPost parcel from Thailand on May 9 last year; its contents were listed as "Vitamin".