{"meta":{"exportedAt":"2026-10-16T07:24:06.032Z","formatVersion":2,"selection":{"q":"paranoia","system":"","harm":"","context":"","country":"","role":"","relation":"core","evidence":"","year":"unknown","response":"","severity":"","verification":"","view":"incidents","sort":"added"},"totalIncidents":1,"coverage":{"cases":1,"countries":0,"languages":1,"unknownLocation":1,"locationPending":0,"unknownLanguage":0,"unknownDate":1,"lawsuits":0,"regulatory":0,"minors":0,"coreRelations":1,"contextualRelations":0,"mixedRelations":0,"unknownRelations":0,"relationPending":0,"relationUnknown":0},"countingNote":"Distinct public cases in this selection. People counts apply within individual cases only; cross-case person overlap has not been resolved. No population incidence estimate.","affectedCountNote":"Interpret person counts with affectedCountStatus and the reported effects. Unquantified zeros are placeholders, not a measured zero.","source":"AI incidents","publisher":"NOPE","url":"https://nope.net/incidents","license":"CC BY 4.0"},"incidents":[{"id":"2025-bromism-chatgpt-poisoning","caseFacts":{"claims":[{"id":"c1","status":"documented","evidence":[{"locator":"'A 60-year-old man with no past psychiatric or medical history presented to the emergency department expressing concern that his neighbor was poisoning him.'; 'In the first 24 hours of admission, he expressed increasing paranoia and auditory and visual hallucinations, which, after attempting to escape, resulted in an involuntary psychiatric hold for grave disability.'; 'Gradually, over the course of a 3-week admission, his chloride and anion gap normalized and psychotic symptoms improved.'; 'His bromide level ultimately was 1700 mg/L'","relation":"supports","source_id":"s1"},{"locator":"'He tried to escape the hospital within 24 hours of being admitted and, after being sectioned, was treated for psychosis.'","relation":"supports","source_id":"s2"}],"assertion":"A 60-year-old man with no past psychiatric or medical history was treated for bromism: he presented fearing his neighbour was poisoning him, developed paranoia and auditory and visual hallucinations, was placed on an involuntary psychiatric hold after trying to escape, and recovered over a three-week admission, with a serum bromide level of 1700 mg/L.","causal_attribution":"The clinical course is the treating clinicians' own record; the diagnosis of bromism rests on their workup and the measured bromide level."},{"id":"c2","status":"reported","evidence":[{"locator":"'For 3 months, he had replaced sodium chloride with sodium bromide obtained from the internet after consultation with ChatGPT, in which he had read that chloride can be swapped with bromide, though likely for other purposes, such as cleaning.'","relation":"supports","source_id":"s1"},{"locator":"'The patient told doctors that after reading about the negative effects of sodium chloride, or table salt, he consulted ChatGPT about eliminating chloride from his diet and started taking sodium bromide over a three-month period.'","relation":"supports","source_id":"s2"}],"assertion":"The patient told his clinicians that, wanting to eliminate chloride from his diet, he had for three months replaced sodium chloride with sodium bromide bought online after consulting ChatGPT, where he had read that chloride can be swapped with bromide, though likely for other purposes such as cleaning.","causal_attribution":"The patient's own account as recorded by his clinicians; the conversation itself was not available to them."},{"id":"c3","status":"reported","evidence":[{"locator":"'Based on the timeline of this case, it appears that the patient either consulted ChatGPT 3.5 or 4.0 when considering how he might remove chloride from this diet. Unfortunately, we do not have access to his ChatGPT conversation log and we will never be able to know with certainty what exactly the output he received was'","relation":"supports","source_id":"s1"},{"locator":"'They added that because they could not access the patient’s ChatGPT conversation log it was not possible to determine the advice the man had received.'","relation":"supports","source_id":"s2"}],"assertion":"The authors did not have the patient's ChatGPT conversation log and state they cannot know what output he received; they judged from the timeline that he used ChatGPT 3.5 or 4.0.","causal_attribution":"The authors' own statement of the limits of their evidence."},{"id":"c4","status":"reported","evidence":[{"locator":"'However, when we asked ChatGPT 3.5 what chloride can be replaced with, we also produced a response that included bromide. Though the reply stated that context matters, it did not provide a specific health warning, nor did it inquire about why we wanted to know'","relation":"supports","source_id":"s1"},{"locator":"'when the authors consulted ChatGPT themselves about what chloride could be replaced with, the response also included bromide, did not provide a specific health warning and did not ask why the authors were seeking such information'","relation":"supports","source_id":"s2"}],"assertion":"When the authors asked ChatGPT 3.5 what chloride can be replaced with, the reply included bromide and said context matters, but gave no specific health warning and did not ask why they wanted to know.","causal_attribution":"The authors' separate test; it does not reproduce the patient's exchange."},{"id":"c5","status":"reported","evidence":[{"locator":"'The chatbot’s guidelines also state it is not “intended for use in the diagnosis or treatment of any health condition”.'","relation":"supports","source_id":"s2"}],"assertion":"OpenAI's guidelines state that ChatGPT is not intended for use in the diagnosis or treatment of any health condition; the Guardian reports no OpenAI comment on this case.","causal_attribution":"General product terms relayed by the Guardian, not a response to this case."}],"effects":[{"label":"bromide poisoning with paranoia and hallucinations, an involuntary psychiatric hold and a three-week hospital admission","claim_id":"c1","direction":"negative"}],"sources":[{"id":"s1","url":"https://www.acpjournals.org/doi/10.7326/aimcc.2024.1260","kind":"peer_reviewed_case_report","access":"read","language":"en","translation_note":"Live URL answered HTTP 403 on 2026-10-11. Read in English from the Internet Archive capture 20250807211025 of this URL (bodies/lr-acp-wb.html): complete article (Background, Case Report, Table 1, Discussion, references, author information), published online 5 August 2025 by Eichenberger, Thielke and Van Buskirk; the treating clinicians' own report of the case.","independence_group":"acp-case-report"},{"id":"s2","url":"https://www.theguardian.com/technology/2025/aug/12/us-man-bromism-salt-diet-chatgpt-openai-health-information","kind":"news_report","access":"read","language":"en","translation_note":"Read in English on 2026-10-11 (live page, HTTP 200). A relay of the case report with no independent contact with the patient or clinicians, so it shares the case report's group; it adds OpenAI's general product statements, which do not address this case.","independence_group":"acp-case-report"}],"version":1,"ai_roles":["own_use"],"contexts":["health","everyday_life"],"unknowns":["What ChatGPT actually told the patient: his prompts, the replies, any warnings and the number of exchanges are unknown because the clinicians had no conversation log.","When the substitution and the hospital admission took place; the report gives a three-month period of ingestion and a three-week admission but no dates.","Where the patient lives and was treated; the report names no hospital or place.","Whether other sources, such as the bought product's labelling, contributed to the decision."],"geography":{"basis":"The complete case report names no city, hospital, region or country: the patient 'presented to the emergency department' and the authors refer to 'Our institution's laboratory' and 'the Poison Control Department' without naming them. University of Washington, Seattle appears only as the authors' affiliation, which is not used as an event or residence location. The Guardian calls the publication 'A US medical journal', which locates the journal and not the patient. No proceeding is reported. Carried forward from the 2026-09-19 metadata review and re-verified in the archived article on 2026-10-11.","court_countries":[],"event_countries":[],"affected_person_countries":[]},"publication":{"basis":"Published as a core case (communicated_with). The treating clinicians' peer-reviewed case report documents the bromide poisoning, psychosis and three-week admission and records the patient's account that he made the substitution after reading in a ChatGPT consultation that chloride can be swapped with bromide. The chatbot's output to him is known only through that account, so AI involvement is reported and causation alleged. The Guardian relays the same report and is not an independent account.","reviewed_on":"2026-10-11"},"ai_involvement":{"basis":"The treating clinicians' case report records the patient's own account that he replaced table salt with sodium bromide for three months 'after consultation with ChatGPT, in which he had read that chloride can be swapped with bromide, though likely for other purposes, such as cleaning'. That exchange is what connects the chatbot to the substitution, and the substitution to the bromide poisoning the clinicians diagnosed. The authors did not have his conversation log and write that they 'will never be able to know with certainty' what output he received. Their own later query to ChatGPT 3.5 about replacing chloride also produced a reply that named bromide without a specific health warning; that test is not the patient's exchange.","status":"reported"},"person_relations":["communicated_with"]},"name":"Case report: man hospitalised three weeks with bromide poisoning told doctors he swapped table salt for sodium bromide after consulting ChatGPT","summary":"A peer-reviewed case report by University of Washington clinicians (Annals of Internal Medicine: Clinical Cases, published online 5 August 2025) describes a 60-year-old man with no psychiatric history who presented fearing his neighbour was poisoning him and was found to have bromism, with a serum bromide level of 1700 mg/L. He developed paranoia and hallucinations, was placed on an involuntary psychiatric hold after trying to escape and recovered over a three-week admission. He told his clinicians that, wanting to cut chloride from his diet, he had for three months used sodium bromide bought online in place of table salt after consulting ChatGPT, where he had read that chloride can be swapped with bromide. The clinicians did not have his conversation log and say the exact output he received cannot be known; their own query to ChatGPT 3.5 produced a reply naming bromide without a specific health warning. No place or date is given.","incidentKind":"single_event","incidentDatePrecision":"unknown","exposurePattern":"unknown","reportedDate":"2025-08-05","aiSystem":"ChatGPT","aiProduct":"ChatGPT","aiCompany":"OpenAI","severity":"high","verificationStatus":"credible","harmCategories":["method_provision"],"harmOutcomes":["medical_deterioration","hospitalization","psychiatric_deterioration"],"harmOutcomeSummary":"One man was poisoned with bromide, developed paranoia and hallucinations, was held involuntarily and spent three weeks in hospital; he attributed the salt substitution to what he read in a ChatGPT consultation, which his clinicians could not inspect.","frameworkFacets":[],"pathwayDirection":"inward","causationStatus":"alleged","participantUsersAffectedMin":1,"otherPeopleHarmedMin":0,"affectedCountStatus":"exact","affectedCountEvidence":"The case report describes one patient.","victimAgeRange":"adult","platformType":"assistant","outcomeType":"media_coverage","outcomeStatus":"resolved","primarySourceUrl":"https://www.acpjournals.org/doi/10.7326/aimcc.2024.1260","primarySourceLabel":"Annals of Internal Medicine: Clinical Cases (Eichenberger, Thielke, Van Buskirk), 5 August 2025: A Case of Bromism Influenced by Use of Artificial Intelligence","firstPublishedAt":"2026-01-12T00:34:09.409015+00:00","updatedAt":"2026-10-11T07:53:07.295887+00:00","scopeVersion":"facts-v3","tags":["chatgpt","openai","bromide","poisoning","hospitalization","case-report","health-advice","psychosis"]}]}